Mayfield Hall is a care home that can accommodate up to 20 older people, some of whom had a diagnosis of dementia. At the time of our inspection there were 18 people living at the service.

We carried out this inspection on 20 December 2016. The service was last inspected in November 2013 and was found to be meeting the regulations.

There was a registered manager in post who was responsible for the day-to-day running of 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 and associated Regulations about how the service is run.

Relatives told us they were happy with the care and support their family member received and believed it was a safe environment. One relative said, “The service is as good as it can be. My mother is safe living at there.”

With met with several people living in the service but most were unable to tell us their views about the care and support they received. However, we observed people were relaxed and at ease with staff, and when they needed help or support they turned to staff without hesitation.

On the day of our inspection there was a calm, relaxed and friendly atmosphere in the service. People had good and meaningful relationships with staff and staff interacted with people in a caring and respectful manner. Comments from people and relatives included, “Staff are brilliant, very kind and patient”, “They [staff] do look after me well here”, “Staff are lovely” and “I have no complaints, staff are kind.”

People were able to take part in a range of activities of their choice. Where people stayed in their rooms, either through their choice or because they were cared for in bed, staff spent one-to-one time with them. This helped to prevent them from becoming socially isolated and promoted their emotional well-being. There were sufficient numbers of suitably qualified staff on duty and staffing levels were adjusted to meet people’s changing needs and wishes.

Staff completed a thorough recruitment process to ensure they had the appropriate skills and knowledge. Staff knew how to recognise and report the signs of abuse.

People had access to healthcare services such as occupational therapists, GPs, chiropodists and dieticians. Visitors told us staff always kept them informed if their relative was unwell or a doctor was called. Relatives commented, “They always let me know if my father is unwell” and “My mother’s health has greatly improved since moving into Mayfield Hall. There is good communication between staff and the district nurses.”

Staff supported people to maintain a balanced diet in line with their dietary needs and preferences. Where people needed assistance with eating and drinking staff provided support appropriate to meet each individual person’s assessed needs. People were given plates and cutlery suitable for their needs and to enable them to eat independently wherever possible.

Care records were up to date, had been regularly reviewed, and accurately reflected people’s care and support needs. Details of how people wished to be supported were personalised to the individual and provided clear information to enable staff to provide appropriate and effective support. Any risks in relation to people’s care and support were identified and appropriately managed.

Management and staff had a good understanding of the Mental Capacity Act 2005 (MCA). Where people did not have the capacity to make certain decisions the management and staff acted in accordance with legal requirements under the MCA. Staff applied the principles of the MCA in the way they cared for people and told us they always assumed people had mental capacity.

People and their families were given information about how to complain. There was a management structure in the service which pro

We spoke with five people during our visit. All of the people told us they liked living in the home. We also spoke with a relative who told us that they thought the home was comfortable and clean with 'very caring staff'.

We saw people being treated with respect and dignity. We observed staff knocking on bedroom doors before entering. We saw staff asking people what they wanted to eat. We observed that people were given a choice about where they sat and activities they wanted to do. We observed staff and managers communicating with people verbally and by writing information down when the person found that easier. We saw staff sitting down beside people when helping them to eat their lunch. We observed that people appeared to enjoy their food and that it had been prepared to take into account their capacity to eat and preferences.

We reviewed care records which showed that consent to care had been obtained from the person or their representative. The care records provided evidence that people's history, likes and dislikes were taken into account.

Whilst there were some minor maintenance issues, the home was safe, in good repair and there were systems to ensure people's safety.

We reviewed records which showed staff had regular supervision and training and an annual appraisal. We talked with staff who told us they had been supported to undertake a relevant qualification.

We observed that records were well organised, up to date and stored securely.

We visited the service as a part of our scheduled programme. Many of the people who lived at Mayfield Hall Care Home had either dementia or some degree of memory loss associated with older age. We saw that people, who were not able to communicate with us verbally about their experiences, appeared contented and settled. We spoke with four of the eighteen people who lived at the home. People told us they were happy living there. One person told us “This is a great place to live” and another “We are all well looked after” and “This is where I live, it’s my home now”.

We found that care plans reflected people’s individuality and included information about how they had lived their lives before they had made Mayfield Hall their home.

We saw people's rights to privacy and dignity were respected by care workers.

We saw that staff interacted with people in a relaxed, friendly and respectful manner. Staff worked at the pace of each individual and encouraged their independence

We found that people had opportunities to engage in activities that met their needs. We saw that people related well to the staff and we saw positive relationships in place.

We found that staff were not receiving supervisions. Not all staff had received up to date training.