Alexandra House

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

This is the first full assessment for this service. This key question has been rated Good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. Care plans were detailed, people told us staff went through their needs with them and felt confident in staffs’ abilities. People’s needs were fully assessed and reviewed as their needs changed. For example, when a person’s wounds were redressed, this was clearly documented with any changes to planned care made. This meant staff had accurate guidance in place to support people safely.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. Staff implemented best practice guidance to identify risks and improve care. For example, the service completed a monthly mouth care assessment tool using the ‘Gwen am Byth – a lasting smile’ programme. This programme aims to improve oral health and hygiene for older adults living in care homes. The use of best practice tools identifies areas of risk and provides guidance to staff to provide effective care.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. Care plans were person centred and detailed people’s clinical needs. We found where specialist input was required their guidance had been included within people’s care plans. For example, a person had detailed guidance from a dietician embedded into their care plan. Staff referred to professionals without delay, we found a person was referred to a number of specialist services following an assessment of their needs. This meant people received effective support in line with their needs without delay.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support. Records were kept of when health professionals visited people, and what advice they gave. Staff explained how they recorded this information and ensured they included any new information to other staff during handovers.People told us staff supported them to access their GP and other healthcare professionals if needed. We observed staff to communicate well about a person’s needs with a visiting professional. Staff encouraged people to spend time doing things they enjoyed, a person told us they liked to go for walk and staff supported them to do this. This prevented this person from becoming socially isolated which promoted their overall health and wellbeing.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves. Care plans were reviewed monthly or as people’s needs changed. This ensured the clinical and leadership teams had effective oversight of people’s needs. An analysis of care plans was completed monthly to review and monitor people’s progress. Where concerns were identified action was taken. The electronic system meant when changes were needed these were made without delay. This meant staff had accurate information to support people effectively.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. Staff completed training regarding the Mental Capacity Act 2005 (MCA) and supported people in the least restrictive way. The MCA provides a legal framework for making decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to make particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. Where people lacked capacity mental capacity assessments had now been completed in line with the legal framework. Some people at the service were subject to a Deprivation of Liberty Safeguard (DoLs), this is where the person cannot make decisions about their care and treatment. So restrictive care arrangements are legally authorised in the person’s best interest. Staff had knowledge of DoLs and how this impacts people.People told us staff respected their rights and asked consent before providing care. For example, a person we spoke with said, “They always ask and knock on my door before they come into my room.” Records supported this feedback, people’s consent to care was clearly documented. This meant people’s human rights were respected.