Archived: Alexandra Lodge Care Home

Updated 30 December 2016

We carried out this inspection 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.

This inspection took place on 8 and 11 November 2016 and was unannounced. The inspection team consisted of two inspectors 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 service.

Before our inspection, we reviewed the information we held about the home. We also contacted the commissioners of the service and Healthwatch Nottinghamshire to obtain their views about the care provided in the home.

During the inspection we observed care and spoke with three people who used the service, seven visitors, two health and social care professionals, a housekeeper, two kitchen staff, three care staff and the registered manager. We looked at the relevant parts of the care records of 10 people, two staff recruitment files and other records relating to the management of the home.

Updated 30 December 2016

This inspection took place on 8 and 11 November 2016 and was unannounced.

Accommodation for up to 19 people is provided in the home on two floors. There were 15 people using the service at the time of our inspection. The home provides personal care for older people.

A registered manager was in post and she was available on the second day of the inspection visit. 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.

People were unnecessarily restricted and put at risk of avoidable harm due to a lack of appropriate equipment. Staff did not always safely manage identified risks to people. Safe infection control and medicines practices were not always followed.

Staff understood their responsibilities to protect people from the risk of abuse. Sufficient numbers of staff were on duty to meet people’s needs during our visit. Staff were recruited through safe recruitment processes.

Not all staff had received all relevant training and observations suggested that the training received was not effective in a number of areas. People’s rights were not always fully protected under the Mental Capacity Act 2005. The mealtime experience was poor for one person and systems to ensure that people received sufficient to eat and drink could be improved.

External professionals were generally involved in people’s care as appropriate, however, the service had not always promptly responded to professional guidance when required. Staff received appropriate induction, supervision and appraisal.

Staff were kind but did not always respect people’s privacy. Staff did not always effectively respond to one person’s distress. People and their relatives were involved in decisions about their care though this could be improved. People’s independence was not always promoted.

People could receive visitors without unnecessary restriction and advocacy information was available to people.

Care records did not always contain information to support staff to meet people’s individual needs. People were supported to take part in activities.

A complaints process was in place and staff knew how to respond to complaints.

The provider was not meeting their regulatory requirements. There were systems in place to monitor and improve the quality of the service provided, however, they were not effective. People and their relatives were not fully involved in the development of the service.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.