Archived: Alexandra Lodge Care Centre

Updated 22 September 2022

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

The inspection team consisted of two inspectors and one medicines inspector.

Service and service type

Alexandra Lodge 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 used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We sought feedback from the local authority. We reviewed the information we had received from the service, such as notifications, since the last inspection. We used all of this information to plan our inspection.

During the inspection

We spoke to 10 people who worked at the service including the registered manager, senior carer, carers, the cook, activities coordinator, registered nurse and the clinical lead. We spoke to four people using the service. We also 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.

We spoke with the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed five care plans, three staff files and the medication administration records of 14 people living at the home. We also reviewed records relating to health and safety and training.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at additional training information and information relating to updates to the service submitted by the registered manager.

Updated 22 September 2022

About the service

Alexandra Lodge Care Centre is a care home registered to provide accommodation with nursing and personal care. The home can accommodate up to 38 people in a large, adapted house. At the time of our inspection there were 34 people living at the service.

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

Following our last inspection, the provider has made improvements around managing medicines safely. However, we continued to identify concerns in this area. For example, there were occasions where people did not receive their medications as they were out of stock. There was a lack of guidance around supporting people with diabetes.

Necessary improvements to the environment had not been completed in a timely way. The home requires further refurbishment works, due to the wear of some of the carpets and the water damage caused by leaks.

There were appropriate risk assessments in place for people using the service. People were supported to eat and drink in line with their abilities. Staff received appropriate training to meet the needs of the people living at the home.

Staff knew people well. We observed kind and caring exchanges between staff and people living at Alexandra Lodge Care Centre. People gave positive feedback about staff at the home. People were supported with dignity and respect.

Staff regularly engaged people in activities which they enjoyed. Staff supported people in activities, within groups and on a one to one basis. People knew how to make a complaint and any complaints received were appropriately responded to by the registered manager. Person centred care plans had been developed for people living at the service. Care plans included people’s preferences relating to their care, food and activities they engaged in. Staff knew people well and were able to communicate effectively with people.

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. The registered manager maintained an accurate log of people who had a deprivation of liberties safeguarding in place.

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 of this service was requires improvement (published 5 August 2021) and there were breaches of the regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection, although some improvements had been made, the provider remained in breach of regulation. This service has been rated requires improvement on the last three consecutive inspections under this provider.

Why we inspected

This inspection was carried out in response to the concerns previously identified and to review if improvements had been made, to assist with capacity in the local area. We also followed up on action we told the provider to take at the last inspection. Following the previous focused inspection, this comprehensive inspection was carried out to see if there had been an improvement to change the overall rating of the service.

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. This included checking the provider was meeting COVID-19 vaccination requirements.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in safe care and treatment and good governance. Please see the action we have told the provider to take at the end of this report. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good.We will request an action plan from the provider to understand what they will do to improve the service.

We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.