CQC report explained · a nursing home
What the CQC found at Alexandra House - Harlow
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People told inspectors they felt safe. Risks and incidents were recorded and reviewed, medicines were managed safely, and inspectors observed staff responding to requests and call bells.
- Effective?
- Good
- People's physical, emotional, cultural, spiritual and social needs were assessed. Staff had training and supervision, and healthcare professionals were involved when needed.
- Caring?
- Good
- Staff treated people with dignity, kindness and respect. People and relatives were involved in decisions about care, and care records included information about protected characteristics.
- Responsive?
- Good
- Care plans reflected people's interests, beliefs, backgrounds and preferences. Activities had increased, communication needs were recorded, and complaints were investigated.
- Well-led?
- Good
- The manager and senior staff provided clearer oversight, with deputy managers on each floor and a clinical lead on the nursing floor. Audits were used to track and complete actions.
What inspectors found, July 2023
Alexandra House - Harlow was rated Good overall; inspectors found kind, organised care, with minor concerns about the kitchen, meals and staffing feedback.
Inspectors visited on 13, 16 and 23 June 2023 without giving advance notice. They spoke with people living there, relatives, staff and healthcare professionals. They also reviewed care plans, medicines records, staff files and management records.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found people felt safe, medicines were managed safely, staffing met people's needs, and risks were assessed and reviewed.
People were treated with kindness and respect. Their care plans included their health needs, preferences, communication needs and personal backgrounds. There were more activities, people could see relatives freely, and complaints were recorded and investigated.
Inspectors found some minor issues with food storage, modified diets, breakfast orders and medicines paperwork. The manager took action during the inspection. The previous Requires Improvement rating from 2020 had improved, and the home was no longer in breach of regulations.
People felt safe
People said they felt safe, and inspectors saw staff respond to requests, answer call bells and check people during the visits.
“Throughout the inspection we observed staff responding to people's requests, answering call bells, and checking people throughout our visit.” from the report
Staff training
Staff said their induction, practical training and clinical updates helped them carry out their roles.
“Staff told us they felt equipped to carry out their role as the induction and training was effective.” from the report
Kind and respectful care
Inspectors saw staff communicate warmly, respect privacy and support people to make choices and remain as independent as possible.
“Staff greeted people warmly, made eye contact when talking to people and used positive touch to connect with, or reassure people throughout the day.” from the report
Activities and personal interests
The home had increased activity staff and offered a range of activities, while also asking people what they wanted to do.
“We have an activity plan, but we also ask residents what they would like to do. We have residents meeting every month” from the report
Stronger management checks
There were clearer leadership arrangements and audits tracked actions until they were completed.
“A series of audits were carried out and any required actions were incorporated into an online system so any actions could be monitored to ensure they were completed.” from the report
Kitchen and modified diets
needs fixingInspectors found concerns about food storage and the provision of modified diets. The manager had already started extra training, checks and other actions.
“During the inspection we identified some concerns with the main kitchen in relation to storage of food and provision of modified diets.” from the report
Breakfast orders
minorTwo people said breakfast items they ordered did not always arrive, and they were not always told why. The manager was monitoring this.
“However, 2 people said sometimes items they ordered for breakfast did not always arrive and whilst they received a breakfast, they were not always told why their ordered items had not arrived.” from the report
Minor medicines paperwork
minorSome as-required medicines were not recorded on consistent forms and the medicines room needed better organisation. These points were completed by the second day of inspection.
“These included as required medicines (PRN) being completed on consistent forms and some organisation of the medicines room.” from the report
- 01What extra checks are now in place for food storage and modified diets?
- 02How do you make sure each person's modified diet is provided correctly?
- 03How do you check that breakfast choices arrive, and explain promptly when an item is unavailable?
- 04What is the current staffing level on the nursing floor, especially at busy times and weekends?
- 05How do you monitor as-required medicines paperwork and the organisation of the medicines room?
