CQC report explained · a residential care home
What the CQC found at Madeira Lodge
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, March 2023
Rated Inadequate and placed in special measures; inspectors found serious safety, care planning and management failures, despite some improvements.
This was an unannounced inspection prompted by continuing concerns from health and social care professionals about people's care and access to prompt healthcare. Inspectors visited on 1 and 8 December 2022, reviewed records and spoke with people, relatives and staff.
Inspectors found people were not always protected from abuse or avoidable harm. Risk assessments and care records were often incomplete or out of date. Healthcare advice was not always sought quickly enough. Staff needed more skills to support people with dementia and complex needs.
The home had some positive practices. Medicines were managed safely, recruitment checks were completed, and some people received kind support and help to remain independent. However, audits did not reliably find problems, and leaders had not created a consistently open culture where concerns were raised.
The overall rating was Inadequate. Safe and well-led were rated Inadequate, while effective, caring and responsive were rated Requires Improvement. The home was placed in special measures and CQC said it would re-inspect within six months.
Medicines
Inspectors found medicines were stored, administered and recorded safely. Staff giving medicines had been trained and assessed as competent.
“Medicines were managed safely in line with national guidance and supported by organisational policies.” from the report
Recruitment checks
The recruitment records reviewed showed appropriate checks of work history, references and criminal record information.
“The recruitment records we reviewed showed staff were recruited safely.” from the report
Communication support
Communication needs were recorded for people, and pictures were used with some people to help them understand and communicate.
“Pictures were used with some people to enhance communication and support understanding.” from the report
Safeguarding concerns
seriousStaff did not always report possible abuse or follow safeguarding processes. Inspectors said this left people vulnerable to abuse.
“The provider and registered manager failed to protect people from abuse and improper treatment.” from the report
Risk management
seriousRisk assessments did not always explain how staff should prevent harm. Inspectors found concerns about falls, pressure sores, weight loss, dehydration and care after incidents.
“Individual risk assessments did not provide sufficient guidance for staff to ensure identified risks were managed well to prevent harm.” from the report
Incomplete care records
needs fixingCare plans and daily records were sometimes inaccurate or lacked important information about people's needs, preferences and treatment.
“People's daily records did not accurately describe the care they had received.” from the report
Delayed healthcare
seriousHealthcare advice was not always requested promptly. Inspectors found delays involving increasing anxiety and unclear follow-up after choking episodes.
“However, there continued to be a delay in requesting advice quickly enough.” from the report
Dignity and activities
needs fixingPeople were not always supported promptly after soiling themselves, and some had few meaningful activities. End of life plans did not always record people's wishes.
“People were not always treated well or with dignity and respect.” from the report
Weak management checks
seriousAudits and daily checks failed to identify several problems, including old risk assessments, heating and hot water issues, odours and inaccurate records.
“The provider and registered manager failed to operate a robust system to monitor the quality and safety of the service provided.” from the report
- 01What has been done to make sure staff report and act on every safeguarding concern?
- 02How are risk assessments for falls, pressure sores, weight loss, dehydration and distress now reviewed and updated?
- 03What specialist training have staff completed for dementia, complex needs and challenging situations?
- 04How do you make sure healthcare referrals and follow-up are made promptly and recorded clearly?
- 05What meaningful activities and end of life planning are now available for each person?
This unannounced inspection rated all five key questions and included infection prevention and control; it was prompted by continuing concerns about people's care and access to prompt healthcare. This explanation was written from the published report of 14 March 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Madeira Lodge
6 rated inspections over 6 years: the service has slipped, from Requires improvement to Inadequate.
- March 2023Inadequatecurrent ratingstayed InadequateSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- January 2023Inadequatedown from GoodSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- June 2021Goodup from Requires improvementSafe: GoodWell-led: Requires improvement
- July 2019Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- February 2017Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- November 2022
Registered with the Care Quality Commission on 14 November 2022.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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39 live-in carers within about an hour of Kent
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,260 a week. 33 can care for a couple. 12 years' experience on average.
“Always on time and with a lovely smile for my mum. Theresa is kind and sensitive to my mum's needs.”
“Irene was a very kind and empathetic carer who knew just the right words to say to put a smile on my face.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.