The Mayfield Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

This is the first inspection for this service. This key question has been rated good. This meant people were safe and protected from avoidable harm.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Accidents and incidents were recorded. Managers reviewed records for themes and patterns to enable them to look for lessons that could be learned, or improvements that could be made. We saw prompt action was taken where needed, including referrals to health care agencies.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

Health care professionals told us communication with staff and managers was good and the staff team highlighted any concerns about people’s health promptly. They said, “If there’s something specific that we need to know about, we are told as soon as we come in the building” and “We have set days, but if there’s an issue, the staff call us, they are very responsive.”

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

Staff had received training in safeguarding people from abuse and were aware of how to raise any concerns. They were very confident any concerns raised would be dealt with appropriately.
People told us they felt safe living at the home. They said, “I feel perfectly safe here” and “Can’t fault the place. I feel safe with people looking after me.” A relative said, “I have always felt [person] is safe. I have no hesitation about [person] being safe.”

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

People were fully involved in all decisions about risk. Staff understood how to support people in a way that ensured risks were managed, whilst respecting people’s choices and individuality.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. The building, equipment and furnishings were well-maintained.

Staff showed a good understanding of health and safety, and the risks equipment and the environment could pose to people. One staff member described moving furniture to ensure there were no tripping hazards. One person said, “It’s a safe environment; comfortable and warm.”
 

Staff recruitment was safe, although some minor improvements were required to ensure a full employment history was held on record. Action was taken during the inspection; managers completed an audit of recruitment records and the recruitment checklist was updated.

The provider had systems in place to determine staffing levels. Records showed staffing levels above those identified as needed by the provider and call bells were answered in a timely manner. We observed care and support that was provided promptly, but in an unrushed way. Staff took time to talk with people and were patient. We received mixed feedback on staffing levels. Whilst some people told us there could be more staff, most people told us there were sufficient staff deployed to provide care that met people’s needs. One person said, “There’s plenty of staff around, they are all pulled in different directions but confident in their job. There’s not a big turnover of staff so I know everyone by their first name.” A relative told us, “I know when I’m not here [person] is well looked after. At times I have had my concerns about there not being enough staff; but you can never have enough staff, and staffing is never to the detriment of anybody.”

We discussed staffing with the registered manager, who said they would revisit discussions with staff, people who used the service and relatives about how staffing levels were decided and reviewed.

Staff received effective training, support, supervision and development. Staff told us the training was good and there were extra courses about people’s specific needs such as health conditions. One said, "Anything we come across, in our work, the training’s there."
 

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

The home and equipment were very clean and risks associated with infections were assessed and well managed. There were ample supplies of personal protective equipment ( PPE). Staff had received training in infection prevention and control.
 

The service did not always make sure that medicines management systems were safe.
Whilst we did not find any errors in medicines administration and people, relatives and staff raised no concerns about medicines management; we identified improvements were needed in the records, guidance and care plans for medicines.

Records were not in place for all creams applied by care staff as part of personal care. Patch application records were not always available to demonstrate rotation in line with manufacturers guidance to prevent side effects.

Some people were prescribed medicines to be taken on a ‘when required’ basis or with a variable dose. Guidance for how these medicines should be administered was not always person-centred and some was missing. There was no information when a variable dose was prescribed.

People’s preferences about how they wanted their medicines were not always clear. Care plans contained conflicting information, including one person where it was not clear if they were self-administering medicine. The medication list in the care plan did not match the MAR. Comprehensive policies and procedures were in place to support the administration of medicines.

The provider, and registered manager, took action during our inspection to review and update medicines records, care plans and auditing and governance procedures.

We observed medicine administrations were respectful, and people were given the time they needed to take their medicines. Medicines were stored securely and safely including controlled drugs.