Alexander House Care Home

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. This is the first assessment for this newly registered service. This key question has been rated good. This meant people were safe and protected from avoidable harm.

This service scored 78 (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 provider shared several examples of how learning was embedded in the service. The managers had clear oversight of the service and used every opportunity to embed learning. All accidents and incidents were reviewed. The system had a built-in alert whereby following 3 safety events the care planning system would send an alert to the team to flag this as a concern. Additional measures had been put in place for 1 person including a crash mat, additional checks by the staff team and new footwear. One person told us they had a fall, and the staff had given them a mat and changed the bedroom around. The person said this made them feel better. Their care plans and risk plans had been updated by the care team to reflect the new changes.

Theprovideralways worked with people and healthcare partners to design, establish and maintain safe systems of care, in which safety was always well managed and monitored. They made sure there was always continuity of care, including when people moved between different services.

For example, the team were asked to carry out an assessment for a person with complex needs. During the assessment it became clear that the team would need additional training to meet their needs. This was put in place by the managers and the team attended specialist training at the hospital. Once everything was in place the team supported a safe discharge from the hospital to the home. The team worked in partnership with the hospital staff. They followed a meticulous care regime, over a 6-month time frame. Clear clinical oversight and monitoring resulted in a full recovery exceeding expectations and improving the person’s quality of life. The person and their family praised the way the team supported the person and met their needs. Due to sustained improvement and a full recovery, the person was able to return to their own home. The team remarked that the success in this example was down to everyone working together and the continuity of the care being provided.

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 with agencies such as the local authority and the Care Quality Commission. Staff were able to explain how to protect people from harm. Staff understood the importance of raising their concerns with managers and told us actions would be taken as a result.

People can only be deprived of their liberty to receive care and treatment with appropriate legal authority. In care homes, this can be done through a procedure called the Deprivation of Liberty Safeguards (DoLS), which is part of the Mental Capacity Act (MCA). We checked whether the service was working within the principles of the MCA and how they managed DoLS within the service. We found that where people needed to be deprived of their liberty to keep them safe, the provider ensured a DoLS authorisation had been made, this meant people’s rights were fully respected.

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. During our visit we observed staff supporting people to manage risks, for example, staff reminded people to use walking aids to reduce the risk of a person falling. Incidents and accidents were analysed monthly. Each incident record was reviewed and measures put in place to reduce risks of harm to people. Staff were able to explain how they supported people to manage risks. Guidance for staff was available in people’s care records. Care plans and risk plans were updated regularly.

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 home was well maintained. There was a clear process in place for staff to report any maintenance issues. Health and safety equipment was in place, for example, fire extinguishers. Health and safety checks were completed regularly and records reviewed showed actions were documented.

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 were recruited safely. For example, the provider checked staff backgrounds including criminal record checks. Staff received training in a range of topics, which assisted them to carry out their role effectively. Staff had regular meetings with line managers, they could seek guidance when needed and were given feedback to support them to develop their skills. During our visit we saw there was enough staff on duty to meet people’s needs. The managers audited call bells monthly. Any concerns were picked up and addressed quickly.

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 was clean and tidy. Staff wore personal protective clothing when required such as aprons and gloves. Staff explained how to protect people from the risk of infections. Staff had training in infection, prevention and control. Audits of the environment were carried out regularly.

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. People’s medicines records were clear and showed that they received their medicines safely, in the way prescribed for them.Protocols were in place to guide staff when any medicines that were prescribed ‘when required’ should be given. Prescribed creams and external preparations were recorded when applied.There were risk assessments in place for higher risk medicines such as anticoagulant blood thinners and paraffin-containing external preparations.

If medicines were given covertly, suitable checks were in place to ensure this was in people’s best interests, and information provided on how to give each medicine safely.There were suitable arrangements for ordering,storage and disposal of medicines.This included items needing cold storage and any medicines requiring extra.Storage temperatures were monitored to ensure medicines would be safe and effective.Staff had training and competency checks to make sure they gave medicines safely. Regular medicines checks and audits took place to identify any issues and areas for improvement.