What life is like for people using this service:

We received consistently positive feedback from people about Mayfair Residential Home. People told us it was homely, safe and that staff were kind and treated people well.

The service had systems to ensure risks were managed and people were kept safe. Staff had the knowledge and skills to keep people safe from avoidable harm.

People received effective care from a well-supported and trained staff team.

Staff understood the importance of providing person-centred care and treated everyone as individuals, respecting their abilities and promoting independence.

There were enough staff on duty at the right time to enable people to receive care in a timely way. People had opportunity to access a wide range of activities including access to the local community.

Staff had built positive caring relationships with people they supported and their families.

People received personalised care that was responsive to their needs and preferences.

Staff liaised with other health care professionals to ensure people's safety and meet their health needs. Where staff noted a concern they quickly involved healthcare professionals, to achieve positive outcomes for people and reduce any risks.

We received consistently positive feedback about how the service was managed.

A range of checks were completed by staff and the management team to ensure the quality and safety of the service was maintained.

More information is in the full report.

Rating at last inspection: Requires improvement (Report published 04 November 2017). When we last inspected the service, we found the provider was not meeting legal requirements in relation to Safe care and treatment; Safeguarding service users from abuse and improper treatment; Need for consent; and Good Governance. Following that inspection, the provider submitted an action plan telling us how they planned to make improvements for people who used the service. During this inspection, we found the provider had made improvements and was meeting legal requirements.

About the service: Mayfair Residential Home is registered to provide care for up to 45 older people. It is situated on the promenade close to shops, buses, local amenities and the beach. Some bedrooms have en-suite facilities. There are two communal lounges, a sun lounge and a spacious dining area.

Why we inspected: This was a scheduled inspection based on the previous rating and to check what improvements the provider had made following the previous inspection.

Follow up: The next scheduled inspection will be in keeping with the overall rating. We will continue to monitor information we receive from and about the service. We may inspect sooner if we receive concerning information about the service.

This inspection visit took place on 24 and 26 July 2017 and was unannounced on the first day.

At the last inspection on 05 May 2015 the service was meeting legal requirements of the regulations.

Mayfair Residential Care Home Limited is registered to provide accommodation for up to 45 older people who require 24-hour care. The home is situated on Morecambe promenade, close to local amenities and overlooks Morecambe Bay. The majority of bedrooms have en-suite facilities. The are several communal areas, including a large dining room, sun lounge and quiet lounge. The provider operates CCTV in communal areas of the home. At the time of our inspection 37 people lived at the home.

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.

Staff had received training to administer medicines, however no checks on their competency had been undertaken. We observed staff left the medicines trolley unattended whilst administering people’s medicines. The provider did not have formal systems to assess the competency of staff who administered medicines. This was in breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 – Safe care and treatment.

We found the provider had not ensured valid consent was gained before care and support was provided to people. Assessments of people’s capacity to make decisions had not been properly assessed. This was in breach of Regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 – Need for consent.

We found people’s liberty was restricted because they lacked insight into keeping themselves safe outside of the home. However, the provider had not followed proper procedures in order to apply these restrictions in accordance with the Mental Capacity Act 2005 Deprivation of Liberty Safeguards. This was in breach of Regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 – Safeguarding service users from abuse and improper treatment.

The provider’s systems to assess, monitor and improve the quality of the service provided had not been effective in identifying and addressing the issues highlighted during our inspection. This was in breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 – Good Governance.

People told us they received personalised care that was responsive to their needs. However, we found people’s involvement in care planning was not always recorded. Although staff knew important details about people, these were not always recorded. We have made a recommendation about this.

The provider used external companies to carry out quality assurance on various aspects of the service provided. However, they had not identified the issues raised above. We have made a recommendation about this.

Relevant checks had been made before two new staff members commenced their employment. These included Disclosure and Barring Service checks (DBS), and references. This helped to ensure only suitable candidates were employed to work with people who may be vulnerable. However, there were occasions where the registered manager was unable to obtain references, or convictions were recorded on DBS checks. There were no related risk assessments available for review. We have made a recommendation about this.

The home was well maintained and generally clean and tidy. However, we found some equipment had not been cleaned properly. We raised this with the registered manager who addressed this during our inspection.

