Mayfield House is a residential care home for six people with a learning disability. At the time of the inspection four people were using the service. Mayfield House is a large detached property with local amenities and transport links close by and the home is staffed 24 hours a day. Mayfield House followed the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

Mayfield House 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.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good, however, the rating for Well-led had changed to Requires Improvement because the manager had not ensured that they remained up to date with changes in legislation and guidance. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People were safeguarded from the risk of abuse as staff were trained to recognise and respond to any signs of abuse. There were sufficient numbers staff to meet people's needs in a safe way. The provider followed safe recruitment procedures to ensure that appropriate staff were employed. Risks to people were assessed and well managed. People's medicines were safely managed and administered. There were effective systems in place to reduce the risk of the spread of infection.

The principles of the Mental Capacity Act 2005 (MCA) were being followed and people were supported to have maximum choice and control of their lives. People were supported to eat sufficient amount of food in line with their needs and preferences. People's health and well-being was monitored and people had access to a range of health service. People were cared for by staff who were supported and had the skills and training to meet their needs.

People were treated with dignity and respect. People's privacy was respected and staff supported people to make choices. People had access to an advocate if they needed one.

People were provided with opportunities for social activities and they were supported to maintain contact with their family and friends. People received a service which met their needs and preferences. There were effective procedures in place to respond to any concerns or complaints. People's end of life wishes were being gained.

There were effective management systems in place and there were systems to monitor the quality and safety of the service provided. People were supported by a team of staff who felt supported and valued.

This unannounced inspection took place on 3 May 2016. At our last inspection during December 2013, the provider was meeting the regulations we looked at. Mayfield House provides accommodation and personal care for up to six people with learning disabilities. At the time of our inspection there were five people living at the home.

There was a registered manager in post. 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.

People told us they felt safe living at the home. Staff knew what they would do to protect a person from the risk of harm and how to respond to any concerns. Staff were aware of risks to people’s health and well- being and these were appropriately managed. There were enough staff to meet and respond to people’s needs. Recruitment processes were in place which ensured staff had the appropriate checks and skills before they began working in the home.

People received their medicines as prescribed and these were managed safely. People had access to healthcare professionals as required to maintain their health. People were asked for their consent before care was provided. People’s care and support was planned in a way that did not restrict their rights and freedom. People were supported to have enough food and drink and were offered meals that were suitable for their individual nutritional needs.

People were cared for by staff who knew them well. People felt the staff were kind and caring. Staff respected people’s dignity and privacy and understood people’s choices and preferences. People were supported to follow their own interests and hobbies. People and their relatives felt comfortable to raise any concerns and felt confident these would be addressed appropriately.

People and staff spoke positively about the approachable nature of the registered manager. There were audits to monitor the quality of the home however these were not being used to identify trends or themes which could be used to improve the quality of service people received.

Although we met all four people living in the home, no one was able to express their views about their experience in any detail. However, everyone we met appeared happy in the home. They all seemed comfortable with the staff and their surroundings. One person was keen to show us their bedroom as soon as we arrived.

We found that people were supported to make decisions and that their choices were respected. We saw evidence that people’s best interests were considered when decisions were taken on their behalf.

We saw staff treating people with respect and in a friendly supportive way. Staff made an effort to understand people and acted in ways that supported their independence as far as possible.

We found that care plans were very person centred and contained lots of information about people’s choices, preferences and their likes and dislikes. Parts of the care plans had been reproduced in an easy to read format to help people understand them.

We found that appropriate checks were properly carried out on staff before they were allowed to start work.

The provider had a suitable complaints procedure in place. It had been made available to people’s relatives and representatives and had been explained to people using the service in terms they understood.

Although we spoke with most people in the home, they were not able to express their views about the service in any detail. However, everyone we spoke with appeared happy in the home. People were keen to show us things they were interested in. One person told us about the things they did on their own at College. People were comfortable with the staff and with each other.

A relative told us that they, "Couldn't be happier" about the service. They told us that their son had, "Come on leaps and bounds" at the home.

We found that people were supported to live full and active lives. People took part in a range of leisure and social activities, both at home and in the local community. The level of support people required varied and this was accommodated by the home.

Staff met people's care and support needs in ways that they preferred and we saw that detailed records gave staff the information that they required to do this. Plans were in place to support people to enjoy their lives and staff were aware of risks, people's rights and their responsibilities.

Staff told us they were well supported by the manager. Staff had received appropriate training to support people living in the home.

We saw that the manager effectively ensured that people's views were considered and listened to. We also saw the home had quality monitoring tools in place to ensure that good quality and safe care was maintained.