Alexandra Court Care Centre

Updated 17 January 2024

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The first day of the inspection was carried out by 3 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 care service. A medicines inspector attended on the second day of the inspection and 3 inspectors completed the inspection on the third day.

Service and service type

Alexandra Court Care Centre is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Alexandra Court Care Centre is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced on the first day and the second and third days were announced.

What we did before the inspection

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We also sought feedback from the local authority contracts team. We used all this information to plan our inspection.

During the inspection

We spoke with 15 members of staff including care staff, senior staff, laundry and admin staff. We also spoke with the deputy manager, the registered manager, the operations manager and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We also spoke with 10 people who used the service, 10 relatives and 2 visiting healthcare professionals. We also observed staff interactions with people at various times throughout the day.

We looked around the service to review the facilities available for people and the infection prevention and control procedures in place. We also looked at a range of documentation including care files, and daily records for 10 people and medication administration records for 18 people. We looked at 3 staff recruitment files and reviewed documentation relating to the management and running of the service such as staff rotas, training and audits.

Updated 17 January 2024

About the service

Alexandra Court Care Centre is a residential care home providing accommodation and personal care. The care home can accommodate 84 people across three floors. At the time of the inspection, 77 people were living at the care home.

People’s experience of using this service and what we found

Quality assurance systems had not highlighted or addressed all shortfalls identified during the inspection. Not all safeguarding concerns were appropriately reported on the provider’s monitoring system or reported to the local authority safeguarding team. People, their relatives and staff raised concerns about staffing levels at the service. We made a recommendation about staffing levels. People’s care plans and risk assessments were not always in place or up to date. We made a recommendation about monitoring and reviewing care plans. The provider had not ensured the Care Quality Commission (CQC) were informed of all notifiable incidents.

People’s medicines were administered safely, and staff responded appropriately to accidents and incidents. Staff were recruited safely, and the resident ambassador helped with interviewing potential staff. The home was clean and well maintained.

Staff received an appropriate induction, regular training and development to ensure they had the relevant skills and knowledge to support people. Staff made appropriate referrals to relevant professionals and worked closely with them.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Systems were in place to gather people’s feedback which was used to help improve the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 1 April 2022).

Why we inspected

We received concerns in relation to staffing levels, falls management, food and drink quality, and not providing person-centred care. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. During the inspection we found concerns with the availability of fluids and opened up the focused inspection to also include effective.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this full report.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Alexandra Court Care Centre on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have made recommendations regarding staffing systems, risk monitoring and food and fluids.

We have identified breaches in relation to safeguarding processes, the governance of the service and informing CQC of notififable incidents at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.