24 May 2022
During an inspection looking at part of the service
About the service
Alexandra Care Home is a care home registered to provide accommodation and nursing care to up to 76 people. The service provides support to adults who require personal and/or nursing care, who may be living with physical disability, sensory impairment or dementia. At the time of our inspection there were 63 people were living at the service.
People’s experience of using this service and what we found
People experienced delays in their care. There were insufficient staff deployed to meet the needs of people at key times. People, relatives, staff and visiting professionals shared concerns regarding the staffing level at the service, which our observations confirmed.
Risks to people were not consistently managed. Records regarding incidents, accidents and untoward events were not consistent in their completion or consistent with entries made in people’s care records. We were not assured that all incidences of concern were investigated or reported to appropriate authorities, when needed. This included relevant statutory notifications to the Care Quality Commission (CQC).
Quality assurance processes failed to identify the impact of the staffing level on people. Actions required following audits, checks and reviews were included in the ‘home development plan’ however, some actions were marked as completed when issues remained.
Staff were recruited safely.Staff were aware of their responsibilities regarding safeguarding people and the concerns to raise, should they have any. Medicines were managed safely with robust infection prevention and control measures in place.
People, relatives and staff found the registered manager approachable and supportive. Relatives reported an improvement in communication with the service and receiving up-to-date information regarding their family member’s care.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 29 April 2022).
The provider completed an action plan after the last inspection to show what they would do and by when to improve.
The provider told us the improvements required would be completed by 30 June 2022. This inspection was carried out before this date.
At this inspection we found the provider in breach of further regulations.
Why we inspected
We received concerns in relation to staffing and risks to people’s health and wellbeing. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has remained the same based on the findings of this inspection.
We have found evidence that the provider needs to make improvements. Please see the safe section of this report.
You can see what action we have asked the provider to take at the end of this report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Alexandra Care Home on our website at www.cqc.org.uk
Enforcement
We have identified breaches in relation to staffing, the management of risks and the submission of notifications 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.