CQC report explained · a residential care home
What the CQC found at Keychange Charity Alexander House Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, October 2023
Keychange Charity Alexander House Care Home is rated Good overall, but inspectors rated well-led Requires Improvement.
Inspectors visited on 13 and 15 September 2023. One visit was unannounced and one was announced. They spoke with people, relatives, staff and healthcare professionals, observed care and checked care, medicine, staffing and management records.
The home was rated Good for safe, effective, caring and responsive care. Inspectors found that people were safe, their needs were assessed, staff were trained, medicines were administered safely, and people were treated with kindness, dignity and respect.
The main weakness was leadership. There was no registered manager in post, and the well-led rating fell from Good to Requires Improvement. Inspectors also found that staff could be task-focused because of their workload, and that activities and social contact were limited for some people.
The overall rating remained Good. The previous overall rating was Good, published on 20 June 2018.
People felt safe
People and relatives described the home as safe. Staff understood safeguarding procedures and risks were regularly reviewed.
“People were risk assessed and their safety monitored.” from the report
Kind and respectful care
Inspectors observed warm interactions. Staff supported people's dignity, privacy, independence and personal choices.
“Staff were caring, patient and provided friendly support that respected people's privacy.” from the report
Good support with meals
People said they enjoyed the food and were supported to eat and drink enough. Care plans included nutrition information and fluid charts where needed.
“People were supported to eat and drink sufficiently to maintain a balanced diet.” from the report
Personalised care
Care plans recorded people's interests, preferences, wishes and support needs. People and relatives were involved in care planning and reviews.
“People received person centred care that meant they had choice, control and their needs and preferences were met.” from the report
No registered manager
needs fixingThere was no registered manager in post when inspectors visited. Applicants were being interviewed and senior management was providing cover.
“At the time of our inspection there was not a registered manager in post.” from the report
Care could be task-focused
needs fixingStaff were present and met people's needs safely, but inspectors found that their approach could focus on completing tasks rather than on each person's experience.
“However, the approach tended to be task driven, rather than person focused because they had so many tasks to perform.” from the report
Limited activities and social contact
needs fixingSome people wanted more face-to-face activities. One-to-one support for people who were bed bound was limited because the activities coordinator was part-time.
“Although the activities coordinator offered people who were bed bound regular one-to-one support to prevent them becoming socially isolated, this was limited as they were part-time.” from the report
Excess medicine supplies
minorExtra barrier creams, medicated shampoos and supplements had built up because electronic re-ordering was not working efficiently. The report says this was addressed during the inspection.
“There was a large surfeit of items such as barrier creams, medicated shampoos and supplements that had built up due to the electronic re-ordering system not working efficiently.” from the report
- 01When will a registered manager be appointed, and what arrangements are in place until then?
- 02How are you checking that staff have enough time to provide person-focused care rather than concentrating mainly on tasks?
- 03What extra face-to-face activities are planned for people who are not interested in the current programme?
- 04How will people who are bed bound receive regular social contact and one-to-one support?
- 05What changes were made to the electronic medicine re-ordering system after the excess supplies were found?
This inspection looked at all five CQC questions, including the premises and care provided, with visits on 13 September unannounced and 15 September announced. This explanation was written from the published report of 21 October 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, June 2018
Alexander House Care Home was rated Good; inspectors found kind, safe and responsive care, with some agency staffing and medicines recording issues.
This was a comprehensive inspection over two visits. One inspector visited on 25 April and 2 May 2018, including an unannounced first visit. Inspectors spoke with people living there, relatives and staff, and reviewed care records, staff files, medicines records, complaints and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff to meet people's needs, safe care planning, suitable training and good support with health care, food, activities and family contact.
People described kind and respectful staff and a friendly, homely atmosphere. The home had improved since its previous inspection in March 2017, when it was rated Requires Improvement and breached regulations about medicines and quality assurance.
Kind and respectful care
Inspectors found positive relationships between staff and people. Staff knew people's preferences and supported privacy, dignity and choice.
“Staff knew people well and treated them with kindness, dignity and respect.” from the report
Individual care planning
Care needs were assessed, recorded and reviewed. The new electronic system helped staff share current information and support continuity of care.
“Care plans were up to date and these helped staff meet people's individual needs.” from the report
Activities and relationships
People could join activities, maintain interests and stay connected with family, friends and the local community.
“People were supported to take part in activities, be part of the local community and to maintain contact with family and friends.” from the report
Use of agency staff
minorSome relatives wanted more permanent staff and less reliance on agency workers. Recruitment was still under way when inspectors visited.
“Some relatives told us they would welcome more permanent staff on duty with the home using less agency staff.” from the report
Medicines records
needs fixingInspectors found a small number of differences between medicines stock and the records for medicines supplied in original containers. The report says these were minor and new audits had started.
“We found a small number of discrepancies between the stock levels and records kept of medicines supplied to the home in their original containers.” from the report
Choice and presentation of food
minorAlthough feedback about food was generally positive, some relatives wanted more variety, fresh vegetables and better presentation.
“Some relatives said they would welcome more variety in the menu” from the report
Communication during changes
minorThe home was going through changes to staff, procedures and job roles. Some relatives said they wanted more information about changes to senior staff.
“Other relatives commented on the change in senior staff and said that they would have liked more information provided about this.” from the report
- 01How many permanent care staff are now working here, and how often are agency staff used?
- 02What checks are now made to ensure medicines stock and records always match?
- 03What changes have been made to the menu since inspectors heard requests for more variety?
- 04How will families be told about changes to senior staff, procedures or job roles?
- 05How are care plans reviewed when a person's needs or risks change?
This was a comprehensive inspection covering all five questions and the overall rating, based on visits on 25 April and 2 May 2018. This explanation was written from the published report of 14 June 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 Keychange Charity Alexander House Care Home
6 rated inspections over 8 years: the service has improved, from Requires improvement to Good.
- October 2023Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
Read what inspectors found at Keychange Charity Alexander House Care Home →
- June 2018Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
Read what inspectors found at Keychange Charity Alexander House Care Home →
- April 2017Requires improvementstayed Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- April 2016Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2015Requires improvementSafe: InadequateEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2015Inspected but not ratedSafe: Inspected but not rated
- August 2014
Report published without a new overall rating.
- June 2014
Report published without a new overall rating.
- August 2013
Report published without a new overall rating.
- May 2013
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 15 February 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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