Archived: Alexander Court Care Centre

The service 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 2008 and associated Regulations about how the service is run.

At the last inspection on 28 and 29 November and 5 December 2016 we found six breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and the service was placed in Special Measures. We found the provider did not ensure risks to people were minimised when receiving care. The service did not have suitable arrangements to manage medicines safely. People’s preferences and choice of activity were not consistently accounted for when planning care. The provider was not providing care in line with the principles of the Mental Capacity Act (2005). People’s dignity was not consistently respected. The provider did not always ensure people received treatment in a timely manner. People using the service and their relatives told us they did not think there were enough staff to meet their needs and they waited for unacceptable periods of time for assistance. Staff were not always given appropriate support through training opportunities to enable them to fulfil their role. Quality monitoring systems had not identified the issues identified in our inspection.

This inspection took place on 5, 6, and 8 June 2017 and was unannounced. We found improvements had been made. Although the service is no longer in special measures we found there continued to be three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. However since the inspection a new provider has taken over the registration of this service and conditions have been attached to their registration to ensure the breaches are rectified.

Risk assessments did not always correspond to the care plans or how care was delivered. Some care plans were missing information or contained contradictory information. Although medicines management had improved we found a few issues of concern. People’s choices and dignity were not consistently respected. The provider’s quality and audit systems did not identify the issues picked up on at inspection.

The building was safe in accordance with building safety regulations. Domestic staff worked hard to maintain cleanliness of the environment. Staff appropriately followed infection control procedures.

The provider and staff were knowledgeable about what was required of them to work within the legal framework of the Mental Capacity Act (2005), Deprivation of Liberty Safeguards and when they needed to obtain people’s consent. People had access to healthcare as they required it. The service offered nutritious meals and there were choices of food and drink for people.

We observed staff were caring and were knowledgeable about how to develop positive relationships with people who used the service. Staff were knowledgeable about maintaining people’s independence.

Staff had awareness of giving personalised care and care plans were personalised. The service had a variety of activities to offer people. The provider dealt with complaints in accordance with its policy.

Staff received support through supervision, meetings and training. Relatives and staff spoke positively of the service and management. The provider had a system in place to obtain feedback from people who used the service.

The service had a registered manager who had been at the service since May 2015. 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 2008 and associated Regulations about how the service is run.

At the last inspection on 10 and 11 March 2016 we found five breaches of the Health and Social Care Act 2008 (regulated activities) Regulations 2014. We found the service required improvements regarding infection control, staffing levels, medicines management, access to nutritious food and drink and quality monitoring of the service. We imposed conditions on the registration of Alexander Court Care Centre.

We inspected Alexander Court Care Centre on 28, 29 November and 5 December 2016. This was an unannounced inspection. At this inspection we found six breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Full information about CQC’s regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.

Risk assessments were not always fully completed or reviewed in a timely manner. Some people’s risk assessments did not include guidelines for their medical condition or for managing a specific risk. We found concerning practices with the management and administration of medicines.

Care plans did not fully reflect people’s needs or preferences and people were not always supported to take part in meaningful activities of their choice appropriate to their level of need.

The service was not always proactive in ensuring people received treatment as required at the time they required it. The service did not always maintain the dignity of people living at Alexander Court Care Centre. The service was not working within the principles of the Mental Capacity Act (2005).

People using the service and their relatives told us they did not think there were enough staff at the service to meet their needs and waited for unacceptable periods of time for assistance.

Staff were not always supported to receive training to enable them to fulfil the requirements of their role. The quality monitoring systems in place had not identified the issues identified during our inspection.

People and their relatives told us they felt safe using the service. Staff knew how to report safeguarding concerns. We found recruitment checks were in place to ensure new staff were suitable to work at the service. Staff received appraisals and supervisions.

People using the service and their relatives told us the service was caring and we observed staff supporting people in a caring manner. People and their relatives knew how to make a complaint.

There were effective and up to date systems in place to maintain the safety of the premises and equipment.

The service 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 2008 and associated Regulations about how the service is run.

At the last inspection on 28, 29 May and 5 June 2015 we found four breaches of the Health and Social Care Act 2008 (regulated activities) Regulations 2014. People were not safe at the service. There were poor arrangements for infection control and there were concerns about the safety and suitability of the premises. There were not enough staff available to meet people’s needs and keep them safe. Staff did not always receive up to date training. People using the service told us they did not always feel cared for and care plans did not always include people preferences. There was poor record keeping and quality monitoring tools used by the service did not identify issues of safety and quality.

We inspected Alexander Court Care Centre on 10 and 11 March 2016. This was an unannounced inspection. At this inspection we found the service required further improvements regarding infection control, staffing levels, medicines management, access to nutritious food and drink and quality monitoring of the service.

We found five breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Full information about CQC’s regulatory response to any concerns found during inspections is added to reports after any representations and appeals have been concluded.

People and their relatives told us they felt safe using the service. Staff knew how to report safeguarding concerns. Risk assessments were completed and management plans put in place to enable people to receive safe care and support. There were effective and up to date systems in place to maintain the safety of the premises and equipment. We found recruitment checks were in place to ensure new staff were suitable to work at the service.

Appropriate applications for Deprivation of Liberty Safeguards had been made and authorised. Staff received appraisals and supervisions. People using the service had access to healthcare professionals as required to meet their needs.

Staff knew people they were supporting including their preferences to ensure personalised care was delivered. People using the service and their relatives told us the service was caring and we observed staff supporting people in a caring and respectful manner. Staff respected people’s privacy and dignity and encouraged independence. People and their relatives knew how to make a complaint. Staff, people and their relatives told us the registered manager was supportive.