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Alexandra House - Eastwood Requires improvement

Inspection Summary

Overall summary & rating

Requires improvement

Updated 24 October 2019

About the service

Alexandra House is a residential care home providing personal and nursing care to 28 people at the time of the inspection. The service is registered to accommodate a maximum of 38 people, however the operational manager told us they would only accommodate 34 people.

People’s experience of using this service and what we found

Actions were not always taken to mitigate risks present in the environment and to protect people from the risks of infection. When risks had been identified in audits, prompt and timely action had not always been taken in response to mitigate risks. Audits were not always effective at identifying shortfalls in the service.

Staff were trained, however staff were not always seen to be competent when assisting people to mobilse with equipment.

Refurbishment plans were in place to improve the decoration and flooring. Areas that had been refurbished had been designed to meet people’s needs. However, areas still waiting for refurbishment were not always supportive to people living with dementia.

Risks associated with people’s healthcare conditions were assessed and monitored and medicines were managed safely. The provider had taken actions to help prevent the abuse of people using the service. There were enough staff to meet people’s needs and staff recruitment processes checked on staffs’ suitability for the role.

Assessment processes were in place to cover people’s health, care and well-being needs. People received food and drink to meet their needs; improvements had been made to how people’s fluid intake was monitored and managed. The service worked in partnership with other healthcare professionals to ensure effective care.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Staff were caring and respectful to people. People’s choices were promoted and their views and preferences for their care and treatment were known and informed care plans. People told us staff respected their privacy and promoted their independence.

Staff understood people’s life histories and interests. People told us they enjoyed a variety of activities, including connections with their local community. People’s communication needs were assessed and met. Where people required care at the end of their lives, procedures were in place to ensure this would meet people’s wishes.

The service was run with an open and approachable management team. People’s views were gathered and used when developments or changes in the service were considered.

For more details, please see the full report which is on the CQC website at

Rating at last inspection

The last rating for this service was Requires Improvement (published 19 July 2018).

Why we inspected

This was a planned inspection based on the previous rating.

We have found evidence that the provider needs to make improvements. Please see the safe, effective and well-led sections of this full report. We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will continue to monitor information we receive about the service. We will request an action plan and meet with the provider. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection areas


Requires improvement

Updated 24 October 2019

The service was not always safe.

Details are in our Safe findings below.


Requires improvement

Updated 24 October 2019

The service was not always effective.

Details are in our Effective findings below.



Updated 24 October 2019

The service was caring.

Details are in our Caring findings below.



Updated 24 October 2019

The service was responsive.

Details are in our Responsive findings below.


Requires improvement

Updated 24 October 2019

The service was not always well-led.

Details are in our Well-led findings below.