The Care Quality Commission
  • Care Home
  • Care home

Archived: Madeley Manor Care Home

Overall: Good read more about inspection ratings

Heighley Castle Way, Madeley, Crewe, Cheshire, CW3 9HJ (01782) 750610

Provided and run by:
Madeley Manor Care Home Limited

Important: The provider of this service changed. See new profile

All Inspections

17 September 2015

During an inspection looking at part of the service

The inspection took place on 17 September 2015 and was unannounced.

Madeley Manor provides accommodation and personal care for a maximum of 42 people who may have dementia and/ or a physical disability. At the time of this inspection there were 20 people living in the home.There had been a change in ownership of the home since the last inspection and the home was currently owned by a receiver company.

At our previous inspection on 10 November 2014 we identified that the provider needed to make improvements in all areas. We found that the provider did not respond appropriately to allegations of abuse. People were not protected against the risks of unsafe care because the provider did not keep accurate records in relation to people’s care and treatment. We found that effective systems were not in place to identify, assess and manage risks to protect people against the risks of receiving inappropriate or unsafe care. The provider did not regularly assess and monitor the quality of care provided. We also identified that the provider did not take appropriate steps to ensure that, at all times, there were sufficient numbers of suitably qualified, skilled and experienced persons to provide care.

We found, from the inspection on 17 September 2015, that the provider had made improvements in all of the above areas.

There was a registered manager in post in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The registered manager of the home was on leave. The home was being managed in the interim by a management company (operations manager) who offered guidance and support to the deputy manager (who was acting as manager of the home).

People’s risks were assessed in a way that kept them safe from the risk of harm. Where possible people’s rights to be as independent as possible were respected.

People who used the service received their medicines safely. Systems were in place that ensured people were protected from risks associated with medicines management.

We found that there were enough suitably qualified staff available to meet people’s care needs. Call bells were responded to in a timely manner. Staff were trained to carry out their role and the provider had plans in place for updates and refresher training. The provider had safe recruitment procedures that ensured people were supported by suitable staff.

Staff knew how to support people in a way that was in their best interests and advice had been sought from other agencies to ensure formal authorisations were in place where people may be restricted.

People told us that staff were kind and caring. Staff treated people with respect and ensured their privacy. Attention to detail would help improve the promotion of dignity for people.

People had opportunities to be involved in hobbies and interests that were important to them and there was activities and entertainment on going at the home.

People and/or their representatives were given opportunities to be involved in their care.

The provider had a complaints procedure available for people who used the service and complaints were appropriately managed.

There was a positive atmosphere within the home and staff told us that the registered manager was approachable and led the team well. Staff received supervision of their practice and had opportunities to meet regularly as a team.

The provider had systems in place to monitor the service. We saw that the provider had made significant improvements to all areas and services provided since our last inspection.

10 November 2014

During a routine inspection

We inspected Madeley Manor Care Home on 10 November 2014. Madeley Manor is registered to provide accommodation, personal and nursing care for up to 42 adults who need support with physical health problems or have dementia care needs. The service also provides short-term respite care to adults who need support with physical health problems. On the day of the inspection, 32 people were using the service and care and support was provided over three floors.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

People were not always protected against the risk of abuse because staff did not always recognise abuse and take appropriate action.

People were at risk of receiving unsafe care because their care records were not always up to date to reflect the support they needed. Some people did not have risk assessments or care plans in in place to guide staff oh how their care should be provided.

Care records were not stored safely and securely. One person’s care records could not be located in order for their care to be reviewed.

Staff were not always available to provide people with care and support when they needed it. We saw that people in communal areas did not have access to call bells. This meant that people with complex needs had to shout for assistance when they needed support.  

Provider did not have effective systems in place to ensure that the quality of the service they provided was monitored and acted on effectively.

People’s medicines were not always managed safely. Guidance was not always available for staff on how ‘as required’ (PRN) medications should be administered safely. Systems for managing medicines in stock were not effective.

People told us and we saw that fresh fruit were not always available for people who used the service. There was limited choice available to people during meals.  People’s food and drink intake including their weights were not monitored effectively to ensure that they remained healthy.

The provider did not always maintain accurate records to demonstrate people’s wishes not to be resuscitated (DNAR) in case of a cardiac arrest. 

Legal requirements of the Mental Capacity Act (MCA) 2005 were not always followed when people were unable to make certain decisions about their care. This meant that people’s liberties were at risk of being restricted.  The Mental Capacity Act 2005 and the DoLS set out the requirements that ensure where appropriate; decisions are made in people’s best interest.

People’s preferences on how they wished to receive care were not always respected. People cared for in their bedrooms were at risk of isolation.

People told us that staff were caring and understood their needs. The provider offered a range of diverse social activities which people enjoyed.

People who used the service told us that they knew the registered manager and the deputy and felt that a manager was always available and they were also approachable.

We identified that the provider was not meeting some of the Health and Social Care Act 2008 Regulations we inspect against and improvements were required. You can see what action we have told the provider to take at the back of the full version of the report.

