Archived: Alexander Court Care Centre

Updated 20 October 2015

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.

We visited the service unannounced on 28, 29 May and 5 June. On the first day of our visit the inspection team consisted of two inspectors and an expert by experience who is a person who has personal experience of using or caring for someone who uses this type of service. We were also accompanied by three specialist advisors. A specialist advisor is a person who has professional experience in caring for people who use this type of care service. On the second and third day an inspector visited the service accompanied by a specialist advisor.

During our inspection we spoke with 25 people who lived in the service, five relatives, the chef, three domestic staff, eight care staff, two activities co-ordinators, six nurses, an administrator, the handyman, business director, regional manager, deputy manager and the registered manager of the service. We also spoke with the three health care professionals who were visiting people using the service during our inspection.

We used the Short Observational Framework for inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk to us.

Before the inspection we reviewed the information we held about the service. We reviewed notifications of incidents that the provider had sent us since the last inspection. We contacted the local commissioning team for the service to obtain their views about it.

We asked the provider to complete a Provider Information Return (PIR) before the inspection. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

We observed care and support in communal areas, spoke with people in private, and looked at care records for 20 people. We also looked at records that related to how the service is managed including training records, staff files, quality assurance records, policies, staff duty rotas and maintenance records.

Updated 20 October 2015

This was an unannounced inspection, carried out over three days on 28, 29 May and 5 June 2015. At the previous inspection of this service in April 2014 the provider was not meeting the legal requirement in relation to safety and suitability of premises, care and welfare of people, safeguarding people from abuse, infection control, nutritional needs, and respecting and involving people.

Alexander court care Centre provides 24 hour care, including personal care for up to 82 older people. This includes nursing care for people with dementia and those with physical needs. The service is a large purpose built property. The accommodation is arranged across five units over three levels. There are three units for people living with dementia and one unit for young people with physical disabilities, all providing nursing care. There is also a residential unit for older people. There were 70 people living at the service at the time of our inspection. During our last inspection of Alexander Court Care Centre on 28 April 2014 we found six breaches of regulations. The provider was not meeting the legal requirements in relation to cleanliness and infection control, safeguarding people from abuse, safety and suitability of the premises, respecting and involving people, meeting nutritional needs and care and welfare of people using the service.

People were not kept safe at the service. There were poor arrangements for the infection control and we had concerns about the safety and suitability of the premises. There were not enough staff available to meet people’s needs.

The service had a safeguarding procedure in place and staff were aware of their responsibility with regard to safeguarding adults.

People received nutrition which was compatible with their specific dietary requirements.

Staff received regular supervision or appraisals and there was a clear line management structure for staff. Training records showed that some staff had not received up to date mandatory training.

Senior staff demonstrated they had an awareness of the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards, which meant they could support people to make choices and decisions where people did not have capacity.

People told us they did not always feel cared for by some staff. The staff knew peoples likes and dislikes. We saw staff speaking with people in a way that promoted their independence.

Some people told us they did not feel there were enough activities at the home. The service had two activities co-ordinators who provided support with activities during weekdays. There was no weekend activity program.

Each person had a care plan which set out their individual and assessed needs. However some preferences were not always evident. People had access to health care professionals. People had opportunities to attend residents meetings.

The service was not always well led. During the inspection we identified failings in a number of areas. These included managing risks, infection control, safety and suitability of premises, staffing levels and training. Records relating to peoples care were not always fully completed.

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