CQC report explained · a residential care home
What the CQC found at Mayfield Hall
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from avoidable harm, with risk assessments for falls, choking, poor nutrition and pressure damage. Medicines were managed safely, although some instructions for medicines given when needed were unclear, and laundry systems needed improvement.
- Effective?
- Good
- People had regular assessments and personalised care plans. Staff had training and support, people received suitable food and healthcare, and the home followed the principles of the Mental Capacity Act.
- Caring?
- Good
- People were treated with kindness, dignity and respect. Staff encouraged independence, involved people in decisions and showed understanding of their personal and emotional needs.
- Responsive?
- Good
- Care plans recorded people's wishes and preferences, and staff knew how people liked to be supported. The home provided activities, communication aids and a complaints process.
- Well-led?
- Good
- The management team worked alongside staff and was available to support them. Audits, feedback and handovers were used to monitor care, although some quality systems needed further development.
What inspectors found, July 2019
Mayfield Hall was rated Good overall; inspectors found kind, safe and personalised care, with some improvements needed to laundry systems and medicines instructions.
The inspection was unannounced and took place on 2 July 2019. One inspector and an Expert by Experience spoke with people living in the home, relatives, the manager and staff. They observed care and checked care records, medicines, recruitment files, audits and complaints.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. The home supported 16 older people living with frailty or dementia. Inspectors found enough staff, suitable care plans, safe medicines systems, kind care and good support with food, health needs and personal choices.
There were some areas to improve. Laundry systems did not clearly separate clean and dirty laundry. Some instructions for giving medicines when needed were unclear. Some records and quality checks needed further development, and parts of the older building needed updating. The overall Good rating was maintained from the previous inspection in January 2017.
Kind and respectful care
Inspectors saw staff supporting people with patience and understanding. People's privacy, dignity and independence were respected.
“People were supported and treated with dignity and respect; and involved as partners in their care.” from the report
Personalised support
Care plans included people's preferences and daily routines. Staff could explain how individuals wanted to be supported.
“Care plans were person centred, and in line with good practice.” from the report
Good food and nutrition support
People enjoyed the food and had choices. The home monitored people's weight and acted when there were concerns about nutrition.
“People's weight and nutritional assessments were reviewed every month and swift actions were taken if people were at increased risk.” from the report
Supportive management
The management team worked alongside care staff and promoted an open culture. Staff said they felt supported and listened to.
“Staff were well motivated and positive in their role and relationships with people.” from the report
Safe medicines arrangements
People received medicines as prescribed, and storage, administration and disposal systems were safe. Staff who gave medicines were trained and checked for competence.
“Medicines were stored, administered and disposed of safely, and people received their medicines as prescribed.” from the report
Laundry separation
needs fixingThe laundry area did not clearly separate clean laundry from dirty or soiled laundry waiting to be washed. Inspectors recommended using best practice guidance to reduce the risk of cross-infection.
“We identified systems in the laundry area were not providing a clear separation between clean and dirty or soiled laundy waiting to be washed.” from the report
Older parts of the building
minorSome accommodation looked tired and needed refreshing. The home had plans for redecoration and refurbishment, and inspectors found no immediate safety risks.
“Some accommodation was looking 'tired' and in need of refreshment, although we did not identify any areas that presented risks to people.” from the report
- 01What changes have you made to separate clean laundry from dirty or soiled laundry?
- 02How do you make sure staff understand unclear instructions for medicines given when needed?
- 03What progress has been made with the planned redecoration and refurbishment?
- 04How have you improved care plans that contained general information which could be misinterpreted?
- 05How do you check that staff supervision and quality audits are being completed and improved?
This was an unannounced inspection of the whole service and all five CQC questions, with the ratings maintained from January 2017. This explanation was written from the published report of 26 July 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, January 2017
Rated Good; inspectors found kind, personalised care, with some records needing improvement and staff vacancies being managed.
Inspectors made an unannounced visit on 20 December 2016. They spoke with people, relatives, owners and care staff. They observed care, looked around the home and checked care records, staff files, rotas, training and other documents.
The home was calm and friendly. People appeared relaxed with staff and were treated with kindness and respect. Inspectors found enough staff on duty, safe medicines arrangements, personalised care plans, suitable support with food and drink, and access to health professionals.
The overall rating was Good, as were the ratings for Safe, Effective, Caring, Responsive and Well-led. Inspectors found two record-keeping issues: cream records did not always say which creams had been used, and care plans did not record all information about people's decision-making abilities. The home was recruiting to staff vacancies and had stopped new admissions until these posts were filled.
Kind and respectful staff
People appeared comfortable with staff, who supported them patiently and respectfully during care and everyday activities.
“The care we saw provided throughout the inspection was appropriate to people's needs and enhanced people's well-being.” from the report
Personalised support
Care plans described people's individual needs, preferences and routines. Staff used this information to provide flexible support.
“Care plans were personalised to the individual and gave clear details about each person's specific needs and how they liked to be supported.” from the report
Activities and emotional support
People could choose from activities such as games, quizzes, crafts, music and singing. Staff also spent one-to-one time with people in their rooms.
“This helped to prevent them from becoming socially isolated and promoted their emotional well-being.” from the report
Visible management
Management was present in the home, worked alongside staff and used checks to monitor care and identify improvements.
“There were effective quality assurance systems in place to make sure that any areas for improvement were identified and addressed.” from the report
Cream records were incomplete
needs fixingStaff recorded that creams had been applied, but daily notes did not always identify which cream was used. Management said a separate medicines record for creams was being introduced.
“However, the daily notes did not always specify what creams had been applied.” from the report
Decision-making information was missing from some care plans
needs fixingStaff understood people's decision-making abilities, but this information was not fully recorded in care plans. Management said the plans would be updated.
“However, care plans did not record all of this information.” from the report
Care worker vacancies
minorThe home had one full-time and one part-time care worker vacancy. Management covered gaps and chose not to admit new people until the vacancies were filled.
“Until these posts were filled the management had taken the decision not to admit any new people into the service.” from the report
- 01Have the separate records for creams now been introduced, and how do you check that each cream application is recorded clearly?
- 02Have care plans been updated to show each person's decision-making abilities and any support they need to make decisions?
- 03Have the full-time and part-time care worker vacancies been filled?
- 04How do you adjust staffing levels when people's needs change, especially at busy times?
- 05How are care plans reviewed with people and their families when needs or preferences change?
This was an unannounced inspection of the overall service and all five key questions, with the overall rating and each key-question rating assessed during the visit. This explanation was written from the published report of 20 January 2017 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Mayfield Hall
2 rated inspections over 3 years: the service has held its Good rating throughout.
- July 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2013
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 24 January 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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