Alexandra House

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question Inadequate. At this assessment the rating has changed to Good. This meant people were safe and protected from avoidable harm.

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 had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. The registered manager effectively utilised the findings from the last assessment as a valuable learning opportunity to drive significant improvements in service quality and safety. Following the last assessment multiple actions were implemented, including improved oversight of clinical records. A culture of prompt action was embedded across the service, issues were identified and reported without delay. For example, issues relating to the environment were rectified in a timely manner. This proactive approach decreases the risk of issues reoccurring, thereby protecting people from the risk of harm.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services. All people had detailed and individualised assessment prior to moving into Alexandra House, this ensured staff could meet their needs safely. Staff completed training on the providers electronic care planning system which provided them with clear, accessible guidance on how to support each person safely. We found staff sought and implemented guidance from external healthcare professionals when needed. For example, specific guidance from a specialist wound care nurse was implemented into a person’s care and support plan, records demonstrated staff followed this guidance to promote wound healing.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately. Staff completed training which enabled them to identify and act on safeguarding concerns. A staff member we spoke with said, “I know what and who to report things to, the management team here would always act on concerns.” A clear culture of openness meant people felt safe and understood their rights. A person we spoke with said,” I feel very safe it’s so nice the staff look after you, they are marvellous it’s nice and relaxed. If I didn’t feel safe, I would speak to the person in charge, they are very nice.” The registered manager was aware of their responsibility to report concerns to the local authority safeguarding team without delay, they ensured timely investigations took place to protect people from any future risks. Consistent and clear processes meant the service prioritised people’s human rights and safety.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. Staff supported people in line with their assessed needs. Care and support plans detailed people’s needs with clear guidance in how staff should support them. For example, a person who become distressed at night had a clear and detailed plan in place. This meant staff had accurate information in how they should support the person to minimise periods of distress. We observed staff to support people safely using mobility equipment where needed. A person said, “Staff help keep me safe and make sure I’ve always got my stick.” Risk reduction measures were implemented to keep people safe. For example, bed rails were safely applied with clear risk assessments in place to prevent the person from rolling out of bed. This protected people from the risk of avoidable harm.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. The environment had undergone significant works to improve safety, making it safer for people living at Alexandra House. We found the home was now well maintained with the safety of the living environment ensured through ongoing monitoring. For example, regular monitoring of water systems meant outlets were safe for people living at the service. Risks associated with the kitchen had been resolved, food was stored in line with guidance, in a clean and organised environment. This promoted food safety and hygiene. People told us they were happy with the environment, one person told us staff had helped move the furniture in their bedroom, so it was more aligned to their needs. The home was safe in the event of a fire, all people had personal emergency evacuation plans in place in the event of an emergency.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs. Staff and people told us there were enough staff on duty to keep people safe. A staff member said, “It’s a really nice place to work, there’s always enough staff on, always someone around to give you a hand if needed.” A person we spoke with said, “I press my buzzer, and they always come very quickly.” Staffing levels were determined using a dependency tool based on people’s needs. Records we reviewed demonstrated there were enough staff on duty to support people safely. Recruitment processes were followed to ensure only suitable staff were appointed. Checks including, interviews, references and Disclosure and Barring Service (DBS) checks were conducted before staff started working at the service. DBS checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. The home had undergone significant works which meant it could now be cleaned effectively. The home was clean, tidy and homely. A person we spoke with said, “It’s spotlessly clean I would recommend it to anyone.” Staff completed training and were supported by an infection control policy. The registered manager had effective oversight of the service and ensured infection control audits were accurately completed to drive service improvement.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened. We found significant improvements following our last assessment, topical medicines were now stored safely in locked boxes which only trained staff had access to. This protected people from the risk of using creams not meant for them. People told us staff supported them to take their medicines safely. We found people received their prescribed medicines on time. Staff received training in medicines and had their competency assessed.The management team completed medicines audits to identify any errors or poor practice. This meant any errors or learning opportunities were identified in a timely manner.