The provider had an ongoing programme of refurbishment for the home to ensure the premises continued to meet the needs of

The inspection visit at Mayfair Residential Home took place on 05 May 2015 and was unannounced.

Mayfair residential care home is registered to provide care for up to 45 older people who do not require nursing care.

The home is situated on the Promenade close to shops, buses and local facilities and the beach. All bedrooms are single occupancy with the exception of one twin room for couples wishing to share. Over half the bedrooms are en-suite. There are several shared communal lounges and dining areas. At the time of the visit there were 35 people who lived at the home.

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 the last inspection on 17 January 2014 the service was meeting the requirements of the regulations that were inspected at that time.

People who lived at the home told us they felt cared for, safe and secure. People’s care and support needs had been assessed before they moved into the home. Care records we looked at contained details of their preferences, interests, likes and dislikes. Relatives we spoke with told us they had been consulted about their relative’s care and were informed of any changes that occurred. People who lived at the home told us their views and choices were listened to by the staff and registered manager.

We saw there were safeguarding policies and procedures in place. Staff we spoke with were knowledgeable about the actions they would take if they witnessed any abuse taking place. Sufficient staff were on duty to enable people to move around the building safely and staff were available to support people. One person who lived at the home said, “There is plenty of staff around if I need someone.”

We observed medication being administered in a safe manner. We observed the person administering medication one person at a time, to minimise risks associated with this process.

Staff were trained well and they told us access to attend courses were supported by the management team. The staff members we spoke with told us they discussed their training needs in their regular formal supervision sessions. These were one to one meetings with their manager. Records demonstrated these meetings were held on a regular basis.

Staff we spoke with had a good understanding of how people should be treated in terms of respect and dignity. During the day and as part of our observations we saw examples of staff being respectful, caring and sensitive towards people who lived at the home.

We found examples where the home had responded to changes in people’s needs. We saw referrals had been made to external professionals. Records were up to date and reviewed providing information for staff to deliver quality care.

People who lived at the home were encouraged and supported to maintain relationships with their friends and family members. Relatives we spoke with told us they were always made welcome at any time.

We found a number of audits were in place to monitor quality assurance. Records demonstrated identified issues were acted upon in order to make improvements. The registered manager and provider had systems in place to obtain the views of relatives and people who lived at the home.

There were 36 people living at Mayfair residential home when we inspected. To help us understand their experiences of living there, we talked with people, observed the care they received and the way staff interacted with people.

People told us that they were happy at Mayfair residential home. They said that they received care and support when they wanted it. We observed people who lived in the home being treated with respect and dignity in a friendly and caring way. People told us that the staff were kind and caring. One person told us, “We are blessed with very good staff.” Another person said, “I couldn’t fault the care I receive here.”

We talked with some people’s relatives to find out their views of the home. One relative said, “We are so pleased with the way Mum is looked after.” Another relative told us, “I think the staff are marvellous, Mum looks better than I have seen her for a long time.”

People told us that the meals were good. We saw staff assisting and encouraging people with their meals as needed. They were attentive and supported people appropriately.

The home was maintained and equipment was serviced regularly so that it was safe for people to use.

People who lived in the home and relatives told us that they were well supported by the staff team. They told us that if they were unhappy with anything staff listened and acted on this.

People said that routines in the home were flexible and they were encouraged to make their own decisions about their daily routine. They told us staff were polite and respectful and asked how they wanted their care to be carried out. One person said, “The staff are kind and patient and ask us what we want.”

Care and treatment was planned and delivered in a way that was intended to ensure people's safety and welfare. People were smartly dressed, well groomed and wearing clean and comfortable clothing. Appropriate aids and adaptations were available to assist people.

We observed staff interacting with people during our visit. Staff supported people living in the home well. We observed people over lunch time and later in the afternoon. Staff assisted people sensitively and unhurriedly, giving help or encouragement where it was needed.

People living in the home were praising about the care and support they received. One person said, "The staff are excellent here. I wouldn't want to be in any other home." Another person said, “I am glad I came here now. The staff have helped me a lot.”

Most staff had enrolled on or had completed national care qualifications. Other training was also available. The staff members we spoke with felt the training they were receiving provided them with the skills and knowledge to support people well.