Background to this inspection
Updated
2 May 2018
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 comprehensive inspection took place 9 and 13 March 2018. It was unannounced on the first day and was carried out by one inspector. The second day was announced.
Before our inspection, we reviewed all the information we held about the service, including previous inspection reports and statutory notifications sent to us by the provider. Statutory notifications contain information about changes, events or incidents that the provider is legally required to send us. We also contacted the local authority, other stakeholders, and Healthwatch to gather their feedback and views about the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.
Before the inspection, the provider completed a Provider Information Return (PIR). This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make.
During our inspection, we spoke with five people who used the service, two relatives, four care workers, one healthcare professional, one advocate, the deputy manager, the registered manager and the nominated individual (provider's representative). We spent time looking at documents and records relating to people's care and the management of the service. We looked in detail at four people's care plans, medicine records, five staff personal files and a variety of policies and procedures developed and implemented by the provider.
Updated
2 May 2018
Alexander Residential Home is a 'care home'. People in care homes receive accommodation and personal care under a contractual agreement. CQC regulates both the premises and the care provided and both were looked at during this inspection.
Alexander Residential Home accommodates up to 49 older people and is situated in the Morley area of Leeds. Alexander Residential Home is a residential home providing accommodation for persons who require personal care, some of whom are living with dementia. At the time of our inspection, 49 people were using the service.
This inspection took place on 9 and 13 March 2018. The inspection was unannounced on the first day. This meant the staff and provider did not know we would be visiting. The second day was announced.
At the last inspection, the service was rated Good. At this inspection, we found the service remained Good.
A registered manager was 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.
We found improvements were needed to fully ensure records were accurate and completed. Audits did not always have completion dates and care plans had not all been updated after review. Some were without dates. Labelling of food within the kitchen was not always date recorded.
Medicines were managed and recorded safely. 'As required' medicines were administered accordingly and protocols were in place for care workers to follow.
Staffing levels were sufficient to meet people's needs and recruitment procedures were robust to ensure new staff were eligible to work with vulnerable people.
People told us they felt safe and care workers had a clear understanding of the procedures relating to safeguarding and whistleblowing.
Risk assessments were completed and reviewed to support people with specific needs to avoid any harm.
The provider followed The Mental Capacity Act 2005 with capacity assessments documented and best interest meetings recorded, when required. We found consent was obtained from people verbally and formally at annual review meetings.
People were supported with their health and nutritional needs and were provided with a range of food and drink.
People living in the home had positive relationships with the care workers; they told us care workers were kind and caring.
People were encouraged to be independent and make choices regarding their care. Care workers respected people's privacy and dignity.
Care plans were detailed and included people's preferences, likes and dislikes, which promoted person centred care.
Complaints had been responded to with outcomes recorded. People using the service told us they felt confident to discuss any concerns with the provider. Incidents and accidents were monitored and managed.
Surveys were provided to people, to gather their views of the service. The quality of the care provided was monitored through governance systems which highlighted where improvements were needed.
Further information is in the detailed findings below.