This was an unannounced inspection covering all five CQC questions, including infection prevention and control; the report says the ratings improved from the previous inspection in several areas. This explanation was written from the published report of 15 July 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, September 2020
Alexandra House - Harlow was rated Requires Improvement; inspectors found staffing pressures, limited activities and weak quality checks.
This was an unannounced inspection carried out on 29 July, 3 August and 4 August 2020. Inspectors spoke with people living there, relatives and staff. They observed care and checked care, medicines, staffing, infection control and quality records.
The home was rated Requires Improvement overall. Safe and Well-led were both rated Requires Improvement. People told inspectors they felt safe, medicines were managed safely, and the home was clean. However, staff said there were not enough of them to help some people get up when they wanted or spend meaningful time with them.
The home had not made enough improvement since the previous inspection. It remained in breach of the rules on person-centred care and good governance. A new manager had been appointed, and the provider took immediate action to increase activity hours.
People felt safe
People told inspectors they felt safe living at the home and with the staff supporting them.
“People told us they felt safe living at the service and with the staff who supported them.” from the report
Medicines were managed safely
Inspectors saw staff giving medicines safely. Records and instructions for medicines given when needed were also described as good.
“The service maintained a good standard of recording in relation to people's medicines and protocols were available to direct staff around the administration of medicines prescribed on a when required basis.” from the report
Infection control
The home was clean, staff had infection control training, and additional measures had been introduced during the pandemic.
“The service was clean and there were systems in place to manage infection control.” from the report
Improved risk records
The new electronic care planning system made risk information more detailed than at the previous inspection.
“At this inspection we found some improvements had been made to record keeping as an electronic care planning system had been introduced and care plans were more detailed in relation to risk.” from the report
Staff teamwork
Despite concerns about staffing, staff described working well together and being positive about their colleagues.
“We have good teamwork here. I've been here for a year and I could say the staff are really good and we work well together.” from the report
Staffing pressures
seriousStaff said there were not enough people to meet residents' preferences. This meant some people, particularly on the nursing floor, could not always get up when they wanted.
“There were enough staff to provide basic care, but limited time was available to engage with people in a meaningful way.” from the report
Limited activities and personal choice
seriousPeople did not always have access to meaningful activities, and care plans did not always clearly record people's preferences about how they wanted to spend their day.
“Not enough progress had been made and the provider remains in breach of regulation 9 HSCA RA Regulations 2014 Person centred care.” from the report
Weak quality checks
seriousThe home's monitoring systems did not identify the staffing and other shortfalls found by inspectors. This was a continued breach of the good governance regulation.
“Systems to monitor the quality and safety of the service provided were not always effective in identifying shortfalls or driving improvements.” from the report
Visitor protocol not followed promptly
needs fixingWhen inspectors arrived early, they were not asked to complete the new infection control visitor protocol until senior staff arrived.
“However when we arrived at 6am, we were not asked to complete this until the Deputy manager came in later.” from the report
Mixed communication
needs fixingRelatives gave different views about communication from the home. One relative described management communication as poor.
“The carers are good the problem is with the management and the poor communication.” from the report
- 01What staffing levels are now in place, especially on the nursing floor, and how do you make sure people can get up when they want?
- 02How do you record and review each person's preferences about getting up, meals and how they spend their day?
- 03What meaningful activities are available now, and how do you make sure all residents can take part?
- 04What changes have been made to the quality checks so staffing and person-centred care problems are identified quickly?
- 05How are visitor infection control checks carried out consistently, including for early arrivals?
This was a focused inspection of Safe and Well-led, initially prompted by local authority safeguarding and staffing concerns; the other three questions were not assessed and were not rated in this report. This explanation was written from the published report of 5 September 2020 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 Alexandra House - Harlow
5 rated inspections over 8 years: the service has improved, from Requires improvement to Good.
- July 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2020Requires improvementstayed Requires improvementSafe: Requires improvementWell-led: Requires improvement
- May 2019Requires improvementdown from GoodSafe: Requires improvementEffective: GoodCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- June 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2015Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- January 2014
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- November 2011
Report published without a new overall rating.
- July 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 16 December 2010.
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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