Archived: Alexandra Lodge Care Home

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.

We spoke with two relatives. They told us their family members were treated with dignity and respect. One relative said staff were, 'Lovely.'

People using the service told us staff provided care that met their needs and they felt safe. However, we found that some care documents did not include appropriate information about people using the service. We found that people's needs were not always fully assessed and care and treatment was not always fully planned and delivered in line with their individual care plan.

People using the service told us they felt safe and would inform staff members or the registered manager if they were worried about anything.

People also told us they felt that the care home was well maintained, clean and warm enough. However, we found that the provider had not taken appropriate steps to provide care in an environment that is suitably designed and adequately maintained.

We found there were enough qualified, skilled and experienced staff to meet people's needs.

We also found that staff received supervision, appraisals and training.

We found that the provider did not have an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who use the service and others.

We found that records were not always kept securely.

We looked to see how people gave their consent to care and treatment. Staff told us they asked people for their consent. They said often people could make a choice of things like what clothing they wore or how they wanted to be washed. A person who used the service told us, 'I get asked for my opinion.

We looked at the care and welfare people received. A person told us, 'I was asked about how I wanted things done. I told them how I like to get up and go to bed.'

We looked at how people's medication was managed. A person who used the service told us, 'They (staff) always explain my medication. They watch me to make sure I have taken it.'

We looked at the support given to staff. A person who used the service told us, 'These staff know what they are doing alright.'

We looked at how people could make a complaint if they needed to. A person who used the service told us, 'I know how to (complain) but I don't want to. Everything I ask for they do for me.'