Archived: Mayfield Nursing Home

There was a registered manager in post who was responsible for the day-to-day running of the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

We carried out this inspection on 04 and 08 January 2018. The first day of the inspection was unannounced and the second day was announced.

At the last inspection, in April 2015, the service was rated Good. At this inspection we found the service remained Good.

People felt safe living at the service. They were protected from abuse and harm because staff understood how to recognise and report safeguarding concerns. Risks to people’s safety were assessed and mitigated, this included risks associated with aspects of people’s care and the environment.

The environment was clean and hygienic and smelt pleasant throughout. Staff followed good infection prevention and control practices such as the use of personal protective equipment (PPE) to help minimise the spread of infection.

Medication was managed safely. There were safe systems in place for the receipt, storage, recording and administration of medication. People received their medication at the right times and it was administered by staff who were suitably trained and underwent regular checks on their competence.

Staff were recruited safely. The suitability of staff was assessed prior to them being offered a position. This included a check on their criminal background, previous work history, skills and qualifications. There were sufficient numbers of suitably skilled and experienced staff to meet the needs of people and keep them safe.

Staff received training and support for their role. New staff completed induction training to learn their role and they were provided with ongoing training in areas of health and safety and topics relevant to the needs of people. Staff received support through one to one supervisions, appraisals and staff meetings.

People were provided with food and drink to meet their needs and help them maintain a balanced diet. People were given a choice of food which was prepared in accordance with their likes, dislikes and dietary requirements set out in their care plans.

People’s healthcare needs were understood and met. Staff supported people to access appropriate healthcare services as and when they needed to. Staff recognised when there was a decline in a person’s health and wellbeing and took the appropriate action. This included prompt contact and referrals to other health and social care professionals.

People’s legal rights were understood and upheld. Staff demonstrated knowledge and understanding of the principles of the Mental Capacity Act (MCA) 2005 and associated deprivation of liberty safeguards (DoLS). Decisions made on behalf of people who lacked capacity were made in accordance with legal requirements. Staff knew how to ensure each person was supported as an individual in a way that did not discriminate against them.

Some items of furniture and carpets were in need of replacing due to wear and tear. The registered provider assured us that these were being replaced as part of an ongoing programme of refurbishment. The environment had some aids including signage to help orientate and stimulate people living with dementia. The registered manager and registered provider recognised that further developments were needed to improve the environment for people living with dementia and this was ongoing.

People were treated with kindness and their privacy and dignity was respected. People were given emotional support when they were anxious or upset and staff provided this in a sensitive and compassionate way. Where people were unable to tell us about their experiences we observed they were relaxed and at ease with staff. People’s behaviour and body language showed that they felt cared for by staff.

Care plans contained personalised information about people’s individual needs and how they were to be met. They included direction and guidance for staff to follow to help ensure people received their care and support they needed and in the way they wanted. Care plans were kept under review and updated with any changes as they occurred.

People were given the opportunity to able to take part in a range of group and individual activities. Profiles detailing people’s backgrounds, life history, things of importance and personal preferences were developed. These gave staff a good insight into people’s past lives and lifestyle choices enabling them to engage people in conversations and activities of interest.

The service was well led. People and relatives all described the registered manager as open, supportive and approachable. There were regular meetings for people, family members and staff so they could share their views about the running of the service. People and their families were given information about how to complain. There were effective quality assurance systems in place to make sure that any areas for improvement were identified and addressed.

We observed during the day that staff were supportive of the people living in the home. Our observations showed that improvements in support could be made particularly over the lunch time. The manager agreed to make improvements in this area and to increase staff awareness in communicating with people.

Improvements have been made since out last visit particularly in record keeping and the management of medication. Both areas showed that effective systems were in place to maintain the safety of people living in the home.

People living in the home told us, 'its lovely here,' 'the food is very nice it's beautiful' and 'we don't have any complaints. The girls are great'.

We spoke to some relatives, the comments were, 'the care plan has been completed and I have seen it,' 'it's pretty alright here,' 'I have seen different activities taking place. My relative was playing cards when I arrived' and 'She (named person) has been given the opportunity to leave, but she has made friends here, so wants to stay'.

One other relative told us that they were very happy with the care and that the standard of care was always good whenever they visited. They felt that the home had a good atmosphere and was always clean and tidy and never had any unpleasant smells.

We spoke to support workers providing additional support from outside agencies. The St Helens enablement team offering, specialist support to people to promote independence to the person receiving the support to move back into the community. Another support worker was also providing additional support to a person living in the home. Some of the comments received from these support workers were. 'It's working great, we have managed to get (named person) walking again' and 'the staff are very friendly and really helpful'.