CQC report explained · a residential care home
What the CQC found at 13 Alexandra Gardens
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, August 2019
Elysium Care Partnerships Limited - 13 Alexandra Gardens was rated Outstanding; inspectors found exceptional care, support and leadership, with safe care rated Good.
The inspection was unannounced and took place on 29 and 30 May 2019. One inspector spoke with people living at the home, staff, relatives and healthcare professionals. They also reviewed care plans, medicines records, staff files and management records.
The home supported up to 12 people with learning disabilities or autism. Inspectors found care was highly personalised. Staff supported people to communicate, make choices, build independence, enjoy activities and access healthcare. The home worked closely with families and other professionals.
The overall rating was Outstanding. Effective, caring, responsive and well-led were all Outstanding. Safe was rated Good, down from Outstanding at the previous inspection because there had been two medicines errors involving the same person, although new safety measures had been introduced.
Personalised communication
Staff used different methods, including pictures, objects, signing, music and easy-read information, so people could understand what was happening and make choices.
“The service highlighted the use of 'total communication' which involved using body language, objects of reference, symbols, Makaton (a form of signing) and words to communicate.” from the report
Learning from incidents
The home analysed incidents carefully and changed support plans and the environment to reduce triggers. This led to a major reduction in incidents for some people.
“For example, one person had up to 83 incidents a month of behaviour that challenged and recently had several months in a row with no incidents.” from the report
Activities and community life
Activities were varied and matched to people's interests and abilities. People took part in community projects, holidays, sport and other activities.
“There was an exceptionally varied range of activities that was tailored to the people using the service.” from the report
Strong leadership
The home had an open culture, regular meetings and effective systems for checking and improving care. Staff worked closely with specialist professionals.
“The provider had a strong ethos and culture of delivering quality care and support to people.” from the report
Medicines errors
needs fixingTwo medicines errors involving the same person happened within one week after the previous inspection. The home introduced new procedures, including two staff checking medicines and daily audits.
“Since the last inspection, there had been two medicines errors associated with the same person within a week.” from the report
Larger than current guidance
minorThe home was registered for 12 people and inspectors said it was larger than current best practice guidance. They found that the building design and local setting reduced the possible negative impact.
“This is a larger care service than current best practice guidance.” from the report
- 01What changes were made after the two medicines errors, and how are daily medicines audits checked now?
- 02How would staff support my relative to communicate choices if they cannot communicate verbally?
- 03How does the home manage the larger size of the service so people still have privacy, quiet space and individual support?
- 04How are positive behaviour support plans reviewed when a person's needs or behaviour changes?
- 05How would my relative be supported to build independence through activities such as shopping, cooking or using the community?
This was an unannounced inspection covering all five CQC questions, with the home, care, records, staff and management systems examined. This explanation was written from the published report of 22 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. The report was longer than we could read in one go; the later sections may not be reflected.
What inspectors found, November 2016
Rated Outstanding; inspectors found exceptionally safe, caring and personalised support for young adults with learning disabilities and autism.
Inspectors visited on 4 and 6 October 2016. The first visit was unannounced. They observed care, spoke with people, relatives, staff and health professionals, and checked care records, medicines, training, safety records and the building.
The home supported 12 young adults with learning disabilities, autism and other needs. Inspectors found that people were safe, happy and treated with respect. Staff understood each person's communication, sensory needs and preferences, and helped people try new activities, gain independence and access college or community facilities.
Inspectors found strong staffing, training, healthcare support and management systems. They saw a major reduction in incidents of aggression and found no physical restraint or seclusion at the home. The home was rated Outstanding in all five areas: safe, effective, caring, responsive and well-led.
This was the first inspection since the home was registered on 14 August 2015. Outstanding is the highest CQC rating. It means inspectors judged the care to be exceptionally good at the time of this inspection.
Personalised support
Staff adapted care to each person's communication, sensory needs, preferences and changing abilities. This included individual flats and support plans designed around how each person wanted to live.
“This meant that each person had a bespoke service which developed with them and changed to reflect the changes taking place in their lives, confidence and abilities.” from the report
Safer support without restraint
Staff looked for the causes of anxiety or distress and changed their approach to prevent incidents. Inspectors found that aggression had become rare and that there was no physical restraint or seclusion.
“The techniques they had introduced, which included anticipating these incidents and changing the way they were supporting the person to prevent these incidents from happening, had resulted in a significant decrease of violent or physical aggression.” from the report
Kind and respectful care
People were treated with dignity and privacy. Staff used different ways to understand people who could not communicate verbally and responded to small signs of distress or preference.
“We saw the staff treat people with dignity and respect at all times, but in a very natural and person centred way.” from the report
Positive life changes
Inspectors found clear improvements in people's lives since the home opened. People were trying new things, developing skills, accessing education and community activities, and becoming more independent.
“There had been positive changes for these young adults in the year since the service opened which could be measured and evidenced through their personal achievements, their happiness and the fact they were able to try new things and have new experiences.” from the report
Skilled staff and healthcare support
Training was linked to the needs of the people living there and was provided with input from professionals who knew them. Staff worked closely with health specialists to monitor and respond to changes in health.
“The staff had exceptional skills and the ability to recognise when people felt unsafe.” from the report
Inspectors raised no specific concerns in this report.
- 01How would you assess and support my relative's individual communication and sensory needs?
- 02How would staffing be arranged if my relative wanted a late activity, day trip or holiday?
- 03How do you try to prevent distress or aggression, and how do you record and review what happened afterwards?
- 04Which healthcare professionals would be involved in my relative's care, and how would changes in their health be identified?
- 05How would my relative be involved in decisions about their care, activities, food and daily routines?
This was the first comprehensive inspection of the home and covered all five CQC areas: Safe, Effective, Caring, Responsive and Well-led. This explanation was written from the published report of 23 November 2016 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. The report was longer than we could read in one go; the later sections may not be reflected.
Every inspection of 13 Alexandra Gardens
2 rated inspections over 3 years: the service has held its Outstanding rating throughout.
- August 2019Outstandingcurrent ratingstayed OutstandingSafe: GoodEffective: OutstandingCaring: OutstandingResponsive: OutstandingWell-led: Outstanding
- November 2016OutstandingSafe: OutstandingEffective: OutstandingCaring: OutstandingResponsive: OutstandingWell-led: Outstanding
- August 2015
Registered with the Care Quality Commission on 14 August 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.
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
At least 100 live-in carers within about an hour of Hounslow
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 £1,270 a week. 85 can care for a couple. 11 years' experience on average.
“Without his support we wouldn't have been able to navigate bringing and keeping Dad at home.”
“I can truly say that Peter always put Dad at the centre of everything and I know that they found a great friendship in difficult times.”
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.