Madelayne Court

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

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has remained good.

This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

The provider had a resident of the day system in place for reviewing care plans and risk assessments. Care plans we reviewed showed evidence of regular reviews being carried out and who had been involved in the review. However, we received mixed feedback from people and relatives around care plan reviews. One relative told us that they had not seen their relatives care plan since they moved in a few months ago. One person told us, “I have seen my care plan I went through it about my likes and dislikes.”

We saw evidence of pre-assessments being carried out prior to people moving into the home.

Staff told us they were kept up to date between shifts of any changes to people’s needs.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

When required, people had their needs assessed by speech and language therapists (SALT) and received meals in line with recommendations. Staff had received specialist training around dysphasia (risk of choking). People were supported with involvement from external healthcare professionals such as district nurses, GPs and community dentist. One professional told us, “We have a meeting once a month, a frailty meeting where we discuss patients that are palliative and frail and make plans together to support them to get everything place.”

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Feedback we received from professionals was positive around the home working alongside external healthcare professionals. One professional told us, “Very organised – the home is proactive and they know the service users really well. They escalate things in a timely way.”

Staff told us they were kept informed of changes to health needs and handovers were carried out. One staff member told us, “We have a good team who listens to each other. We all work together really well. It’s a good environment and we all support each other.”

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

People were supported to attend appointments with healthcare professionals, for example the community dentist attended the home. We saw evidence of people’s dietary requirements documented within their care plans, for example if they required a modified diet or were diabetic. However, during our onsite part of the inspection we observed the food served at lunchtime did not look appealing to people and when reviewing the meal monitoring report, there was often the same option repeatedly offered to those on a modified diet. Feedback we received from people and their relatives supported they were not always happy with the food offered. One relative told us, “They seem to have just soup and sandwiches for tea at 4.30pm, and it’s that every day.” One person told us, “The food, sometimes it’s cold, or just warm, and plates not hot. The Sunday roast is not that good, bit dried up.” We did observe that meals were of a good portion size and people were offered choices.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Monitoring tools were used to help identify any changes to people’s needs and wellbeing. For example, a MUST (Malnutrition Universal Screening Tool) was used monthly when service user’s weights were recorded, which helped to identify if the person needs a referral to an external healthcare professional such as a dietician or the GP. We saw evidence where there were concerns around a person’s health needs, external advice was sought and documented within the care plan.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

We found that during our onsite inspection, we observed people being offered choices, and staff sought consent prior to supporting people. People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In [care homes/hospitals], this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act 2005 (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found that during our onsite inspection, we observed people being offered choices, and staff sought consent prior to supporting people.