CQC report explained · a residential care home
What the CQC found at Alexander Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm. Medicines, infection control, equipment and risk assessments were generally managed safely, but inspectors recommended reviewing staffing levels and deployment.
- Effective?
- Good
- People's care needs were assessed and staff had training and support. Staff worked with healthcare professionals, and this rating improved from Requires Improvement at the previous inspection.
- Caring?
- Good
- People said staff were kind and caring. Inspectors saw staff respecting people's privacy, dignity, choices and independence.
- Responsive?
- Good
- Care plans were detailed and personalised, and complaints were investigated. Some people said they were bored and wanted more activities.
- Well-led?
- Good
- People, relatives and staff said the home was well run. The manager carried out checks, listened to concerns and used feedback to identify improvements.
What inspectors found, August 2019
Rated Good; inspectors found kind, effective care, but staffing levels and activities needed review.
Inspectors visited on 15 and 17 July 2019. The first day was unannounced. They reviewed care records, staff files, training records, policies and quality checks. They spoke with five people, six relatives and 10 staff members, and observed care.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. People and relatives generally said they felt safe and well cared for. Staff were described as kind, respectful and supportive, and care plans were detailed and regularly updated.
Inspectors found some people waited for staff and communal areas were sometimes left without supervision. Some people also said they were bored and wanted more activities. The manager was asked to keep staffing levels under review and had already taken action to improve access to call bells.
Kind and respectful care
People spoke positively about staff. Inspectors saw staff respecting privacy, dignity and people's choices.
“People told us staff were kind and caring.” from the report
Detailed care planning
Care plans covered physical and emotional needs, preferences and advice from healthcare professionals. They were reviewed and updated.
“Care plans were very detailed and covered a wide variety needs including physical and emotional health needs.” from the report
Safe medicines and infection control
The home had systems for medicines and responded to issues found in audits. Infection control practices were rated positively, and laundry improvements had been completed.
“People were being safely supported to take their medicine as required.” from the report
Improving management
The manager and senior staff had clear responsibilities and carried out audits. People and relatives said the home had improved since the manager started.
“People and their relatives told us the home had improved since the registered manager had started working there.” from the report
Staffing and supervision
needs fixingStaff and visitors had mixed views about staffing. On the first day, communal areas were sometimes left unattended and people could wait for support.
“We recommend that the registered manager continue to review staffing levels to ensure sufficient staff are deployed throughout the home and available to support people when and where required.” from the report
Limited activities
needs fixingSome people said they were bored and wanted more activities and opportunities to go out. The manager accepted that activities needed to be more readily accessible.
“People told us they would like more to do throughout the week and that they felt bored.” from the report
End of life training not completed
needs fixingStaff had started end of life care training, but it was incomplete because of changes in the home. The manager said this was an area they hoped to develop.
“Staff told us that they had begun training to provide end of life care, but this had not been completed due to changes within the home.” from the report
- 01How many staff are deployed at different times of day, and how do you make sure communal areas are supervised?
- 02How long might people wait for help with food, drink or using the toilet?
- 03What activities are now available during the week, including one-to-one activities and opportunities to go out?
- 04Has end of life care training now been completed, and what support can the home provide?
- 05What changes were made after inspectors found that call bells in communal areas were not always accessible or visible?
This was a planned inspection covering all five CQC questions; the previous rating was Good overall, with Effective previously rated Requires Improvement. This explanation was written from the published report of 8 August 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.
What inspectors found, February 2017
Rated Good overall; inspectors found kind, safe care, but improvements were needed in staff understanding of consent and some parts of the building.
This was an unannounced comprehensive inspection. Inspectors visited over two days, spoke with people living in the home, visitors and staff, and reviewed care records, medicines records, staff files, training records and quality checks. They also observed care and used a specialist observation method for people who could not easily describe their experiences.
The home was rated Good overall and was rated Good for Safe, Caring, Responsive and Well-led. People generally felt safe and well cared for. Inspectors saw kind and respectful staff, detailed care plans, suitable activities, safe medicines systems and regular checks on quality.
Effective was rated Requires Improvement. Most staff did not fully understand their legal responsibilities under the Mental Capacity Act and Deprivation of Liberty Safeguards. Some decoration and repairs were also unfinished, and people gave mixed views about the food.
The home had improved since the November 2015 inspection and had met the previous required action. The report made a recommendation for better staff training on consent and people's rights. It did not report a breach of regulations or special measures.
Kind and respectful care
People and visitors spoke warmly about the staff. Inspectors saw staff being patient, sensitive and respectful, including when supporting people who could not communicate using words.
“We observed staff interactions that were polite, kind, patient and sensitive.” from the report
Detailed care planning
Care records described people's routines, preferences, life histories and risks. They were reviewed and changed when people's needs changed.
“We found they were detailed; person centred and also included information about people's daily living skills, routines and preferences.” from the report
Activities and individual support
The home offered activities in the home and community, as well as one-to-one activities for people who did not want to join group sessions.
“Individual activities were also offered to people who didn't want to join in group activities.” from the report
Good health and safety systems
Inspectors found arrangements for safe recruitment, safeguarding, medicines, risk management, fire safety and infection control. Health professionals were contacted when needed.
“We found that people were receiving their medicines as prescribed.” from the report
Regular management checks
The home used weekly, monthly and annual checks to review areas such as medicines, accidents, complaints, training and care records.
“We found there were good systems of weekly, monthly and annual quality assurance check and audits.” from the report
Unfinished repairs and decoration
needs fixingSome parts of the home still needed work. Inspectors found peeling paint and wallpaper, stained carpet and ripped laundry-room flooring that left the surface underneath exposed.
“In the entrance hall and stairway there were two areas where paint was peeling from the ceiling, missing or peeling wallpaper had not been replaced in the lounge and flooring in the laundry was ripped leaving the floor underneath exposed.” from the report
Mixed views about food
needs fixingSome people said the food was good, but others found it inconsistent or unappealing. There was not always a suitable evening choice for people needing a soft diet.
“We noted that there was not always a suitable choice of evening meal for those people who needed a soft diet.” from the report
Night-time waiting
minorSome people said they sometimes waited longer for help at night because fewer staff were on duty. Inspectors did not see delays during their visit.
“Some people said that on occasions they had to wait longer at night time as there were less staff on duty.” from the report
- 01What training have staff completed on the Mental Capacity Act and Deprivation of Liberty Safeguards, and how do you check that they understand their legal responsibilities?
- 02Were the promised repairs and refurbishment completed by May 2017, including the lounge wallpaper, entrance hall and stairway ceilings, and laundry flooring?
- 03How many staff are normally on duty at night, and how do you respond when people need help or staff are absent?
- 04What changes were made to the menu after the mixed feedback about food, especially for people who need a soft diet?
- 05How are my relative and our family involved in reviewing their care plan and risk assessments?
This was an unannounced comprehensive inspection covering all five question areas; the report says improvements required at the previous inspection had been made. This explanation was written from the published report of 1 February 2017 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 Home
3 rated inspections over 4 years: the service has improved, from Requires improvement to Good.
- August 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2017Goodup from Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- January 2016Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- April 2015Inspected but not ratedSafe: Inspected but not ratedWell-led: Inspected but not rated
- January 2015
Registered with the Care Quality Commission on 16 January 2015.
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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