Archived: Alexandra Care Home

Updated 14 June 2016

We carried out this inspection visit under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014. Our inspection was unannounced and the team consisted of one inspector and an expert by experience, an expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service and on this occasion our specialist advisor had experience of working with people who have dementia.

We checked the information we held about the service and the provider. This included notifications that the provider had sent to us about incidents at the service and information we had received from the public. We also spoke with the local authority who provided us with current monitoring information. We used this information to formulate our inspection plan.

The provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

We spoke with two people who used the service and five relatives. Many of the people living at the home were not able to tell us, in detail, about how they were cared for and supported because of their complex needs. However, we used the short observational framework tool (SOFI) to help us to assess if people’s needs were appropriately met and they experienced good standards of care. SOFI is a specific way of observing care to help us understand the experience of people who could not talk with us. We reviewed four care records to see if the information matched the support they were receiving and to ensure it covered all aspects of their care.

We also spoke with four members of care staff, two team leaders, the housekeeper, activities coordinator, a nurse, the deputy and the registered manager. We reviewed four staff files to see how staff were recruited. We looked at the training records to see how staff were trained and supported to deliver care appropriate to meet each person’s needs. We looked at the systems the provider had in place to ensure the quality of the service was continuously monitored and reviewed to drive improvement.

Updated 14 June 2016

This inspection was unannounced and took place on 16 May 2016. At our last inspection on 20 and 21 April 2015 we asked the provider to make improvements to ensure there were enough staff to meet people’s needs. . The provider sent us a report explaining the actions they would take to improve. At this inspection, we found improvements had been made. We also asked the provider to make some improvements in other areas of their service. These covered medicine management, the meal experience for people, the responsiveness of staff to support people’s needs, the stimulation on offer to people and staff support and the quality monitoring systems in place. At this inspection we saw that improvements had been made in all these areas of concern.

The service was registered to provide accommodation for up to 40 people. People who used the service had physical health needs and some were living with dementia. At the time of our inspection 35 people were using the service.

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 2008 and associated Regulations about how the service is run.

The provider determined the staffing levels on the number of people living in the home and the level of support they required. Staff had received training in dementia which they told us had increased enhanced the support they were able to offer and increased their knowledge. Other training was on-going and offered as directed from audits or through staff requests. Relatives had told us they felt people who used the service were safe and staff understood their role in ensuring people were protected from abuse or poor practice.

We saw that the provider and manager understood their responsibilities in complying with the requirements of the Mental Capacity Act 2005 (MCA). Where people lacked capacity to make certain decisions, appropriate assessments had been completed and recorded how w how people were supported to make those decisions. Where people were being restricted of their liberty in their best interests, the appropriate authorisations had been applied for.

. Everyone we spoke with felt the changes being made at the home were positive and had improved people’s experience of care. We saw that people were responded to in a kind and friendly manner and staff respected their decisions. Risk assessments were in place to ensure people’s safety was maintained.

Medicines were managed safely and in accordance with good practice. People received food and drink that met their nutritional needs and had a choice of the foods they liked. Staff made referrals to healthcare professionals in a timely manner to maintain people’s health and wellbeing.

Staff were caring in their approach and they created a warm homely environment which people told us they liked and enjoyed. People felt confident they could raise any concerns with the provider and manager. There were processes in place for people to express their views and opinions about the home. The provider and manager had systems in place to monitor and improve the quality of the service.