Mayfield Road

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

We assessed all the quality statements within this key question. Our rating for this question has improved to Good. However, we found some areas still required improvement. We continued to have concerns that staff’s interaction with people was task focused and there was little opportunity to engage in activities at the service, putting people at risk of boredom and social isolation. Despite this, staff were respectful of people’s individual differences, and respected their religion and culture. Staff were supporting people to develop their skills and become more independent.

This service scored 65 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People felt valued by the staff that supported them. Family members’ comments included, “[Staff] speak kindly to [my relative]. [Staff] always talk to him and say- ‘hello how are you?” and “[Staff] wash [my relative] and he’s treated with dignity and respect.” Staff spoke politely to people, and they used words such as please and thank you.

Staff knew when people needed their space and privacy and respected this. Staff’s comments included, “You need to be kind and think it's your family members. We cover and close the door when helping to change” and “We knock before entering [a person’s] bedroom.” Staff told us they called people their preferred names.

Partner agencies told us when they visited the service, staff treated people respectfully and with dignity. They respected people’s rights, and treated people with kindness and compassion.

Although staff were caring towards people, they did not always appropriately interact with people. A family member told us, “So little interaction goes on with the residents. I don’t believe there is a lot of interaction – no-one is talking to them.” We observed that staff's communication with people was mainly task-focused and in relation to personal care. Staff were seen to engage better with people who had verbal communication, and they were less interactive where people had complex communication needs. We also noticed that staff did not start or encourage conversations between people helping them to build friendships and socialise. In response, the management team told us they were aware about this concern and that the action was planned to facilitate group supervision sessions with staff regarding engagement and interactions.

Staff encouraged people to practice their culture and religion. This included people receiving support to attend the church, have culturally appropriate meals, and celebrate cultural and religious festivities. People’s individualities were acknowledged by staff who understood and supported a person to explore their sexuality safely.

People were encouraged and motivated by staff to reach their goals and aspirations. A staff member told us, “I encourage service users every day to follow their goals. Everyone has different goals. We encourage [name of a person] to eat by herself. She is special, everyone is special in their own way. [People] understand, it's important to talk to them.”

People were provided with personalised care. Staff appeared to know people well, including their daily routines, eating habits and how they liked to be supported, for example with their hobbies. People’s preferences were reflected in their clothing. We saw a person wearing a t-shirt that showed their interest in [name of activity].

Processes were in place to capture information about people, including their likes and dislikes, their interests and things that were important to them. People’s care plans contained this information so it was available for all staff to read.

Since our last inspection, adjustments were made in the support people received to access the community and activities of their choices. Family members’ comments included, “As far as I know they take [my relative] out. [My relative] should be going bowling today”, “[Staff] took a trip to Milton Keynes, to a farm recently. I can’t tell how often [my relative] goes to the park or to the shops but there is improvement now” and “There’s a bit more action there now, it’s come to life a bit. Before it was very different.” Some people attended college where they wanted to learn new skills and pursue their interests.

People were encouraged to develop new skills and gain independence. A family member told us, “There is progress. [My relative] is trying to be a bit more independent and [staff] encourage him. They put a cup in front of him and he can drink from it. He seems to like doing it.” Staff told us how they encouraged people to eat, dress and maintain their mobility in order to achieve greater confidence in themselves. Some people used cups with straws to enable them to drink independently. A staff member commented, “Everyone can do things for themselves, we just need to know what and how. We help where [people] need support. Like [name of the person], she is doing personal care herself but we need to prompt her.”

People were not always supported by staff to explore the indoor activities of their choice. Group activities such as baking and arts and crafts were facilitated encouraging people to join as they wanted to. However, apart from the group activities at the home, people were lacking stimulating which resulted in boredom. We noticed people spending a lot of their time relaxing and observing surroundings because staff had not initiated activities to help them occupy their time. We did not see any interactive tools such as board games, books or puzzles being used to help people enjoyably pass their time at the home. A family member told us, “We’re fearful [my relative] is in his room for hours and hours with no prompting.” This also meant that people were at risk of social isolation if they did not wish to take part in the group activities.

Systems were in place to ensure people’s independence was maintained, including supporting them with adaptations to manage their own mobility where able. Processes showed that people were offered and encouraged to make choices. Where people had shown a preference for certain leisure activities, details about these were recorded in their care plan so all staff had access to the information.

Staff responded quickly when they noticed changes in people’s mood. This included a person being encouraged to spend time on their own when the staff member noticed them feeling overwhelmed.

Staff knew the type of epilepsy seizures that people had and actions they had to take in response. This included a person being correctly positioned and given medicines at the right time to ensure their safety during the epilepsy seizure.

We observed staff being clear about their role responsibilities and that they had enough time to carry out their duties without being rushed.

Staff’s wellbeing was promoted at the service. The registered manager told us, “We look to lead with kindness while maintaining standards. This include looking at what shifts are working for staff which we try to accommodate as much as possible. However, the service users are the priority and if it is not working for them, we do not agree.” Staff’s working hours were monitored making sure they didn’t get overworked.

Processes were in place to support staff’s wellbeing. This included flexible working opportunities and equality and diversity policies.