Alexandra Rose Residential Care Home

We found the following examples of good practice.

There was a procedure in place to welcome visitors to the home, personal protective equipment [PPE] was available and there was a hand basin for washing at the entrance. Visitors were asked to show they had completed a COVID -19 lateral flow test, complete a short health questionnaire and have their temperatures taken before entry.

The registered manager had recently updated their visiting policy and risk assessments so that people could receive their visitors within their own rooms, in line with government guidance.

The service was very clean and employed a high level of domestic staff to ensure infection control risks were managed safely. Regular cleaning schedules and audits were monitored and demonstrated they were effective.

The registered manager ensured the most up to date information on infection control risks and processes were available for staff and visitors and staff completed IPC training and specific Covid training.

Staff wore personal protective equipment [PPE] in line with government guidance and there were PPE stations around the service, ensuring staff had access to and changed their PPE regularly.

People and their relatives told us they felt safe, were comfortable with staff and visitors wearing masks and understood it was to prevent the spreading of infection. People were encouraged to socially distance, whilst being mindful of the need for a homely environment.

We found the following examples of good practice.

Staff put on, took off and disposed of personal protective equipment (PPE) safely in line with the relevant guidance. Throughout our inspection staff were wearing the required levels of PPE and maintaining social distancing as much as possible.

Robust processes were in place for any visitors which were clearly displayed on entrance to the home and included a temperature check outside the home prior to entry. On entry visitors were asked to wash their hands in a sink placed just inside the entrance. Hand sanitiser was available, visitors were screened via a questionnaire. LFD test were in place to ensure visitors were safe to have face to face contact with their relative following government guidance. Appropriate PPE was available for use.

Regular testing was completed for staff and people living at the service. This meant prompt action could be taken should anyone test positive for COVID-19.

Processes and policies were in place to ensure people were admitted safely and self-isolated for 14 days, in accordance with national guidance.

Staff had training to manage infection control and COVID-19. There was a contingency plan for the service to follow in case of an outbreak. Any double rooms were being used for single occupancy. This meant people had their own room and were less at risk of contracting COVID-19 if there was an outbreak.

The service was clean and hygienic. Robust cleaning measures were in place. For example, measures were in place to make sure high touch areas were cleaned on a regular basis and visiting areas were thoroughly cleaned prior to being used again. All bedrooms had been fitted with hand wash and paper towel dispensers.

Up to date policies, procedures and guidance for the service had been implemented. The staff were following current guidance.

Quality assurance audits were being completed during the COVID-19 pandemic to reflect best practice. Staff knew how to immediately instigate full infection control measures to care for a person with symptoms to avoid the virus spreading to other people and staff members.

Alexandra Rose Care Home is registered to provide accommodation and personal care services for up to 32 older people and people who may be living with dementia. At the time of our inspection there were 27 people living at the home. They were accommodated in an extended residential building providing spacious communal areas and access to enclosed rear gardens. The majority of bedrooms were for single occupancy and had ensuite facilities.

At the last inspection the service was rated Good. At this inspection we found the service remained Good.

The provider had arrangements in place to protect people from risks to their safety and welfare. Arrangements were also in place to store medicines safely and to administer them according to people’s needs and preferences. People were supported to access healthcare services, such as GPs and community nursing teams.

Staffing levels enabled people to be supported safely and in a calm, professional manner. Recruitment processes were followed to make sure only workers who were suitable to work in a care setting were employed. Staff received appropriate training and supervision to make sure they had the skills and knowledge to support people to the required standard.

Staff were aware of the need to gain people’s consent to their care and support. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The arrangements included processes and procedures to protect people from the risk of abuse.

People were supported to eat and drink enough to maintain their health and welfare. They were able to make choices about their food and drink, and meals were prepared appropriately where people had particular dietary needs.

People found staff to be kind and caring. They were encouraged to take part in decisions about their care and support and their views were listened to. Staff respected people’s individuality, privacy, dignity and independence.

Care and support were based on plans which took into account people’s needs and conditions, as well as their abilities and preferences. Care plans were adapted as people’s needs changed, and were reviewed regularly.

People were able to take part in leisure activities which reflected their interests and provided a high level of mental and physical stimulation. Group and individual activities were available if people wished to take part.

The home had an open, friendly atmosphere in which people, visitors and staff were encouraged to make their views and opinions known.

Systems were in place to make sure the service was managed efficiently and to monitor and assess the quality of service provided. The provider took action where these systems found improvements could be made.

There was limited communication with people because of their care needs. Consequently, we used our SOFI (Short Observational Framework for Inspection) tool to help us see what people's experiences at mealtimes were. The SOFI tool allows us to spend time watching what is going on in a service and helps us to record how people spend their time and whether they have positive experiences. This included looking at the support that is given to them by the staff. We spent 40 minutes observing people and staff together at the lunch time meal. We saw people had positive experiences. Staff were observed to help people who needed it. People were offered choices of food. Each person had an assessment of their nutritional needs. We saw people had a nutritious diet and were supported to eat.

We saw the home provided people with a range of activities and stimulation.

We saw the home comprehensively assessed people's needs before being admitted to the home. Each person had care plans covering their needs. People told us they were consulted about their care.

We looked at the home's medication procedures and found staff recorded a signature each time they administered medication to someone.

The premises were found to be safe. People told us how much they liked their rooms and the communal areas.

Appropriate checks were carried out regarding the suitability of newly appointed staff. Staff had access to a range of training courses. The home provided enough staff to meet people's needs.

The home sought the views of people about the service it provided by the use of survey questionnaires and residents' meetings.

We also spoke to three visitors, all were very positive about the service. They told us they felt communication with the home had been excellent and that care provided at the home had been regularly discussed with them. One visitor we spoke to made us aware that they had been involved and contributed to assessment and care planning.

People were very happy and positive about the quality of care being provided. One visitor said 'I heard this home was good but it has exceeded all my expectations'

We saw that people's privacy and independence were respected, people experienced safe and effective care based on detailed care plans and risk assessments that met individual needs.

People using the service were protected from abuse as they were supported by a staff team who had appropriate knowledge and training on safeguarding adults. We saw policies on whistle blowing and safeguarding. People's rights were respected.

Staffing levels were appropriate to meet the care needs of the people using the service.

The Provider had effective systems in place to monitor quality assurance and compliance.