7 February 2014

During an inspection looking at part of the service

This inspection was unannounced which meant the provider and the staff did not know we were coming. We spoke with seven people using the service and three staff. We also spoke with the manager and operations director. There were no visitors available at the time of our inspection.

In this report the name of a registered manager appears. They were not in post and not managing the regulatory activities at this service at the time of the inspection. Their name appears because they were still a registered manager on our register at the time. A new manager was in post and were in the process of submitting their registered manager's application to CQC.

At our last inspection on 25 July 2013 we made five compliance actions. This meant the provider had to make improvements to demonstrate they were fully protecting people using their service in these areas.

We found that suitable and sufficient improvements had been made where we had identified concerns. We saw the provider had put right what was required. This meant the home could demonstrate outcomes for people using the service had improved.

25 July 2013

During an inspection looking at part of the service

At the time of our inspection the provider was in the process of working towards meeting fire safety requirements and commencing work to replace the passenger lift which had been out of use for over four months.

The length of time in which the lift had been out of action was having a direct effect on the well-being of people, and on the level of care and support people received. We found that people were not always afforded choices, dignity and respect.

We saw examples of poor communication between staff and the people they were looking after. Some staff did not understand what the needs of people were or how to meet these needs.

We found that the care and support people received was not always effective and responsive to meet their individual needs. there was not enough staff with the right skills and experience to deliver care and support effectively and safely.

We noted inconsistencies in the care and support people received. Some people were happy with the care they received. A person told us, "The care in here is excellent." Other people told us that there were not enough staff to look after them, that some of the staff did not understand them and that they sometimes waited for long periods of time for assistance. One person said, "There just isn't enough staff here."

Some improvements had been made in record keeping, but the provider had not made all the improvements we had asked for following our previous inspection of the service.

11 April 2013

During an inspection in response to concerns

Since we carried out our last inspection of this service there had been two changes of manager. The current manager was not on duty so we rang and spoke with her the next day to discuss the inspection.

At the time of our visit the passenger lift was out of action and the provider was planning to install a new lift. People who used the service and the relatives we spoke with told us that this was not worrying them too much as they felt that their needs were being met. We saw staff working on each floor supporting people with personal and nursing care.

The people who used the service told us that they were well cared for by the staff and that the staff were friendly and supportive. One person said, "This is a good home and they look after me well here." Another person said, "X is very well looked after. The staff attend to all X's needs."

Before we carried out this inspection we had received concerns about the recruitment procedure and that some new staff may not have had the necessary checks to work there. We looked at the relevant recruitment records and spoke with staff and we were satisfied that the appropriate checks had been carried out. These staff members had also received basic training in order to meet the needs of people.

We saw that there had been inadequate records maintained in relation to care plans and staff training. We have told the provider that they must take action to improve in this area.

10 May 2012

During an inspection looking at part of the service

We visited the home as part of our scheduled inspection programme. We wanted to see what life was like for the people who lived in the home. We also wanted to see whether the service had made any improvements since we last visited.

Before our visit we contacted other people who may have had an interest in the service. We had received a report from the fire safety officer following his recent visit to the service. The report had highlighted that the providers needed to take some action in order to make improvements to meet with fire safety regulations. At the time of our visit the providers had started to address this.

We had not received any concerns about the service from any other organisation.

During this inspection visit we looked at outcomes one, four, seven, fourteen and sixteen of the essential standards of quality and safety, under the regulations of the Health and Social Care Act 2008.

At the time of our visit the service had 29 people in residence.

We spoke with four care staff, two nurses and two kitchen staff during our visit. We also spoke with seven people who lived in the home and five visitors.

The visit was unannounced. This means that the service did not know that we were coming. The manager was on duty at the time of the inspection visit and assisted us throughout our inspection. We first visited the service on 3 May 2012 but we were informed that the home had an outbreak of the influenza virus. For this reason we confined our visit on this day to looking at records of care and other relevant documentation within the office. We returned the following week, on 10 May 2012 when visiting restrictions had been lifted to continue with our inspection visit.

We observed staff to be attentive to the needs and welfare of people and there was a happy friendly atmosphere at the home. People told us that they felt well cared for by the staff. People we spoke with were happy about the care and support provided.

People were dressed according to their personal choice and looked warm, comfortable and well cared for.

Staff had received basic training and mandatory health and safety training. This helped to ensure that staff delivered safe appropriate care. However other staff training and development had been limited since our last inspection. The provider might support staff more by providing training in dementia care and managing the needs of people who have challenging behaviours.

People had their needs assessed and care plans were effective. The service was in the process of developing these plans in order to make them more person centred. This would help to ensure that plans become more centred on people as individuals and will consider all aspects of people's individual circumstances.

Not all of the nursing staff we spoke with were clear about the procedures for the reporting and referral of poor practice and/or abuse. The provider might like to consider introducing more staff training and instruction in this area. This will help to ensure that staff respond appropriately in order to keep people safe when it is suspected that abuse has occurred.

The service had employed a new manager since we last visited. Management of the home was effective and the home was run in the best interests of the people who lived there.