CQC report explained · a residential care home
What the CQC found at Alexander House - Dover
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People told inspectors they felt safe. Risks were assessed, staff had guidance to reduce them, medicines were managed safely and infection control arrangements were effective.
- Effective?
- Good
- This area was not inspected during this visit. Its previous rating was carried forward when calculating the overall rating.
- Caring?
- Good
- This area was not inspected during this visit. Its previous rating was carried forward when calculating the overall rating.
- Responsive?
- Good
- This area was not inspected during this visit. Its previous rating was carried forward when calculating the overall rating.
- Well-led?
- Good
- Inspectors found effective quality checks and an open management culture. People, relatives and staff were invited to give their views, and complaints were recorded and investigated.
What inspectors found, January 2023
Rated Good; inspectors found safe care and strong management, but this was a focused inspection covering only Safe and Well-led.
The unannounced inspection took place on 19 December 2022. One inspector spoke with people, relatives and staff, observed care, and checked care plans, medicines records, recruitment files and management records.
The home was rated Good for Safe and Well-led. Inspectors found that risks were assessed, staff were recruited safely, there were enough staff, medicines were managed safely and infection control arrangements were effective.
Inspectors also found an open management culture. People and relatives felt able to raise concerns, audits were used to identify and fix shortfalls, and people were involved in decisions about menus and activities.
This was a focused inspection because the CQC had received concerns about risk management and staffing. The overall Good rating remained unchanged from the previous inspection, published in July 2018. The other areas were not inspected during this visit and their previous ratings were carried forward.
Risk planning
The home had detailed guidance for staff on risks such as catheters, seizures, diabetes and swallowing difficulties. Staff followed specialist advice when people needed modified food.
“Potential risks to people's health and welfare had been assessed and there was guidance available for staff to mitigate the risks.” from the report
Staffing and medicines
Inspectors found safe recruitment, enough staff and suitable induction arrangements. Medicines were given as prescribed and records and storage were checked.
“People were supported by staff who had been recruited safely. There were enough staff to support people in the way they preferred. People received their medicines as prescribed.” from the report
Open management
People and relatives felt comfortable raising concerns. The home used audits and action plans to identify and address shortfalls.
“Relatives told us they were confident to raise concerns with the registered manager and they would take action.” from the report
Choice and activities
Staff offered people choices about food, drinks, activities and where they spent their time. People helped shape menus and activities, including trips out.
“People and staff had been invited to regular meetings to discuss the service and any suggestions they may have.” from the report
Inspectors raised no specific concerns in this report.
- 01What are the current ratings and evidence for Effective, Caring and Responsive, which were not assessed in this inspection?
- 02How do you currently make sure there are enough permanent or regular staff on each shift?
- 03How are individual risks, such as seizures, diabetes, catheter care and swallowing difficulties, reviewed and updated?
- 04How do you check that medicines given when required are still effective and that records remain complete?
- 05What changes have been made since the inspection following any shortfalls found through audits?
This was a focused inspection of Safe and Well-led only; the other ratings were carried forward from the previous inspection published on 14 July 2018. This explanation was written from the published report of 10 January 2023 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, July 2018
Rated Good; inspectors found kind, personalised care, but some medicines and safety records were not clear enough.
The unannounced inspection took place on 15 May 2018. Three inspectors spoke with nine people, staff and visiting professionals. They observed care, checked records and looked at how the home was run.
All five areas were rated Good: Safe, Effective, Caring, Responsive and Well-led. People were described as safe, relaxed and well supported. Staff knew people's needs, treated them respectfully and offered personalised activities and care.
The home had improved since its previous Requires Improvement rating. However, some medicines records, diabetes guidance and checks on water temperatures and fire testing were not always clear or complete. The registered manager took action during the inspection to address these issues.
Kind and respectful care
Staff knew people well and treated them with kindness, respect and equality. They supported people at their own pace and encouraged independence.
“Staff were kind and caring, they treated people with mutual respect and equality.” from the report
Personalised support
Care plans covered people's preferences, health, communication and daily support needs. Staff used this information to respond to anxiety, mobility needs and changes in health.
“Individual care plans were detailed with information about people's mobility, behaviours, how people preferred to receive their personal care, a history of falls, nutritional needs, skin care, communication, oral hygiene, and medical history.” from the report
Activities and community links
People were offered activities linked to their interests, including dancing, music and pen-friend projects. The home also involved families, schools and community groups.
“Staff found creative ways of supporting people with activities of their choice.” from the report
Improved leadership
The home had clear leadership, regular checks and action plans. Inspectors found that the service had improved since the previous inspection.
“The registered manager had clear leadership skills with an oversight of the service.” from the report
Medicine records
needs fixingPeople received their medicines safely, but records did not always clearly show stock levels, deliveries or refusals. Inspectors said this needed improvement.
“People received their medicines safely, however medicine records were not always clear to confirm this.” from the report
Written diabetes guidance
needs fixingStaff knew what to do if blood sugar levels became unstable, but care records did not always say which food or drink should be used to raise blood sugar.
“However, further detail was required in the risk assessments to give staff clear written guidance of what drink or food people might need to increase their blood sugar levels.” from the report
Some worn areas
minorSome downstairs skirting boards and door frames had flaking or worn paint. The garden was also overgrown, although work was under way.
“Some areas of the home such as the skirting boards and door frames downstairs needed attention as the paint was flaking and worn away.” from the report
- 01How are medicines records checked now, especially when medicines are refused or new stock is delivered?
- 02What written guidance is in place for people with diabetes, including the food or drink they may need if their blood sugar falls?
- 03How often are water temperatures and fire testing points checked, and how do you make sure the records are complete?
- 04Have the worn paintwork and garden improvements mentioned in the report been completed?
- 05What activities are currently available, and how are they matched to each person's interests and choices?
This was an unannounced inspection of the overall quality of the home, covering all five CQC questions; inspectors spoke with nine people and reviewed five people's care records. This explanation was written from the published report of 14 July 2018 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 House - Dover
5 rated inspections over 7 years: the service has held its Good rating throughout.
- January 2023Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2018Goodup from Requires improvementSafe: GoodWell-led: Good
- May 2017Requires improvementup from InadequateSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2016Inadequatedown from GoodSafe: InadequateEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Inadequate
- September 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- January 2014
Report published without a new overall rating.
- September 2013
Report published without a new overall rating.
- January 2013
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 19 January 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.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
39 live-in carers within about an hour of Kent
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,260 a week. 33 can care for a couple. 12 years' experience on average.
“Always on time and with a lovely smile for my mum. Theresa is kind and sensitive to my mum's needs.”
“Irene was a very kind and empathetic carer who knew just the right words to say to put a smile on my face.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.