Madeira Lodge

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

The rating for the key question of Effective has remained the same Requires Improvement. People's needs were assessed using recognised assessment tools. These were completed appropriately. However, the information they provided, such as the level of risk to the person, was not used to its full advantage. For example, a tool was used to identify the risks of a person’s skin integrity. Where people were scored as being at high risk of acquiring pressure sores or bruising to the skin, this had not always led to the development of an individual care plan and/or risk assessment. Staff told us they work well together and understood the reporting structure that was in place to ensure people were supported promptly and effectively. Information about the support people required from external healthcare professionals had been recorded within their care plans however, people’s care records were not always accurate or up to date.

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The manager told us that an assessment of people's needs was completed before moving into the service. This had enabled the manager to make more informed decisions as to whether people's needs could be met at the service in a safe way. People's needs were determined and mapped alongside people who already lived at the service to minimise the potential of distress.

Staff told us they learnt about people's needs by reading the assessments but also getting to know people as individuals.

The manager told us that people's needs were regularly reviewed to ensure the information contained within care plans was accurate and up to date. However, people’s care records were not always up to date or written in some cases. Staff handed over important information about needs of people between themselves during the day and night.

People's needs were assessed using recognised assessment tools. These were completed appropriately. However, the information they provided, such as the level of risk to the person, was not used to its full advantage. For example, a tool was used to identify the risks of a person’s skin integrity. Where people were scored as being at high risk of acquiring pressure sores or bruising to the skin, this had not always led to the development of an individual care plan and/or risk assessment.

We did not look at Delivering evidence-based care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.

Staff we spoke with told us they worked well together and understood the reporting structure that was in place to ensure people were supported promptly and effectively. One member of staff said, “If we notice something, like someone is poorly we would tell seniors and they would look and they would do referral to the person's GP. We don’t always receive feedback but we often see professionals come to the home.”

The manager told us that although she was new in post, she has not felt any push back from the staff teams. They felt that the staff were struggling due to the management changes that have recently happened but they found the staff to be wholly positive. They recognised that there is a lot of work to be done but the manager is “up for the challenge.”

The commissioning team had not had any negative feedback from colleagues such as social workers/care managers. A new commissioner visited in early January 2024 mainly to introduce himself. The manager had just started in post that week and she told him of her plans so far. He did not have any concerns from what he saw.

The service worked with others involved in people’s care, for example, community nurses and GP’s, to make sure people received the care they needed. Staff accessed health care for people when they needed medical advice

Some people’s care records contained information about external health care professionals they were working with and any action that had been taken, however, this was not consistent across all records we reviewed. Some care records had either been written following the on-site assessment when this had been requested or they had been reviewed by the new manager, some documentation contained the incorrect information including the person’s name and gender.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Consent to care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.