Our inspection team was made up of two adult social care inspectors. We answered our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?We spoke with seven people who lived at the home and a visiting relative. During the inspection, we spoke with the provider, manager, deputy manager, care staff and the chef. We also obtained feedback from the local authority after the inspection.
Below is a summary of what we found. The summary describes what people who lived at the home told us, what staff told us, what we observed and the records we looked at. If you want to see the evidence supporting our summary please read the full report.
Is it safe?
Care staff had a comprehensive understanding of the Mental Capacity Act 2005 (MCA). Before people received care, staff obtained consent and acted in accordance with the person's wishes. People were supported and enabled to make day to day decisions. Observations of care found staff provided people with sufficient information to make informed decisions and respected their decisions made.
The Care Quality Commission (CQC) is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS). This is where restrictions may be placed on some people to help keep them safe. While no DoLS applications had needed to be submitted, we found that suitable policies and procedures were in place. People's freedom was not restricted in any manner. People were seen freely coming and going from the home as they pleased.
People received care in an environment that was clean and tidy. The home employed a dedicated cleaner who maintained high standards of cleanliness. A dedicated infection control lead was in post that monitored and improved standards of infection control at Princess Alexandra House.
Is it effective?
Care plans had been devised and developed. However, we found that people's health needs had not been factored into the planning of their care. Therefore guidance and support was not recorded or available to care staff. A compliance action has been set for this and the provider must tell us how they plan to improve.
For people experiencing mental health needs, risk assessments did not sufficiently detail their needs. The support required to manage their mental health or any triggers which may cause their mental health to relapse. A compliance action has been set for this and the provider must tell us how they plan to improve.
People's health needs were not monitored by the home. For people with diabetes, the home did not monitor people's blood sugar levels or have an awareness of what their normal blood sugar level should be. Where risks of dehydration or poor nutritional intake had been identified, we could not see how staff were monitoring the person's nutritional intake. A compliance action has been set for this and the provider must tell us how they plan to improve.
Is it caring?
Care records contained personalised information which helped staff to know the people they supported. People told us that the staff treated them well, were kind and friendly.
Observations of staff interactions saw that staff clearly knew people living at the home and had built rapports with people.
People were dressed in accordance with their own wishes. People had their hair neatly done. Women had their jewellery and make up on as they so wished. Rooms were made individual to the person. We saw that people had their pictures and ornaments around them.
Is it responsive?
People's needs had been assessed before they moved to Princess Alexandra House. This meant that the home had the skills and facilities to meet their identified needs.
Information was available on how to make a complaint and people told us they would feel happy approaching staff with any concerns.
People were encouraged to give their views and opinions on the running of the home and the home encouraged this. People's views were listened to and the home acted upon any feedback received.
Is it well-led?
The home had quality assurance systems intended to monitor and improve the service provided. Monthly and six monthly audits were completed. Where any shortfalls were identified, a plan of action was implemented.
Staff spoke positively of management and the provider. Staff received regular supervision and training. This ensured staff had the skills and knowledge to provide care that meet people's needs.
We have asked the provider to review its Statement of Purpose and make it clearer to people who use the service what types of care they provide and how they intend to provide this care.