Alexandra House

Updated 7 March 2023

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 inspection was carried out by 1 inspector and 1 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

Alexandra House 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 House 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 not a registered manager in post. A new manager had been in post for one week and planned to submit an application to register.

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. 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 used all this information to plan our inspection.

During the inspection

We spoke with 13 people and 7 relatives about their experience of the care provided. We spoke with 13 members of staff including the area manager, manager, former manager, 8 support workers including 2 senior support workers, 1 housekeeper and 1 domestic staff member.

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 with us.

We reviewed a range of records. This included 4 people’s care records and multiple medicine records. We looked at 4 staff files in relation to recruitment and staff training. A variety of records relating to the management of the service, including training information, policies and procedures and quality assurance documents were reviewed.

Updated 7 March 2023

About the service

Alexandra House is a residential care home providing accommodation and personal care to up to 40 older people, including people who may live with dementia or a dementia related condition. At the time of our inspection there were 40 people using the service.

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

At our last inspection the provider had failed to ensure robust systems were in place to ensure people received safe care and treatment, including management of their medicines.

At this inspection improvements had been made and the provider was no longer in breach of legal requirements.

There was a welcoming, cheerful and friendly atmosphere at the service. A relative told us, “I’m so happy [Name] is here. It is free and easy here, people are well- presented, own choice how they dress, I value that. Staff do encourage choice and they sit and chat with people” and “Staff are lovely.” Staff spoke positively about working at the home and the people they cared for. They said communication was effective to ensure they were kept up-to-date about any changes in people’s care and support needs.

People's diversity as unique individuals with their own needs was respected by staff. The staff team knew people well and provided support discreetly and with compassion. People and relatives were positive about the caring nature of staff and had good relationships with them. They trusted the staff who supported them. People said they felt safe with staff support. A person commented, “I feel safe here. It’s friendly and staff are around.”

There were enough staff to support people safely and effectively. A relative commented, “There are plenty of staff. They are very active with the people, walking round with them.” Staff had received safeguarding training and were clear on how and when to raise their concerns. Where appropriate, actions were taken to keep people safe.

Staff followed effective processes to assess and provide the support people needed to take their medicines safely. Staff contacted health professionals when people’s health needs changed. Staff followed good infection control practices and the home was clean and well maintained. A person commented, “The place is immaculate and clean.”

There were systems to assess the quality of the service, which were closely monitored. Improvements were made as a result of analysis of any accidents, incidents and feedback to ensure people received safe and person-centred care.

Processes were in place to manage and respond to complaints and concerns. A relative told us, "You can ask them [staff] anything, they listen to you” and “If you have any complaints you can tell staff." People, relatives and staff gave us positive feedback and told us they had opportunity to comment on 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 and update

The last rating for this service was requires improvement (published 7 April 2022) and there was a breach of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We carried out an unannounced inspection of this service on 3 February 2022. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

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 changed from requires improvement to good. This is based on the findings at this inspection.

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

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.