The inspection took place on 9 August 2017 and was unannounced. The home provides accommodation and support for people with mental health needs. There were four people living at the home at the time of our inspection.

There was a registered manager in place. 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.

At our last inspection in March 2015 the service was rated Good. At this inspection, the service remained Good.

There were some difficulties at the time of our inspection with relationships and dynamics between people living at the home. This had led to people reporting they didn't always feel safe. However the registered manager was aware of this and working with other professionals to manage the situation and ensure that people were safe.

People received safe support with their medicines. Those people who were managing their own medicines had undergone an assessment to ensure they were safe to do so.

At the time of our visit there were two permanent members of staff in post; a number of staff had recently left their posts for various reasons. Recruitment was under way and the registered manager was using consistent bank staff and agency staff to cover the necessary shifts. Staff who were lone working were able to contact senior staff on call if they needed to.

Staff told us they were well supported with training and supervision to enable them to carry out their roles effectively. Training included safeguarding, medicines and equality and diversity.

There was nobody in the home with a DoLS authorisation in place; we observed how people went out as they pleased. Staff were aware of the principles of the Mental Capacity Act and gave examples of how they put it in to practice.

There were clear plans in place to support people's mental health needs and these were reviewed regularly to ensure they were reflective of people's current needs.

People were supported by staff who were kind and caring and treated people respectfully. People's independence was encouraged and supported. People were able to be involved in planning their own care and running of the service.

People were able to complain and make their views known if they needed to. There was a process in place and we viewed examples of complaints that had been investigated and responded to.

Staff were positive about the support they received from the registered manager and felt able to raise their concerns when necessary.

There were effective systems in place to manage the quality of the service provided.

45 Mayfield Park North provides accommodation and personal care for up to four people with mental health problems. The inspection took place on 29 March 2015 and was unannounced. On the day of our visit there were three people living at the home.

At our last inspection in May 2013 the service was meeting the regulations inspected.

There was a registered manager for 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 found that care plans had been written with the full involvement of the person concerned. This ensured people were supported in the way they wanted to be. However, care plans were not always properly reviewed. This meant they may not have been up to date and showed how to provide people with the support they required to meet their needs.

The service was safe for people and they were assisted by staff who knew how to report abuse if they suspected it. The staff also understood how to whistleblow if they had concerns about the way the service was run.

People were supported by enough qualified and experienced staff to provide them with the care they required. They were protected from the risks of unsafe and unsuitable staff being employed by the provider’s recruitment and staff selection procedures.

People’s rights were protected at the home. This was because there were systems in place to ensure that the Mental Capacity Act 2005 Code of practice and the Deprivation of Liberty Safeguards were followed if decisions needed to be made on their behalf.

Staff felt properly supported and were provided with training to do their job effectively. This helped ensure staff cared for people in the way they preferred. People confirmed that the staff were caring and kind. Staff also showed they had a good knowledge about people’s different needs and how to meet them.

People were included and consulted about the care and support they received at the home. There was friendly communication between people at the home and the staff.

People were provided with healthy food and drink that ensured their nutritional needs were met. They were also well supported with their health care needs by other healthcare professionals when needed.

People were supported with their mental health needs so that they lived a fulfilling life. They were encouraged to be independent and to take part in interests that mattered to them in the home and the community.

People’s physical health needs were monitored by staff and they were supported to stay healthy.

People were encouraged to make their views known about the service. The registered manager made sure complaints were properly responded to by following the provider’s complaints procedure. Peoples views were also sought as part of the process of checking the quality of the service they received. There were systems in place to ensure that the quality of care and service was properly monitored.

Staff understood what their roles and responsibilities and the values and philosophy of their organisation were. The organisation’s key values were to promote independence and provide care in a way that was centred on the person and what they wanted. The care and service people received was regularly checked and monitored to ensure it was safe and of a good standard.

People living at the home told us they were happy and that the staff were kind. They were confident that if they were unhappy about something the staff would listen.

Staff understood that everybody living at the home had capacity and were able to make their own decisions about how they lived their life. They understood and protected people's right to refuse care or treatment.

Each person had their care needs assessed and an individualised person centred care plan. Individual risk assessments had been carried out and plans to support people with risks had been developed. Where risks or care needs had changed records had been updated to reflect these changes.

The home was clean and smelled fresh. Improvements had been made to the home's infection control systems and there was now a robust and thorough system in place.

People were supported to manage their own medicines but where additional help was needed the home had safe systems in place to manage medicines.

Staff training and supervision took place on a regular basis and records were kept to ensure this was happening.

There was an effective quality assurance system in place to monitor the quality of the service. Where improvements needed were identified the improvements were carried out.

People told us that they were happy at the home and felt safe. They told us they could spend their time as they wished.

We found 45 Mayfield Park to be homely and centred around the needs and wishes of the people who lived there. It was a small home for just four people and three people had lived there for more than ten years. People had been involved in decisions about decoration and how they would like their rooms to be painted.

People's preferences were respected and they had been involved in planning their care.

Bathrooms and toilets in the home were in poor condition and, due to the deterioration of flooring and sealant, posed a potential infection control risk. Staff had not received safeguarding training for several years and some other important training needed to be updated. However, the manager had identified these shortfalls and had begun to take action to address this.