Alexander Care Centre

Updated 8 October 2021

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 Care Act 2014.

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

This inspection was carried out by two inspectors, a specialist professional advisor, who was a registered nurse 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.

Service and service type

Alexander Care Centre is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

We spoke with 10 people using the service and three relatives. We spoke with six members of staff including the registered manager, two nurses and two care workers and the chef. We reviewed a range of records. This included 10 people’s care records. We looked at five staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at multiple medicines and quality assurance records. We spoke with one health and social care professional who regularly visits the service.

We asked the provider to share a questionnaire with the staff team to give them an opportunity to give us feedback about their experience of working for the service. We received feedback from a further 10 care workers.

We provided formal feedback to the management team on 22 July and via a video conference call on 27 July 2021.

Updated 8 October 2021

About the service

Alexander Care Centre is a residential care home. At the time of the inspection the service was providing personal and nursing to 72 people, some living with dementia or physical disabilities. The service can support up to 78 people. The accommodation was spread over three units.

People’s experience of using this service

People and their relatives gave positive comments about their experience of receiving care and the management of the service. A relative said, “Nothing is too much trouble for the staff, I have no worries about my [family member].”

People, relatives and staff praised the management team for their support, openness and transparency. Monitoring checks were completed and an action plan implemented to ensure people received good quality care. However, notification of incidents were not always reported to the Care Quality Commission as legally required.

The provider had an assessment that identified the numbers of staff required to meet people’s needs safely.

Staff had a good understanding of the provider’s safeguarding processes and knew what actions to take to report any harm and abuse.

Staff were recruited safely, they completed an induction and training to support them to provide safe and effective care and to meet the care standards.

People were supported with taking their medicines to manage their health care needs. Records used in the administration of medicines were completed accurately and reviewed to ensure they were of a good standard.

Staff assessed risks to people’s health and wellbeing and had developed plans to manage these. Staff reviewed people’s needs to ensure these were relevant and continued to meet people’s needs and reduce risks.

There were suitable measures to protect people from COVID-19, including the use of protective personal equipment (PPE), testing and vaccination. The service was clean and hygienic throughout, with enhanced cleaning of frequently touched surfaces to protect people from cross infection. The service had a designated infection prevention and control (IPC) lead who had been trained and was knowledgeable about the current guidance. The service’s IPC and COVID-19 policies were up to date. Managers contacted their local health protection team in a timely way when they suspected a COVID-19 outbreak.

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.

Rating at last inspection

The last rating for this service was requires improvement (published 25 April 2019).

Why we inspected

We received concerns in relation to the management of risks, quality of care records, recruitment and staff support. As a result, we undertook a focused inspection to review the key questions of safe, effective and well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

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.

The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection. However, well-led has remained requires improvement due to the failure to send CQC notification of incidents as required. Please see the Safe, Effective and Well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Alexander Care Centre on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.