CQC report explained · a residential care home
What the CQC found at Mayfield House
Rated Inadequate: inspectors found the home performing badly and the CQC has taken enforcement action.
What inspectors found, June 2022
Requires Improvement; inspectors found unsafe medicines systems, gaps in risk assessments and weak oversight, although people generally felt safe and supported.
Inspectors made unannounced visits on 9, 12 and 13 May 2022. They spoke with people, relatives and staff, observed care, and reviewed care, medicine, recruitment and management records.
The home was not always safe. Inspectors could not be assured that medicines were given as prescribed. Risk assessments and care plans did not always give staff enough individual information. Staffing levels varied, and the home could not show that safe staffing numbers had been properly established.
People were generally positive about staff and communication. Staff respected people's choices, food and drink were provided, and complaints were handled better than at the previous inspection. However, capacity decisions, personalised care planning, activities and management checks needed improvement.
The overall rating remained Requires Improvement, as did Safe, Responsive and Well-led. Effective fell from Good to Requires Improvement. The provider remained in breach of regulations, and CQC said it would monitor progress.
Respectful, familiar staff
People were supported by staff who knew them and respected their choices and preferences.
“Overall people were supported by familiar staff who understood their needs and respected their choices and preferences.” from the report
Complaints handling improved
The home had improved how it logged, investigated and responded to complaints. The previous breach about complaints was no longer present.
“At this inspection we found improvements and the provider was no longer in breach of regulation 16.” from the report
Food and drink support
People were offered enough food and drink. Meals were well presented and staff supported people effectively at mealtimes.
“The food was well presented, and staff supported people effectively at mealtimes.” from the report
Safe recruitment and staff training
Staff had pre-employment checks, induction and training. Staff were also supported through supervision and appraisals.
“Staff had pre-employment checks to ensure their suitability before they started working with people.” from the report
Medicines were not reliably managed
seriousInspectors could not confirm that medicines were always given as prescribed. Errors were not always reported or investigated, and some supplies had run out.
“We could not be assured people had received their medicines as prescribed.” from the report
Risk information was incomplete
seriousSome risk assessments were missing or did not contain enough individual information. Inspectors said this placed people at risk of harm.
“We found systems were either not in place or robust enough to demonstrate that risk management and safety were effectively managed.” from the report
Management checks missed problems
seriousAudits identified some issues but failed to identify all the problems found during the inspection. The provider remained in breach of good governance requirements.
“Despite audits identifying some areas which required improvement, they did not highlight all the issues we found during the inspection.” from the report
Care plans lacked detail
needs fixingCare plans did not always explain people's needs, preferences or how staff should provide care. Reviews with people and relatives had not always happened regularly.
“Whilst care plans were in place, these did not always contain enough information to guide staff about people's care needs, taking account of their individual preferences or how they wanted their care to be provided.” from the report
Mental capacity knowledge gaps
needs fixingThe home had processes for capacity assessments and best-interest decisions, but staff knowledge gaps meant these were not always completed correctly.
“Gaps in staff knowledge had resulted in these not always being completed correctly in line with the MCA.” from the report
- 01What changes have been made to prevent missed, excessive or insufficient medicines, and how are medicine supplies and topical creams now checked?
- 02Which residents' risk assessments were incomplete, and how are risks such as falls, choking and ineffective sensor mats now managed?
- 03How are staffing levels calculated from residents' needs, and has the promised dependency tool been introduced?
- 04What training and checks now ensure staff complete mental capacity assessments and best-interest decisions correctly?
- 05How often are care plans reviewed with residents and relatives, and what support is now available for activities and emotional wellbeing?
This focused inspection covered Safe, Effective, Responsive and Well-led; no separate Caring rating is shown, and the report says the previous comprehensive inspection can be read separately. This explanation was written from the published report of 10 June 2022 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, October 2019
Rated Requires Improvement; inspectors found kind and effective care, but concerns about safety checks, complaints and management oversight.
This was an unannounced inspection carried out on 19 July, 25 July and 9 August 2019. Inspectors spoke with people living in the home, relatives, staff and visiting health professionals. They also observed care and checked care, medicine, recruitment and management records.
The home was rated Good for Effective and Caring. People were treated with kindness and respect, medicines were managed safely, staff were trained, and people received support with food, drink and healthcare.
The home was rated Requires Improvement for Safe, Responsive and Well-led. Inspectors found hazards involving fire doors and ventilation, weaknesses in recruitment records, complaints that were not fully investigated, and quality checks that had not identified these problems. The manager took action during the inspection, and no harm was identified from the issues found.
The overall rating fell from Good at the previous inspection, published in January 2017. The provider breached regulations about complaints and good governance. CQC requested an action plan, said it would monitor progress with the provider and local authority, and planned to inspect again.
Kind and respectful care
Inspectors observed compassionate care and found that staff understood people's individual needs, preferences and communication needs.
“Staff were seen to be genuinely caring and kind when providing support.” from the report
Safe medicines practice
Inspectors found that medicines were received, stored, given and disposed of safely. Staff had medicines training and access to guidance.
“Medicines were received, stored, administered and disposed of safely.” from the report
Staffing and support
There were enough staff to meet people's needs. Staff received induction, training and regular supervision, and inspectors found them skilled and knowledgeable.
“There was enough staff on duty to meet people's needs and to ensure their safety and wellbeing.” from the report
Partnership working
Visiting health professionals spoke positively about how staff and managers worked with them to meet people's healthcare needs.
“Visiting health care professionals spoke highly of the staff and management team” from the report
Fire doors and ventilation
seriousInspectors found a very hot conservatory with restricted ventilation and faults affecting fire doors and a fire-door alarm. The manager and provider acted during and after the inspection to address these issues.
“A fire door in the ground floor sensory room had a faulty catch which meant the door was not secure” from the report
Complaints not fully investigated
seriousA complaint had not been recorded in full or investigated thoroughly and promptly. Inspectors found that the person's concerns remained largely unresolved. This was a breach of Regulation 16.
“Complaints records showed that a complaint made in June 2019 had not been investigated thoroughly.” from the report
- 01What has been done to make sure fire doors, fire-door alarms and ventilation are checked regularly and remain safe?
- 02How are complaints now recorded, investigated and resolved, and how will the home show that people receive a proper response?
- 03What quality checks are completed now, and how are missed checks or inaccurate records followed up?
- 04Are residents and their relatives shown their care and support plans and asked to agree them?
- 05Have all required recruitment checks been completed before staff start work?
This was an unannounced inspection of the care, premises and management arrangements across all five CQC questions; Safe, Responsive and Well-led had deteriorated from Good, while Effective and Caring remained Good. This explanation was written from the published report of 17 October 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.
Every inspection of Mayfield House
3 rated inspections over 5 years: the service has slipped, from Good to Requires improvement.
- June 2022Requires improvementcurrent ratingstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- October 2019Requires improvementdown from GoodSafe: Requires improvementEffective: GoodResponsive: Requires improvementWell-led: Requires improvement
- January 2017GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- May 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 12 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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