CQC report explained · a residential care home
What the CQC found at Madelayne Court
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, June 2019
Madelayne Court was rated Good overall; inspectors found safe, kind care but improvements were needed in staffing, call-bell response, activities and meal choice.
This was a planned, comprehensive and unannounced inspection. Inspectors spoke with 19 people living at the home, five relatives or friends, staff and health and social care professionals. They also reviewed care plans, staff records and management documents.
The home was rated Good for Safe, Effective, Caring and Well-led. People were generally safe, treated with respect, supported by trained staff and involved in their care. Risks, medicines, safeguarding and healthcare support were managed well.
Responsive was rated Requires Improvement. Some people waited too long for call bells, had limited time with staff and missed activities because of staffing pressures. There were also mixed views about the warmth, quality and choice of meals.
The overall Good rating means the inspectors found the service met the required standard overall, but it was not consistently meeting people's needs in a responsive way. The provider was asked to review staffing, call-bell waiting times, social isolation and meal choices.
Managing risks
Care records contained detailed risk assessments and guidance for staff. Inspectors found that people were kept safe while being supported to maintain independence.
“Risk was well managed at the service. Measures were put in place to keep people safe and risks were balanced so that people had freedom and independence.” from the report
Personalised care plans
Care plans recorded people's needs, histories, preferences and dislikes. Reviews took place when people's needs changed.
“Care plans were clear and written in a respectful person centred way.” from the report
Kind and respectful care
Inspectors saw staff chatting, laughing and responding sensitively to people. People's privacy, dignity and independence were generally respected.
“People were supported and treated with dignity and respect; and involved as partners in their care.” from the report
Working with professionals
The home worked with health and social care professionals to coordinate people's care. Weekly meetings helped share information and respond to changing needs.
“The service worked very well with a variety of health and social care professionals.” from the report
Open management
The management team was described as approachable and used audits, feedback and incidents to improve the service.
“The registered manager promoted a person-centred approach and an open culture.” from the report
Staffing pressure
needs fixingSome people, relatives and staff said there were not enough staff for timely care and meaningful time together. The provider was reviewing staffing levels.
“They always seem short-staffed, they say it to me, and you can see it.” from the report
Slow call-bell responses
needs fixingSome people reported waiting a long time after using their call bell. Inspectors asked the provider to monitor waiting times.
“People's needs were not always responded to in a timely way in relation to staff responding to people's call bells.” from the report
Meal choice and temperature
needs fixingPeople had mixed views about the food. On the inspection day, there was only one main meal choice, and some people said food was not always warm enough.
“On the day of the inspection, a roast dinner was the only choice for people to have.” from the report
Activity information
minorActivities were provided, including outings, but the programme was not distributed throughout the building or to people's rooms. This meant some people did not know what was available.
“The leaflet advertising events was very colourful but not distributed around the building or to people's rooms, so they could choose to engage in the group activities of the day.” from the report
- 01What changes have been made to staffing levels since the inspection, and how do you check that call bells are answered promptly?
- 02How much time do staff normally have to spend with residents for conversation and social support, beyond personal care?
- 03What meal choices are available now, including for people needing soft or pureed food?
- 04How are residents told about daily activities, especially if they live in their rooms or on different floors?
- 05How do you check that residents are dressed appropriately and that their dignity and privacy are maintained?
This was a planned, comprehensive and unannounced inspection covering all five CQC questions; the previous December 2017 inspection had only looked at Safe and Well-led. This explanation was written from the published report of 8 June 2019 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.
What inspectors found, February 2018
Rated Good; inspectors found safety and leadership had improved after earlier concerns about falls, but noted gaps in training and communication.
This was an unannounced, focused inspection on 5 December 2017. Inspectors checked whether earlier concerns about falls, moving people safely and staff skills had been addressed. They spoke with people, relatives, staff and health professionals, observed care, and reviewed care and management records.
The home was rated Good overall. Safe and well-led were both rated Good. Inspectors found clearer care plans, improved staff skills, enough staff to keep people safe, and better learning from accidents and mistakes.
There were still areas to improve. The report recommended checking that senior staff were suitably skilled to train others in moving and handling. Inspectors also noted busy mealtimes, delays in providing individual slings, and that people were not always kept informed about changes.
Safer moving and handling
Staff had received refresher training and inspectors saw people being supported patiently and safely with walking aids and other equipment.
“Staff skills had improved and they supported people to move and transfer safely.” from the report
Clearer care plans
Care plans and risk assessments had been revised to give staff more individual guidance about how to support people safely.
“People's care plans had been revised to provide staff with the necessary guidance and advice to keep people safe.” from the report
Learning from incidents
The manager reviewed falls and accidents, looked for patterns and arranged further reviews or support where needed.
“The manager supported staff to learn from mistakes and used this information to drive improvements.” from the report
Open management
People, relatives and staff said management was visible and approachable. Staff felt able to raise concerns.
“The registered manager promoted an open culture where staff, people and families felt able to speak about any concerns they had.” from the report
Training senior trainers
needs fixingThe report recommended checking that senior staff who trained others in moving and handling had the right skills. They were not formally observed while delivering training.
“We recommend the service finds out more about best practice to ensure senior staff are appropriately skilled to train care staff to safely support people to mobilise at the service.” from the report
Busy mealtimes
needs fixingInspectors found enough staff to keep people safe, but mealtimes were particularly busy and managers had to provide extra support. One person said they could wait a long time at these times.
“During lunch, we observed care staff depended on other staff such as the registered manager and deputy manager to provide additional support” from the report
People not always informed
minorSome people were not always told about changes, such as planned maintenance in their rooms. Feedback about meetings for residents and relatives was mixed.
“Two people told us they were not always communicated about changes which happened, for example when maintenance was planned in their rooms.” from the report
Individual slings
needs fixingThe size of the sling needed was not always recorded, and people did not have their own sling at the time inspectors looked. The home said assessments and records were being updated.
“The size of the sling people required was not always recorded and people were not provided with their own sling.” from the report
- 01Have senior staff who train others in moving and handling now been formally observed and assessed?
- 02How many staff are available during mealtimes, and how long might people wait for help?
- 03Has each person who needs one received an individually assessed sling, and is the sling size recorded in their care plan?
- 04How are residents and relatives now told about planned maintenance and other changes?
- 05What was the outcome of the planned change to the deputy managers' roles, and did it affect support at busy times?
This was a focused inspection of Safe and well-led, looking mainly at improvements after concerns about falls and moving people safely; the other three questions were not assessed or rated in this report. This explanation was written from the published report of 13 February 2018 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 Madelayne Court
4 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- June 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- February 2018Goodstayed GoodSafe: GoodWell-led: Good
- October 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- August 2015Requires improvementSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- June 2014
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- September 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 16 December 2010.
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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
35 live-in carers within about an hour of Essex
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 £1,020 to £1,260 a week. 25 can care for a couple. 10 years' experience on average.
“Not only was she professional, polite and efficient but she bought a lovely smile and laughter to my parents home.”
“She brought fun and stimulation into mums life.”
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.