What life is like for people using this service:

People continued to receive safe and effective care from kind and caring staff. Staff knew people well and had a good understanding of their personality traits and emotional needs as well as their health and social care needs.

People and their relatives had been fully involved in the assessment and planning of their care before they moved into the service. A care plan had been developed with each person detailing their likes, dislikes, preferences and care needs.

Consent had been sought before any care had been delivered in line with legal requirements. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

Staff treated people and their relatives with kindness, dignity and respect. People’s privacy was protected and confidential information was stored securely. People were supported and encouraged to remain independent and do as much as possible for themselves.

People enjoyed the range of activities on offer, trips out on the mini bus and entertainment provided by visiting entertainers. People encouraged and supported to remain active and to take part in social events at the service. Mealtimes were relaxed, informal, social occasions and people enjoyed the homemade food on offer.

Steps had been taken to make sure people were safe. Risks to people had been assessed and minimised in the least restrictive way. The environment was fully adapted to meet the needs of people living with dementia and was clean, safe and hygienic.

The premises and equipment had been routinely serviced and checked to make sure it was safe. Staff had access to protective clothing such as gloves and aprons and had completed training in infection control.

There were enough safely recruited and trained staff on duty to meet people’s needs and respond to request for assistance. Staff felt supported by their manager and had completed the training they needed to meet people’s assessed needs.

Management and staff worked in collaboration with other stakeholders such as health and social care professionals, volunteers and befrienders to improve outcomes for people and support them to live the best possible life.

A process was in place which ensured people could raise any complaints or concerns. Concerns were acted upon promptly, lessons were learned and apologies were given when needed.

The service continued to be well managed. The registered provider had systems in place to monitor the quality of the service. Actions were taken and improvements were made when required.

Rating at last inspection: Good (report published August 2016)

About the service: Mayfields is registered to provide accommodation and personal care to up to 46 people. There were 44 people living at the service at the time of the inspection most of whom were living with dementia and other age-related conditions. People’s accommodation was situated on the three wings.

Why we inspected: This was a planned inspection based on the rating at the last inspection. The service remained good overall.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

This was an unannounced inspection, carried out on 7 September 2015.

Mayfield's is a purpose-built single storey home which provides care for a maximum of 46 older people with a diagnosis of dementia. The service is located in the Overpool area less than two miles from Ellesmere Port town centre. The service consists of three wings called Rosebank, Bluebell and Greenacres which are located off a main central lounge. Each wing has its own separate lounge/dining area with domestic scale kitchen facilities and a range of shared bathroom/toilet facilities. All bedrooms are single with en -suite facilities. There are car parking facilities outside of the building and a large garden which is accessible to all people throughout the year.

The service has a 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.

We last inspected this location in November 2013 and we found that the registered provider met all the regulations we reviewed.

People were safe. Staff understood what is meant by abuse and the different forms it can take Staff knew the process for reporting any concerns they had and for ensuring people were protected from abuse. Staff told us they would not hesitate to raise concerns and they felt confident that they would be dealt with appropriately. Family members told us they had no concerns about their relative’s safety. They commented; “There are always plenty of staff to support [my relative] and I know they are safe here”.

Staff were caring and they always treated people with kindness and respect. Observations showed that staff were mindful of people’s privacy and dignity and encouraged people to maintain their independence. Relatives and visitors told us that they had no concerns about the care. They said they had always been made to feel welcome and part of a family when visiting.

People’s needs were assessed and planned for and personalised in order to how best to meet people’s needs. People’s wishes, preferences and beliefs were reflected in the care plans. Care plans were person centred, detailed and reviews always promoted the involvement of the person or other important people such as family members. Staff worked well with external health and social care professionals ensure people received the care and support they needed. People were referred onto the appropriate service when concerns about their health or wellbeing were noted.

Robust recruitment processes were followed and there were sufficient qualified, skilled and experienced staff on duty to meet people’s needs.

