CQC report explained · a residential care home
What the CQC found at Madeleine House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors were assured that infection risks were being managed through visitor screening, testing, protective equipment, cleaning, social distancing and outbreak planning.
- Effective?
- Good
- This area was not covered by the targeted inspection.
- Caring?
- Good
- This area was not covered by the targeted inspection.
- Responsive?
- Good
- This area was not covered by the targeted inspection.
- Well-led?
- Good
- This area was not covered by the targeted inspection.
What inspectors found, March 2021
Inspected but not rated; inspectors were assured about infection prevention and found thoughtful ways to support safe family contact.
This was a targeted, announced inspection on 23 February 2021. It looked at infection prevention and control during the coronavirus pandemic, rather than giving a full service rating.
Inspectors were assured that the home was managing visitors, admissions, shielding, social distancing, personal protective equipment, testing, cleaning and possible outbreaks safely. The home had increased cleaning and used a fogging machine for deep cleaning.
People were supported to stay in touch with those important to them through virtual meetings and carefully managed visits. Staff used photographs of themselves on lanyards because some people found it difficult to recognise them while they wore protective equipment.
The service was inspected but not rated. This means the report gives findings about infection control, but it does not provide an overall rating or ratings for the other key areas of care.
Safe visiting
Visitors were screened for symptoms and had to take a lateral flow test before visiting. Perspex screens were also used during some visits.
“Visitors were screened for symptoms of Covid-19 and were required to complete a lateral flow test on their arrival” from the report
Family contact
The home helped people maintain contact with important people through virtual family meetings and a virtual Christmas carol concert.
“People had been supported to maintain contact with people who were important to them.” from the report
Support with protective equipment
Staff wore protective equipment correctly and used photographs on lanyards to help people recognise them.
“Staff wore a photograph of themselves on a lanyard around their necks which reminded people who they were.” from the report
Infection control
Staff worked in set areas, used walkie-talkies to share information, and increased cleaning schedules. A fogging machine was used for deep cleaning.
“Cleaning schedules had been increased to monitor cleanliness of the environment.” from the report
Inspectors raised no specific concerns in this report.
- 01How have your infection prevention and control arrangements changed since the inspection on 23 February 2021?
- 02How do you currently support residents to see and communicate with family members?
- 03How do you help residents recognise staff when protective equipment is being worn?
- 04How often are deep cleans carried out, and how is the cleanliness of the home checked?
- 05What are the home's current ratings for care, effectiveness, responsiveness and leadership, which were not assessed in this inspection?
This was a targeted inspection of infection prevention and control during the coronavirus pandemic; it did not provide a full rating or assess the other key questions. This explanation was written from the published report of 3 March 2021 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, December 2018
Rated Good; inspectors found safe, kind and responsive care, with some minor issues about the environment, noise and medicines practice.
This was an unannounced inspection on 20 November 2018. Inspectors spoke with six people living at the home, six relatives and five staff. They observed care, checked five care plans, medicines records, staff recruitment and training records, and records about how the home was managed.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, safe recruitment, improved medicines checks, kind care and suitable support for people's health, choices, activities and complaints.
The home had been rated Requires Improvement in all five areas at the September 2017 inspection, when legal requirements were not met. Inspectors found enough improvement at this inspection to raise all ratings to Good. Some work was still under way, including making the environment more suitable for people living with dementia.
Safety systems
Staff knew how to respond to safeguarding concerns and risks were reviewed. Incidents were investigated and action was taken to reduce the chance of them happening again.
“People were protected from the risk of abuse and avoidable harm because staff knew what action to take and the provider had safeguarding systems and processes in place to keep people safe.” from the report
Kind and respectful care
Inspectors saw warm and respectful interactions. Staff supported people's dignity, privacy, independence and day-to-day choices.
“People were supported by staff that was caring, kind and respectful.” from the report
Improved medicines management
Medicines records were accurate and regularly checked. Staff errors had been investigated, with further training and checks put in place.
“On checking medicine administration records (MAR) we found they were completed accurately and regularly audited by the deputy manager with the registered manager giving oversight.” from the report
Personalised support
Care plans included people's likes, dislikes, hobbies and interests. Staff were able to explain how they supported individual needs and changing health conditions.
“We sampled five care plans and found they contained personalised information.” from the report
Open feedback
People and relatives were asked for their views, and complaints were investigated and resolved. Inspectors found that people and relatives were positive about the home.
“People and relatives we spoke with all said they would recommend the home.” from the report
Lounge condition
minorSome lounge chairs were stained and needed replacing, and inspectors noticed an unpleasant smell. The home said refurbishment was planned and some replacements were arranged after the visit.
“However, on first entering the lounge area, that was carpeted, we noticed several the chairs were stained and in need of replacement and there was an unpleasant odour.” from the report
Mealtime information
minorStaff offered people food choices, but did not always explain sandwich fillings or the flavour of soup. This could make choosing food harder for some people.
“We noted the staff when showing the plate of sandwiches, did not say what the fillings were.” from the report
Medicine hidden in food
needs fixingInspectors found one instance where medicine had been hidden in a person's food without evidence of pharmacist involvement. This was dealt with on the inspection day, and the home said future cases would be checked with a pharmacist first.
“We had raised with the senior one issue concerning the concealment of medicine in a person's food. We could not see there had been involvement from a pharmacist.” from the report
- 01What changes have been made since the inspection to replace the stained chairs and improve the lounge environment?
- 02How do you reduce noise in communal areas for people living with dementia?
- 03How do you make sure people are told what food is being offered, including sandwich fillings and soup flavours?
- 04What is the current process when medicine needs to be given in food or drinks, and when is a pharmacist consulted?
- 05How are relatives involved in reviewing care plans and decisions about changing health needs?
This was an unannounced inspection covering all five key questions; it checked improvements since September 2017, when all five ratings were Requires Improvement and a Regulation 17 breach was found. This explanation was written from the published report of 11 December 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 Madeleine House
3 rated inspections over 3 years: the service has held its Good rating throughout.
- March 2021Inspected but not ratedcurrent ratingSafe: Inspected but not rated
- December 2018Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2017Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- July 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2013
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- May 2012
Report published without a new overall rating.
- August 2011
Report published without a new overall rating.
- August 2011
Report published without a new overall rating.
- April 2011
Report published without a new overall rating.
- November 2010
Registered with the Care Quality Commission on 25 November 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.
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