About the service: Mayflower Court Residential Care Home is situated in the residential area of Oxton, Wirral. The home is registered to provide accommodation and support to up to 20 older people. At the time of our inspection, there were 17 people living in the home.

People’s experience of using this service: There were not always sufficient numbers of staff on duty to meet people’s individualised needs in a timely way.

Systems in place to monitor the quality and safety of the service did not identify the issues we highlighted during the inspection. The provider had not displayed the last rating of the service on their website as required.

Risk to people had been assessed but records were not always up to date. We made a recommendation about this in the main body of the report.

Plans of care reflected people’s preferences and had been reviewed regularly, however they did not always reflect people’s current needs. The registered manager was in the process of reviewing and updating all care files.

Consent was not always sought and recorded in line with the principles of the Mental Capacity Act 2005. Applications to deprive people of their liberty had been made appropriately, but records did not clearly reflect those that had been authorised. Following the inspection, the registered manager told us consent had now been sought and recorded.

People’s nutritional needs were known and met by staff, however the feedback we received regarding the meals available was mixed. Systems were in place to gather feedback from people regarding the service.

Activities were available to people within the home, however there were no activities available within the community, which people told us they would like.

Staff had been recruited safely to ensure they were suitable to work with vulnerable people. They were supported in their role and received regular training to help ensure they had the knowledge and skills to support people safely.

People living in the home told us they felt safe and their relatives were confident that safe care was provided. People told us they received their medicines when they needed them and we found that they were managed safely. The building and equipment were maintained to ensure they remained safe. Relevant equipment was available to enable staff to meet people’s needs.

People told us staff were kind and caring, protected their dignity and treated them with respect. Staff knew the people they were supporting well and spoke about people warmly. Staff supported people to be as independent as they could be.

People and their relatives knew the registered manager and felt able to speak to them if they had any concerns.

Rating at last inspection: Rated good at the last inspection in May 2016 (Report published August 2016).

Why we inspected: This was a planned comprehensive inspection based on the previous rating.

Enforcement: You can see what action we told the provider to take at the end of the full version of this report.

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 inspection took place on 12 and 24 May 2016 and was unannounced. Mayflower Court Residential Home is a period style detached building in well-kept grounds on a residential street in Oxton, Wirral. The home had bedrooms over three floors. The home is registered to provide personal care for up to 20 people. At the time of our inspection 19 people were living in the home.

There was a registered manager working at the home. 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.

The manager had a warm and kind approach to people. Staff and visitors we spoke with told us they found her approachable. She consulted with people and was open to new ideas. Staff members told us they felt well supported by her. The manager was visible and there was a culture of continuous improvement at the home. She completed regular audits of the home and its processes. People’s relatives that we spoke with told us that communication from the manager and staff at the home was good and timely.

Many people we spoke with commented positively on the atmosphere and feel of the home. We observed staff to be warm and kind towards people, using people’s names, treating people with dignity and respecting their private space. During less busy times of the day staff told us they liked to sit and chat with people and their visitors. Visitors came and went from the home throughout the day, those we spoke with told us they were made to feel welcome at the home. The home had recently recruited a new activities co-ordinator and there was a range of activities available to people.

There was an adequate number of staff to meet people’s needs. People living at the home and their relatives told us they felt the home was a safe place. The environment people lived in and the care people received was safe. The home was clean, well maintained and clutter free. The manager had arranged for a series of health and safety checks and services to be completed on the homes safety systems, equipment used by people and the maintenance of the home’s environment. Accidents and incidents were recorded and learnt from. People’s medication was stored and administered safely.

Staff received training on safeguarding vulnerable adults and understood how to keep people safe from harm. New staff went through a number of checks to ensure they were recruited safely. New staff also received initial induction training and at first shadowed an experienced member of staff.

People were treated as individuals and were supported to make decisions regarding their care. People’s care records we looked at were recent, person centred and they had regular dated reviews. They contained brief information about the person, their care plan and risk assessments. Daily care notes were updated on a computer system that was password protected. Information relating to people’s health had been used effectively when supporting people to access healthcare services. Health and social care professionals who visited told us that they had confidence in the care at the home and the staff, “advocated for people”.

Staff received training and periodic refreshers that were appropriate to their role. In addition to this they received regular supervision meetings and annual appraisals with the manager. Staff were also invited to staff meetings and could place items for discussion on the agenda. Staff we spoke with told us they felt comfortable approaching the manager when necessary. Staff told us they felt well supported in their role.

People told us they enjoyed the food provided. It was cooked fresh and there was a variety of options available to people. The cook catered for people’s different tastes and dietary requirements. The kitc

We spoke to different people about this service to gain a balanced overview of what people experienced, what they thought and how they were cared for. We spoke to two people who used the service, three relatives of people and three members of staff.

People said it was, “marvellous here; the staff are wonderful”, and that they were “very impressed with the care” that people received. A relative said that they had been “involved from the start” and that staff were all approachable and friendly. We saw detailed accounts of people’s preferences and needs in their care plans.

Staff who administered medicines had received training and told us about the procedures that they followed to ensure the safety of people using the service. These matched the policy documents that we saw.

The people that we spoke to said that they had never had reason to make a formal complaint. They said that any small concerns that they had raised with staff had always been acted upon.

We saw staff interacting and caring for people who used the service in a kind and friendly way. Staff were able to describe the needs of different service users showing us that they understood what care individuals needed.

Staff told us that they had received training about all aspects of care relevant to the service when they started work at the home and that they received regular update training. We saw records that confirmed this. Staff said they felt supported by their colleagues and their manager.

At our last visit we found that care plans had limited information about mobility, mental health needs and falls risk assessments.

At this visit we found that improvements had been made to records. We found that care files had been reviewed and risk assessments had been put in place in relation to mobility and falls. We saw records that people had been referred to the falls team and requests had been made to supply assistive technology. In the absence of the assessments being undertaken we found that action had been taken when possible to minimise the assessed risks.

We found that records had been improved and identified signs and symptoms of the individual's care needs relating to their mental health.

Visitors to the home told us they had no concerns regarding the care of the people in the home.

We sought information about Mayflower Court from Wirral Borough Council's department of adult social services no issues of concern were raised.

We observed care workers and the manager engaging with people in a sensitive and caring manner. People who used the service told us they were happy the service provided and felt valued and cared for.

The six care records looked at had information about people’s personal histories, interests and lifestyle choices. This meant the service supported and promoted people's diversity, values and respected people's human rights. However there was limited information in their mobility care plans or falls risk assessments.

The three relatives spoken with told us they felt their relatives were safe living at Mayflower Court and that a good standard of care was provided. They told us if they had any concerns they would feel comfortable discussing them with the manager or the register provider.

There were systems in place to monitor the quality and safety of the service provided. The nominated individual for the company carried out a monthly audit of the service.

We spoke with a number of people living in the home on the day of our visit, looked at some of the relatives’ comments and spoke with the relatives who were visiting or telephoning on the day. Relatives told us that they were kept up to date with any health issues in respect of their mother.

One family told us that they still felt involved with their mother's life and care; that they visited her regularly and were kept informed of her needs.

Comments from relatives found in the comments book said, “how kind and caring staff are”, “how well the residents are being looked after”.

People living in the home told us that they are often asked if they are satisfied with the care and support they receive. One relative told us that they receive satisfaction surveys so that they can comment on the quality of service in the home.

One resident told us that staff were lovely.