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Alexandra House - Eastwood Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 19 July 2018

The inspection took place on 16 April 2018 and was unannounced. Alexandra House is a care home that provides accommodation with personal care and nursing and is registered to accommodate 38 people. The service supports older people who may have nursing needs or are living with dementia.

Alexandra House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. At the time of the inspection there were 29 people using the service.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Alexandra House was last inspected on 25 February 2016 and the service was rated as Good On this inspection the service has been rated as Requires Improvement. Providers should be aiming to achieve and sustain a rating of ‘Good’ or ‘Outstanding’. Good care is the minimum that people receiving services should expect and deserve to receive and we found systems in place to ensure improvements were made and sustained were not effective.

This is the first time the service has been rated Requires Improvement. This was because there was not enough staff to meet people’s needs in a timely manner. This lack of sufficient staffing impacted on all aspects of the service. It meant people had to wait too long for their needs to be met. Staff employed to provide activities had to provide care when staff were very busy. When they rang their call bell, staff checked if they were safe and if they were came back later to attend to them. This could be up to 20 minutes later. People were left unattended at busy times due to pressure on staff.

Risk was recognised and managed. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Staff were aware of the Mental Capacity Act and people’s rights under this.

Staff were aware of their duty of care to keep people safe. They understood what abuse was and how to respond appropriately should they be concerned about people’s safety or welfare.

People’s medicines were administered as prescribed and stored appropriately. Staff were trained to care for the people they supported.

People were not always happy with the food. However people’s dietary needs were recognised and met.

Staff were seen to be kind and caring in their interactions with people. However, some staff did not always acknowledge people when they were in the communal rooms.

Floor covering was worn and broken in some areas, this meant staff could not always clean it effectively. The environment was not well maintained and some areas showed signs of neglect.

People maintained important relationships, as relatives and friends could visit at any time. People were able to regularly review their care to ensure it was still relevant for them. People enjoyed a varied programme of entertainment and support with their hobbies to prevent them from becoming socially isolated, however this could be interrupted due to staff shortages. People knew who to speak with if they wanted to discuss a concern or complaint.

People received support from health care professionals where they needed this to keep well. Staff supported people to attend healthcare appointments and liaised with their GP and other healthcare professionals as required to meet people’s needs. People felt the registered manager was approachable and keen to listen to their views and they were able to share their views about how the service was managed.

We found a breach of the Health and Social Care Act 2008 (Regulated Ac

Inspection areas

Safe

Requires improvement

Updated 19 July 2018

The service was not always safe.

People were left unattended for periods of time at the busiest times. Infection control could not be guaranteed due to broken and worn floor covering.

Medicines were administered as prescribed. Staff were recruited safely.

Effective

Requires improvement

Updated 19 July 2018

The service was not always effective.

People were not happy with the quality of the food. The environment was in need of attention. People’s rights were protected under the Mental Capacity Act. Staff were trained to care for people effectively. People’s mental and physical health was promoted.

Caring

Requires improvement

Updated 19 July 2018

The service was not always caring.

People’s dignity was not always promoted. Some staff ignored people. Other staff were caring and kind. People privacy was promoted.

Responsive

Requires improvement

Updated 19 July 2018

The service was not always responsive.

There was not enough staff to meet people’s individual needs in a timely manner. People had to wait too long for their call bells to be answered. This impacted on all aspects of their lives. There were activities in the service. There was a complaints system in place. The service had many complements.

Well-led

Requires improvement

Updated 19 July 2018

The service was not always well led.

The manager understood their responsibilities for the management and governance of the service, however they had not have the staffing levels to put this in place and the service lacked direction from the provider. Care was not always personalised.

Systems were in place to monitor and improve the quality of the service. Staff were supported and they were happy with the registered manager.