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Inspection carried out on 23 May 2017

During a routine inspection

The inspection took place on 23 and 24 May 2017 and was unannounced.

The Mayfields Care Home provides residential care for up to 60 older people. Accommodation is over two floors. At the time of our inspection, 18 people were living in Primrose which was located on the ground floor. The first floor, entitled Bluebell, supports those living with dementia and 29 people were living there at the time of this inspection. The home had a number of communal areas and outside spaces.

The home did not have a registered manager in post at the time of our inspection although one had been recruited and was due to start. 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. The home was being managed by two unit managers with the support of senior management.

The service had procedures in place that minimised the risk of employing people not suitable to work with those that used the service. Staff received regular training and supervision, had their competency to perform their role regularly assessed and told us they felt supported.

There were enough staff to meet people’s needs in an individual manner and we saw that staff worked effectively as a team. The culture of the home was positive, open and transparent with a warm and friendly approach. Staff morale was good.

People told us that all staff were kind, patient and compassionate and went out of their way to provide help and support. They told us that staff were prompt at meeting their needs and we saw that staff were quick to support those who were becoming distressed or upset.

Staff were discreet when supporting people with their personal care and maintained their dignity. Their approach was a respectful one and they considered people’s level of independence. Choice was encouraged and supported.

Procedures were in place to help protect people from the risk of abuse and staff had knowledge in safeguarding people. The risks to individuals had mostly been identified, assessed and managed. The risks associated with the premises had been effectively managed and preventative measures were in place including a plan for adverse incidents. Accidents and incidents were recorded and used to mitigate future risk and occurrences.

People received their medicines as prescribed and medicines administration and management followed good practice guidance. However, although no harm came to any of those living in the service, there were discrepancies in regards to the auditing of medicines.

The CQC is required to monitor the Mental Capacity Act (MCA) 2005 Deprivation of Liberty Safeguards (DoLS) and report on what we find. Staff had received training in the MCA and had good knowledge of it. Where there was doubt over a person’s capacity to make a decision, this had been assessed and best interests decisions made as appropriate.

People had been involved in the planning of their care and they received a person centred service. Care plans were in place that gave staff guidance on how to support people. These were individual to each person, accurate and had been reviewed on a regular basis.

People’s nutritional needs were met and they had a choice in what they had to eat and drink. We saw that people had plenty of drinks available and were encouraged to ensure they had a good fluid intake. Access to a variety of healthcare professionals was in place.

The service provided a number of activities that were varied and catered for those that liked both group events and individual support. People were encouraged to take part and contribute to the planning of them.

The provider had an effective and robust system in place to assess, monitor and improve the service. This ensured a good quality service was delivered. Senior mana

Inspection carried out on 13 May 2015

During a routine inspection

This inspection took place on 13 May 2015 and was unannounced. The Mayfields Care Home is a residential care home providing personal and nursing care and support for up to 60 older people, some of whom may live with dementia. On the day of our visit 52 people were living at the service.

The home had a manager who has been in post since January 2015. The manager had submitted an application to us to become the registered manager. 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.

People felt safe living at the home and staff supported them in a way that they liked. Staff were aware of safeguarding people from abuse and they knew how to report concerns to the relevant agencies.

Individual risks to people were assessed by staff and reduced or removed. There was adequate servicing and maintenance checks to equipment and systems in the home to ensure people’s safety.

There had been an increase to the number of staff members available and there were enough staff available to meet people’s needs.

Medicines were safely stored and administered, and staff members who administered medicines had been trained to do so.

Staff members received other training, which provided them with the skills and knowledge to carry out their roles. Where they had not received training, they were given enough guidance and information to properly care for people. Staff received support from the manager, which they found helpful.

The CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) Deprivation of Liberty Safeguards (DoLS) and to report on what we find. The service was meeting the requirements of DoLS. The manager had acted on the requirements of the safeguards to ensure that people were protected.

Staff members understood the MCA and presumed people had the capacity to make decisions first. Where someone lacked capacity, best interests decisions were available. Further information was needed for some people about who else could make the decision or how to support the person to be able to make the decision.

People enjoyed their meals and were given choices about what they ate. Drinks were readily available to ensure people were hydrated. Staff members worked together with health professionals in the community to ensure suitable health provision was in place for people.

Staff were caring, kind, respectful and courteous. Staff members knew people well, what they liked and how they wanted to be treated. People’s needs were responded to well and care tasks were carried out thoroughly by staff. Care plans contained enough information to support individual people with their needs. Records that supported the care given were completed properly.

A complaints procedure was available and people were happy that they did not need to make a complaint. The manager was supportive and approachable, and people or their relatives could speak with her at any time.

The home monitored care and other records to assess the risks to people and ensure that these were reduced as much as possible.

Inspection carried out on 20 August 2013

During a routine inspection

The Mayfields Care Home opened in November 2012. At the time of our inspection there were 30 people living at the service.

We spoke with four people who used the service and two of their relatives. They told us that they were happy with the care provided. One person said, “They (the staff) are always very kind to me.” Another person said, “I am very well looked after, I can talk to the staff if I am not happy about anything.” A relative told us, “This place is absolutely brilliant.”

We found that people were involved in making decisions about their care. They were given choices regarding the planning of their care, food and daily activities. The service encouraged people’s independence.

People’s individual needs and their safety had been assessed and plans of care were in place to ensure that the care they received was delivered safely and effectively.

Staff were aware of their responsibilities regarding the reporting of abuse and which authorities any concerns identified needed to be reported to.

The provider had performed appropriate checks to ensure that the staff were of good character before they employed them.

The provider had an effective system in place to monitor the quality of the service to protect people from the risks of unsafe or inappropriate care.