Alexandra Park

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last inspection we rated this key question requires improvement. At this assessment the rating has remained the same. This meant people’s needs were not always met.

The provider was in breach of the legal regulation in relation to governance.

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This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Some relatives said that people did not always receive care from the same small group of staff. This had a negative impact upon people’s wellbeing and the level of person-centred care provided.

We identified shortfalls relating to meeting people’s social needs, nutrition and hydration and promoting people’s independence where person-centred support had not always been evidenced. This posed a risk to their health and wellbeing.

Some staff told us that due to staffing and the availability of staff who could drive, it was sometimes difficult to person-centred support in relation to accessing the local community.

Several staff told us they had not completed specific training in relation to supporting people who sometimes exhibited distressed behaviour. This training helps staff support people with their distressed behaviours and helps ensure staff follow non-abusive psychological and physical interventions.

Most of our observations between staff and people were positive. We visited a person with a staff member who had supported them for many years. The person appeared relaxed and happy, and the staff member was knowledgeable about the person’s needs.

Some relatives said people did not always receive care from the same small group of staff which they said sometimes had a negative impact upon people’s wellbeing. They also explained there had been frequent changes in management which had affected the continuity of the service and people’s care. A relative told us, “How many managers have we have had in that place - it is ridiculous.”

Some staff told us that due to staffing and the availability of staff who could drive, it was sometimes difficult to support people to access the local community.

Management staff explained there had been an increase in staff who could drive following our last inspection.

Most health and social care professionals told us communication at the service was not always effective to ensure people received responsive care and support. A health and social care professional also said that people did not always receive care from the same small group of staff which they said sometimes had a negative impact upon the person’s wellbeing.

An effective communication system was not fully in place to ensure people’s care and support was coordinated.

Due to the management structure at the time of the assessment and lack of a deputy manager and team leaders, communication systems had not always been effective.

A new electronic staff scheduling system had been introduced to plan rotas and schedule staff on duty. At the beginning of our assessment, it was not always possible to ascertain whether people had received their assessed hours. However, following the implementation of the new system, staffing allocations were clearer.

Management staff told us a new manager had been appointed together with 2 deputy managers and team leaders to ensure there was effective oversight and management of the service.

People were able to access information in a format which met their needs.

Staff could explain people’s communication needs and preferences.

Since 2016 onwards all organisations that provide publicly funded adult social care are legally required to follow the Accessible Information Standard (AIS). The standard was introduced to make sure people are given information in a way they can understand. The standard applies to all people with a disability, impairment or sensory loss and in some circumstances to their carers.

Information was available in an easy read format and people’s communication preferences and needs were documented in their care plans.

Relatives told us they did not always feel listened to and said there were issues relating to communication and delays in responding to their concerns.

Management staff told us systems were in place to listen to and respond to people and relatives.

An effective system was not fully in place to demonstrate how the provider was listening to and involving people and their relatives. Records were not provided to demonstrate how concerns and issues raised by relatives were responded to or to evidence they were responded to in a timely way.

Whilst people and relatives did not provide any specific feedback in relation to this area; we found that people did not always have access to the care and support they needed in relation to advocacy and nutritional advice and support which posed a risk to their health and wellbeing.

Management staff explained people were supported to access health and social care services. However, we found evidence that this was not always done in a timely way and advice given had not always been followed.

A person met the criteria for an advocacy referral in relation to a specific decision regarding their support at night. Management staff said that an advocacy referral had not been made. Following our feedback, management staff stated that a referral had since been made.

An effective system was not fully in place to ensure people could access the care and support they needed. We identified shortfalls relating to advocacy arrangements and seeking nutritional advice which had not been identified by the provider’s monitoring system.

Some relatives told us people did not always achieve positive outcomes because they did not always have the same core team of staff who understood their support needs well.

Relatives also said that additional supported hours were not always provided which had impacted on people’s experiences and outcomes they should have been able to achieve.

We heard and read examples from management staff about how being at Alexandra Park had led to people achieving positive outcomes. However, some staff told us that due to staffing and the availability of staff who could drive, people did not always receive equity in experiences and outcomes.

An effective system was not fully in place to demonstrate everyone achieved good outcomes. People’s records did not always evidence people had equity in experiences and outcomes. A person’s records did not evidence how they were supported to achieve positive outcomes in relation to accessing new activities and trying out new experiences to ensure they achieved a good quality of life.

Whilst we did not discuss this area with people or relatives, records did not evidence how people were supported to plan for the future. This meant there was a risk that people’s wishes and future care preferences may not be identified and followed.

At our last inspection we found that information about end of life wishes and support was generic and not always person centred. The regional manager at the previous inspection had explained further training around communication and end of life care was being organised.

At this assessment, management staff explained that further training and work in relation to this important area had not been carried out.

An effective system was not fully in place to support people to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Care records we reviewed did not include information about planning for the future and end of life care despite this being raised as an area where improvements were needed at the last inspection.