CQC report explained · a nursing home
What the CQC found at Alexander Care Centre
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Inspectors found enough staff, safer recruitment, accurate medicines records and effective risk assessments. Infection control measures were also in place, although cleaning records for mattresses and frequently touched areas were not completed at weekends.
- Effective?
- Good
- Staff had induction, training, supervision and appraisal arrangements. People were supported with healthcare, eating and drinking, consent and their individual needs.
- Caring?
- Good
- This area was not inspected during this focused visit. The report says there were no concerns identified in the information held about the service, so the previous rating was used in the overall rating.
- Responsive?
- Good
- This area was not inspected during this focused visit. The report says there were no concerns identified in the information held about the service, so the previous rating was used in the overall rating.
- Well-led?
- Requires improvement
- Management checks, care records and action planning had improved. However, one safeguarding incident was not reported to CQC or the local authority safeguarding team as legally required.
What inspectors found, October 2021
Rated Good overall; inspectors found safe and effective care, but the home was Requires Improvement for leadership because an incident was not reported to CQC.
This was an unannounced focused inspection on 22 July and 3 August 2021. Inspectors looked at Safe, Effective and Well-led. They spoke with people, relatives, staff and a health professional, and reviewed care records, staff files, medicines and management records.
The home was rated Good for Safe and Effective. Inspectors found enough staff, safer recruitment, accurate medicines records, suitable risk plans and good infection control. Staff were trained and supported, and people received help with their health, food, drink and choices.
Well-led remained Requires Improvement. Most incidents were reported, but one safeguarding incident was not reported to CQC or the local authority safeguarding team as required. The overall rating improved from Requires Improvement at the previous inspection to Good, although Caring and Responsive were not inspected during this visit.
Safe staffing and recruitment
The home assessed staffing levels and completed key checks before staff started work. Inspectors found enough improvement in recruitment procedures since the previous inspection.
“The provider had an effective recruitment process for the employment of suitable staff.” from the report
Medicines managed safely
Medicines were stored securely and administration records were accurate. Staff administering medicines had training and regular competency checks.
“Medicines were managed consistently and safely in line with national guidance.” from the report
Risks assessed
People had individual plans for risks such as moving safely and choking. These plans were reviewed and gave staff clear guidance.
“Risks to people were assessed, reviewed and monitored effectively.” from the report
Infection control
Inspectors found suitable measures for COVID-19 prevention, including PPE, testing, vaccination, cleaning and outbreak arrangements.
“The service was clean and hygienic throughout, with enhanced cleaning of frequently touched surfaces to protect people from cross infection.” from the report
Improved management systems
Audits, care record checks and action plans had improved since the previous inspection. Staff and relatives described the management as approachable and supportive.
“Since our last inspection, the monitoring systems had improved.” from the report
Incident not reported
needs fixingOne safeguarding incident was not reported to CQC or the local authority safeguarding team as required. CQC was considering whether to take action.
“we found one safeguarding incident that was not report to CQC or the local authority safeguarding team.” from the report
Weekend cleaning records
minorRecords showing cleaning of mattresses and frequently touched areas were not completed at weekends. The provider was signposted to resources to improve this.
“these charts were not completed on the weekend.” from the report
- 01What changes have you made to ensure every safeguarding incident is reported to CQC and the local authority when required?
- 02How do managers check that cleaning records for mattresses and frequently touched areas are completed at weekends?
- 03What actions from the current management action plan are still outstanding?
- 04How do you check that staffing levels continue to meet each person's needs on every shift?
- 05How are medicines audits and staff competency checks kept up to date?
This was a focused inspection of Safe, Effective and Well-led; Caring and Responsive were not inspected and their previous ratings were used in calculating the overall rating. This explanation was written from the published report of 8 October 2021 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, April 2019
Rated Requires Improvement; inspectors found kind, responsive care but serious fire safety, recruitment and management weaknesses.
This was an unannounced inspection over three days. Inspectors observed care, spoke with people, relatives, staff and health professionals, and reviewed care records, medicines records, recruitment files and management information.
People were treated kindly and with respect. Care plans were generally person-centred, activities reflected people's interests, and people had enough food and drink. Staff supported people with healthcare, religious practices and end of life care.
However, the home was not consistently safe or well managed. Fire safety risks had not been dealt with, recruitment checks were incomplete, some safeguarding concerns were not reported promptly, and records and quality checks were not always reliable.
The overall rating was Requires Improvement. Safe, Effective and Well-led were rated Requires Improvement, while Caring and Responsive were rated Good. The report says the provider breached four regulations and was required to send CQC an action plan.
Kind and respectful care
People said staff were caring and compassionate. Inspectors saw calm, friendly and respectful interactions, with privacy and dignity maintained.
“People said staff were caring and compassionate. The interactions between staff and people were friendly and respectful.” from the report
Person-centred care
People and relatives contributed to care plans. Plans recorded people's preferences and were reviewed when needs changed.
“Assessments were person centred because people were involved and contributed to them.” from the report
Activities and personal interests
People took part in music, games, performances and other activities, or could choose to spend time alone. Cultural and religious needs were also supported.
“People were encouraged to take part in activities and we saw people were involved in a variety of activities.” from the report
Food and healthcare
People had enough to eat and drink, with choices and specialist support where needed. Staff contacted healthcare professionals when people's needs changed.
“People had access to specialist support when required.” from the report
Fire safety
seriousThe report identified several fire safety problems, including blocked or unsecured fire doors, gaps in fire compartments and delays in the process for calling the fire service. Inspectors said this created a potential risk to people's health and wellbeing.
“The conclusion was that the fire safety at the home was inadequate, not suitable or sufficient.” from the report
Recruitment checks
seriousSome staff started work before required checks or references had been completed. This increased the risk that unsuitable staff could be employed.
“This meant that there was a risk that unsuitable staff were employed at the service providing care and support to people.” from the report
Staffing and staff support
needs fixingPeople and relatives reported lower staffing at weekends. Many staff had not received appraisals, and some mandatory training was overdue.
“45 out of 54 members of staff did not have an appraisal in 2018” from the report
Records and quality checks
needs fixingAudits and improvement plans did not consistently identify or resolve problems. Some care, food intake and repositioning records were incomplete or inaccurate.
“We found that the quality audits did not find all the concerns we found.” from the report
Safeguarding reporting
seriousStaff understood safeguarding processes, but allegations were not always reported to the local authority promptly and some safeguarding training was overdue.
“Staff did not always report allegations of abuse promptly.” from the report
- 01What has been done to fix the fire safety problems, including the fire doors, emergency lighting and gaps in walls and ceilings?
- 02Are all current staff now working only after the required DBS checks and employment references have been completed?
- 03How many staff are normally on duty at weekends, and how is cover arranged when staff are absent?
- 04How many staff now have up-to-date safeguarding and infection control training, regular supervision and appraisals?
- 05Who is managing the home now, and how are outstanding actions from the inspection being checked and completed?
This was an unannounced inspection of all five key questions, covering care, accommodation, records, staffing, medicines and how the home was managed. This explanation was written from the published report of 25 April 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Alexander Care Centre
6 rated inspections over 7 years: the service has held its Good rating throughout.
- October 2021Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- April 2019Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- July 2017Goodstayed GoodSafe: Good
- July 2016Goodstayed GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2016Goodstayed GoodSafe: Requires improvement
- January 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2013
Report published without a new overall rating.
- December 2012
Report published without a new overall rating.
- October 2011
Registered with the Care Quality Commission on 31 October 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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