The inspection was carried out on 4 and 7 February 2019. The first day of the inspection was unannounced.

Mayfield Court is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection

The home is registered to provide support for up to 35 people. At the time of our inspection 35 people were living there. The home provides support for people who have a physical disability. Some of the people living there also have additional needs for support due to a learning disability or the fact they are living with dementia.

At our last inspection we rated the service outstanding. At this inspection we found the evidence continued to support the rating of outstanding and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Everybody we spoke with was complimentary about the service provided at Mayfield telling us they believed it to be exceptional. Comments we received from people living at the home included, “It’s the best place to live,” “Best place ever” and “I love it. I’ve got my freedom, space, independence but can be around everyone. The best of both worlds. 24-hour care for me but I can be left alone [if I want].” Relatives were similarly complimentary about the service provided. Their comments included, “Mayfield is second to none,” and “It’s her home, she is comfortable here.”

Mayfield Court was exceptional at putting people who lived there at the heart of everything they did and recognising that this was people’s home and actively enabling and supporting people to make their own choices and decisions. This included regularly seeking people’s opinions formally and informally. This enabled people to take control of their lives and ensure staff delivered their support in partnership with people. Their innovative approach included a well-established residents meeting led by a committee of people who lived at the home. Committees for gardening and decorating were also set up by people living at the home. The registered manager had established procedures for listening to people’s views and acting on them. She provided formal feedback to residents committees and ensured people were kept up to date within information about the running of their home. As a result of this people all had confidence in the staff team and confidence that the they could live the lifestyle of their choosing and make their own decisions.

People felt safe living at Mayfield Court and were very confident to approach any member of staff or the registered manager to discuss any concerns they had. Concerns were taken seriously, thoroughly investigated and the outcome was always shared with people.

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. Where people needed support to express their views of make decisions the service was pro-active at seeking advocacy and support for them.

People living, working and visiting the home had confidence in and felt supported by the registered manager and management team. The management team were a visible presence throughout the home and people felt comfortable approaching senior staff.

There was a culture of learning imbedded in the home. New guidance, ideas and research were discussed with staff and people living there and a ‘can do’ attitude was taken to implementing new ideas if they would benefit people’s lives.

The building and equipment within the home were safe and regularly health and safety checks were carried out.

People received the support they needed with their physical

This inspection was carried out on 19 and 22 July 2016. The first day of the inspection was unannounced.

Mayfield Court is registered to provide accommodation and support for up to 35 people. At the time of our inspection 33 people were living there. The home provides support for people who have a physical disability. Some of the people living there also have additional needs for support due to a learning disability or the fact they are living with dementia.

The home had 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.

During the inspection we met a number of the people living at Mayfield and spoke with twelve of them and relatives of two people who live or lived there. We also looked around the premises and spoke with ten members of staff who held different roles in the home. This included speaking with the registered manager.

We examined a variety of records relating to people living at the home and the staff team. We also looked at systems for checking the quality and safety of the service.

Everybody we spoke with was positive about the home and the support it provided. Comments from people living there included, “A good opportunity. There’s always someone around 24/7. It’s one of the best homes you could get.” “It’s the best place for anyone with disabilities,” And “It’s a wonderful place – nothing is too much trouble.” A relative said, “It’s like a big family house. A happy place.”

The home consistently engaged with and worked in partnership with the people who lived there and the fact that it was their home was consistently respected by staff. People were confident that their views were always listened to and acted upon by the manager and the staff team. One person told us, “They listen” and another person said, “We talk it through.”

The views of people living at the home were central to systems for checking the quality of the service and planning improvements. For example people had been activity involved in choosing décor, recruiting new staff and agreeing changes to the way meals were managed. A residents committee provided a forum for people to express their views and this was backed up by individual discussion with people and a series of questionnaires. People living at the home were well informed about how their home operated via the residents committee, newsletters and notices displayed in the foyer. Information was consistently given to people about how their views had shaped decisions made regarding the running of the home and discussions about decisions were open and transparent between the people living there and the management team.

People living at Mayfield felt safe and were well informed about safeguarding adult’s procedures. They were very confident any concerns they raised would be listened to and addressed.

Complaints were taken seriously, thoroughly investigated and lessons learnt from them.

People received the support they needed to manage their medication and their health. This support was discussed and agree with the person or their representative and was provided in a way that maximised their independence and choices.

Individual care plans were written with and agreed with the person or their representative wherever possible. They provided clear guidance for staff to follow and were reviewed continually as people’s support needs or lifestyles changed. People were fully aware of the contents of their care plan and regularly had the opportunity to discuss this with staff.

People told us that they were supported and given advice about decisions they needed to make but that staff were always aware that they had the right to make the final decisions themselves. Staff had a good awar

We found that people who used the service were treated well and with dignity and respect. They were involved in how they were cared for. Care plans demonstrated people had been involved in discussions and reviews regarding their care and treatment plans. They were involved in and able to have their say in how services were provided through residents meetings that they chaired.

People who used the service and a relative we spoke to told us they were very satisfied with the care and support given to them. They said:

“It’s brilliant, such a lovely atmosphere, it’s like a family”

“I am very happy living here”,

“I enjoy living here very much”,

Care and support plans identified people’s needs and how their needs were to be met. Risk assessments and care plans were seen to be individualised and covered all aspects of a person’s needs including physical, behavioural, mental health and social. Risk assessments and care plans had been completed in full and reviewed regularly every two to three months.

People were protected from the risks of abuse as staff were trained and knowledgeable in safeguarding vulnerable adults and appropriate guidance and support was available.

There were sufficient numbers of suitably qualified and experienced staff in order to care and support people and their relatives. Records were found to be held securely and accurate.

We spoke with many of the people who were living at the home and their feedback was positive in all aspects of their support. People made some of the following comments; "It’s brilliant here I can’t fault the place”, “I get all the support I need when I need it”

and “The support I get is fabulous”

People told us they felt well supported to make choices, maintain their independence and to influence how the service was run. People were regularly asked to give their views about the service and their feedback was used to make improvements to the service.

Each of the people using the service had a care plan which provided a good description of the person’s needs and how to meet these. We saw some good examples whereby staff had referred for specialist advice and support to meet people's needs.

People told us they were happy with the home environment and the quality of furnishings provided in their own rooms and in communal areas. We found that the environment was well maintained and systems were in place to make sure the environment was clean and safe.

We asked people if they had any complaints about the service and people told us that they didn't. People told us they would feel confident to raise a complaint if they had reason to and felt their complaints would be listened to and resolved to their satisfaction.

People living at the home told us they like to be called 'residents' when referred to collectively. Residents confirmed that staff respected them at all times and made them feel safe. They confirmed they were actively involved in the planning of their care and in the running of the service. They were consulted about all aspects of the home and were involved in decision making and the recruitment of new staff.