Archived: Alexander House

Alexander House is a care home for up to 16 older people situated in East Sheen.

The home 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 and associated Regulations about how the service is run.

At the last inspection in November 2015 all the key questions of safe, effective, caring, responsive and well-led were rated good and there was an overall rating of good.

People and their relatives found the home was a very pleasant and homely place to live with staff providing very good support and care, in a respectful way, that they enjoyed. People were able to do as they wished and join in the activities provided if they wanted to.

The atmosphere at Alexander House was warm, welcoming, enabling and inclusive. The visitors during the inspection said, they were always made welcome. The home provided a safe environment for people to live and work in and was clean and well maintained.

The records kept were thorough and up to date with care plans containing fully completed, clear information that was regularly reviewed. This meant staff were able to perform their duties appropriately.

Staff knew people they worked with and their likes, dislikes, routines and preferences well and treated everyone equally. They had the required skills, qualifications and were focussed on providing individualised care and support for people, in a professional, friendly and compassionate manner. Staff were aware of their responsibilities to treat people equally and respect their diversity and human rights. They treated everyone equally and fairly whilst recognizing and respecting people’s differences. The registered manager and staff made themselves accessible to people and their relatives. Staff told us they had access to good training and support.

People were protected from nutrition and hydration associated risks with balanced diets that also met their likes, dislikes and preferences. People and their relatives told us that the choice of meals and quality of the food provided was what they wanted and enjoyed. People were encouraged to discuss health needs with staff and had access to community based health care professionals, if they required them.

The registered manager and staff were approachable, responsive, encouraged feedback from people and consistently monitored and assessed the quality of the service provided.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We saw that staff treated people with dignity and respect during our visit and the home had a light, friendly and inclusive atmosphere. People said they enjoyed living at the home, the staff were very supportive and they felt safe living there. People told us "I cannot speak highly enough of the service I receive" and "There is no need for improvement here, it is as I expected and more". We saw that the safeguarding procedures in place were robust, staff had received suitable training in them, knew how to operate them and they understood how to safeguard people individually and as a group. Details of areas or circumstances of concern specific to individual people were also recorded in the sample of two care plans we looked at.

The organisation had systems that ensured the manager and staff learnt from accidents and incidents, listened to people's concerns, complaints, whistleblowing and investigations. This reduced risks to people and helped the service to improve.

The home had policies and procedures that adhered to the Mental Capacity Act and Deprivation of Liberty Safeguards (DoLS). The manager was trained to understand when an application should be made and how to submit one. This meant that people and their rights were safeguarded.

We walked around the building, garden and saw that the home was safe, clean and hygienic with well-maintained equipment that was regularly serviced. This meant people were not put at unnecessary risk.

People's individual care and support needs were taken into account by the manager when making decisions regarding the required staff numbers, qualifications, skills and experience. This was reflected in the staff rota, numbers on duty during our visit and ensured that people's needs were met.

No staff were currently subject to disciplinary action and policies and procedures were in place to make sure that unsafe practice was identified and people were protected.

Is the service effective?

The home assessed people's health and care support needs with them and they were supported to contribute as much as they wished to their care plans. One person said "I can express my views and actually have no complaints". Any specialist care and support required such as diet, mobility or equipment needs were identified in people's care plans and the home liaised with community based health teams to ensure these were met. A sample of the care plans we saw had been signed identifying that people had been involved in producing them.

The layout of the service enabled people to move around freely, safely and there was suitable equipment to support them to achieve this.

The visiting policy and visitors' book demonstrated that people were able to see their visitors in private and that visiting times were flexible. Two relatives visited during the inspection and we were told they visit at least once per day.

Is the service caring?

We saw that people were supported by kind, professional and supportive staff. The staff were patient and encouraged people to give their opinions. People said, "The service is brilliant, the staff are lovely and never cross' and "My brother turned up, he hadn't visited for a very long time but the staff knew his name and who he had come to visit".

People and their relatives completed an annual satisfaction survey and there were bi-monthly house meetings. Where shortfalls or concerns were raised these were addressed by the manager.

We saw in two care plans that people's preferences, interests, aspirations and diverse needs had been recorded and that care and support had been provided in accordance with this information.

Is the service responsive?

During our visit people told us about the various activities they were engaged in. They participated in these either individually or as a group depending on the nature of the activities and their interest. People were involved in activities at home, within their local community and further afield.

Is the service well-led?

We saw that the manager and staff listened to people's needs, opinions and acted upon them. The service worked well with other agencies and services to make sure people received linked support. This was demonstrated by the relationship the home had with community based health services.

Appropriate notifications were made to the Care Quality Commission.

People's health, safety and welfare was protected when more than one provider was involved in their care and treatment, or when they moved between different services. This was because the provider worked in co-operation with others. Relatives of people living at Alexander House reported that doctors and other health care professionals were contacted when people needed them. The communal rooms where people spent most of their time were well presented and appeared clean yet homely.

New staff we spoke with explained that they had visited the service for an interview following their application for work. Staff were invited to meet the manager and discuss their interest in working at the home. They told us "I was asked about my experience" and "I had to answer some questions at my meeting".

We looked at records and documents in relation to the running and management of the home including minutes to team meetings, communication records, staff supervision sessions and care plans. We looked at three care plans and found that detailed assessments of people's needs had been gathered, recorded and stored safely.

People told us that the home was warm, friendly and comfortable. One person said 'If you have to go into a home this is the one to come to'. Another person said 'I already knew of the home and it was the right choice for me'. Another person commented saying 'I was getting very lonely at home once I couldn't get out, I'm much happier now I'm around other people'.

The relative of one person who uses the service told us staff make time to give attention to people. 'They always keep me informed of how my relative is doing and what the food has been like'. 'It's very clear that they care about their work and how people are supported, they are always helping people'.

We asked people about their care and one person said 'The food is very good here ' always plenty to eat'. Other comments shared with us were 'everyone is so kind and they really look after us well' We spoke with a community health professional who told us that the home is warm and staff were welcoming and always in contact when they need health support.