Staff received support through supervision and team meetings which enabled them to discuss any matters, such as their work, training needs or areas of development. There was a well-developed programme of planned training which was relevant to the work staff carried out and the needs of the people who used the service. All new staff at the service completed an in- depth induction programme before they supported any people on a one to one basis at the service.

Policies and procedures were in place to guide staff in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). The registered manager had a good knowledge and understanding of the Mental Capacity Act 2005 and their role and responsibility linked to this. Staff had received training in the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS) and were able to show an understanding of the key principles when asked.

People received their medication as prescribed and staff had completed competency training in the administration and management of medication. Medication administration records (MAR) were appropriately signed and coded w

We looked at care plans and other care records for four people who lived at the home. An assessment of each person's health and social needs had been completed. The care plan documentation was up to date and had been reviewed monthly.

We looked at the systems in place for managing medication and found that good procedures were in place and were followed.

We looked at menus and the food that was available for people who lived at Mayfields. We found there was a good variety of meals available and people said the food was good and plentiful.

We spoke with two people who used the service, one relative, three staff and one professional involved in the service. People who used the service said: “The staff are nice”, “The food is good” and “The staff are lovely.”

One relative commented: “The home is pleasant and inviting” and “The staff are very caring and there are lots of activities going on.” They didn’t have any concerns or complaints about the home.

Staff commented “We have regular team meetings”, “Residents needs come first here”, “The training is good” and “The staff team is nice, we all get along well together.” The staff said they got good support from the management team and that the registered manager was good and helpful.

The visiting professional said: “The home is good, there is no unpleasant smell and its always clean. The staff are very helpful and the service users appear happy.” They said they had no issues or concerns with the home.

We looked at staff recruitment and found that robust recruitment procedures were in place and were followed.

Many of the people who lived at Mayfields were not able to talk to us, so throughout the day we observed interactions between the people who used the service and staff and found there was a relaxed and friendly atmosphere between them.

We used a number of different methods to help us understand the experiences of people living at Mayfields. This was because all of the people using the service had complex needs which meant they were not able to tell us their experiences. We observed during our inspection that the people living at Mayfields appeared happy and content living there. We found people were treated respectfully and given support to have their say in how they wanted to be helped, and were supported to do the things they wanted to do.

We spoke with visitors and relatives of the people who lived at Mayfields who commented:

"If I had dementia, I would like to come here".

"The staff are very kind".

"There are never any smells here".

"We have been to quite a few care homes and we think this is the best."

Some of the people who lived at Mayfields had limited verbal communication but could communicate in a number of other ways.

They were given information in a way that they could understand and were supported by their families and people who knew how to communicate with them when decisions needed to be made about their care and welfare. There was an effective system in place to deal with complaints.

The people who lived at Mayfields were cared for in an environment that was well maintained, safe and suitable for their needs. The staff who cared for them were well trained, experienced and appropriately supported.

During the inspection we spoke with four people who live in Mayfields and four relatives. People said staff were always careful to make sure doors were closed to protect their privacy and dignity. They told us staff always consulted them about their individual needs, explained what was happening and involved them in decisions about their care and support.

A visitor said their relative had been in Mayfields for almost a year. They said that they were welcomed into the home at any time and liked how they were included in the activities going on at the home.

Another visitor said that staff kept them fully informed of their relative’s needs and what staff were doing to support their relative. This visitor also said they had recently attended a relatives’ meeting and been introduced to the chefs.

People told us that they were happy with their care. One person said “The staff are very nice” and another said “The girls are lovely and I enjoy going on the trips out”.

One visitor told us that their relative had come in for a month’s trial. They said they were very happy with the care so far and that their relative had settled very quickly.

Another visitor said “The home is really lovely. The staff are very friendly and have really helped me and dad through a difficult time”.

A third visitor said “The staff are lovely and do a very good job. It’s always like this, nothing is too much trouble and they are very kind. We have been very lucky to find such a good place”.

People we spoke with told us that they felt safe and well cared for in the home. They said that their needs were able to be met by the number of staff available and that they were consulted about their views of the service.