We carried out a review of the data available to us about Alexandra Nursing & Residential Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Alexandra Nursing & Residential Home, you can give feedback on this service.
Alexandra Nursing and Residential Home is a residential care home providing personal and nursing care for up to 46 people. At the time of our inspection there were 43 people using the service.
People’s experience of using this service and what we found
People were protected from the risk of abuse and avoidable harm. People told us that they felt safe in the home and risks in relation to people's care were identified and managed to keep them safe.
Staff had been recruited safely and during the inspection we observed there were enough staff to respond to people's needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People’s medicines were administered and managed safely. Infection prevention and control (IPC) risks were well managed throughout the home and there were plentiful supplies of personal protective equipment (PPE).
Accidents and incidents were recorded and monitored to ensure trends and patterns were identified and action taken to reduce risks occurring. The registered manager kept a record of lessons learned and took appropriate actions to improve the service.
People’s care plans were detailed and included information about family, social history, children, childhood and siblings. People were involved in the running of the home and some were champions for specific aspects of the service. This was clearly displayed for people, staff and visitors to see.
There were systems in place to monitor the service and a range of meetings and audits were in place to support the management of the home.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 11 September 2019) and there was a breach of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We carried out an unannounced comprehensive inspection of this service on 6 August 2019. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve governance.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions safe and well-led which contain those requirements.
We looked at infection prevention and control measures under the safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has changed from requires improvement to good based on the findings of this inspection.
You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Alexandra Nursing and Residential Home on our website at www.cqc.org.uk
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
We found the following examples of good practice:
Staff knew people at the service well and were aware of the importance of supporting people’s wellbeing during the pandemic.
Staff encouraged people to participate in activities to reduce feelings of isolation, and facilitated video calling for people to stay in touch with their loved ones.
An enhanced cleaning schedule of high touch areas was in place and a deep clean was conducted nightly.
All visitors to the service were required to complete a lateral flow test prior to accessing the home, and were provided with appropriate PPE. The service completed risk assessments to support people to spend time with their relatives.
Visitors accessed the home not only through the main reception, but also through various fire doors to minimise the areas of the home they walked through.
Alexandra Nursing and Residential Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Alexandra Nursing and Residential Home is in the Thrybergh suburb of Rotherham, South Yorkshire. It is in its own grounds in a quiet, residential area, but close to public transport links. The home accommodates up to 47 adults with both nursing and residential care needs. At the time of the inspection, 44 people were using the service.
People’s experience of using this service and what we found
People told us they felt safe and staff had good knowledge of safeguarding.
Staff told us they knew how to manage risks effectively and identify signs and symptoms of abuse and who to report concerns to.
The provider had failed to keep an accurate record of people's personal belonging and failure to risk assess the safekeeping of personal belongings.
The registered manager had robust recruitment procedures and staffing levels delivered responsive support to people.
People received their medicines on time and as prescribed by trained staff.
The home was well maintained, clean and staff had access to protective equipment to protect people from the risk of infections.
Staff received training at the start and throughout their employment to ensure they had the skills to provide effective care.
People received regular review of their care needs and risks were assessed and monitored to ensure people received safe care and treatment. Care plans contained personalised information on people's health and communication needs plus their likes and dislikes. Activities were available for people to participate in if they wished.
Staff felt very supported by the manager and management team.
People told us food and drinks were of a good quality. People told us the food was very nice and plentiful.
We saw the provider worked with community health professionals to ensure people received effective care.
We saw that staff treated people with dignity and respect.
The service had been responsible for the safe keeping of people’s personal possessions without assessing the risk and had failed to reimburse for loss of belonging through their insurance.
The registered manager was aware of their regulatory responsibility to inform CQC of specific incidents which occurred within the service and were doing so when required. However, the registered manager was not aware that they were not registered to provide all of the regulated activities they were providing.
People, staff and relatives spoke positively about the registered manager and management team. There was a positive culture throughout the service which focused on providing care that was individualised. The registered manager used a variety of methods to assess and monitor the quality of the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was requires improvement (published 20 August 2018).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Alexandra Nursing and Residential Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Alexandra Nursing and Residential Home is in the Thrybergh suburb of Rotherham, South Yorkshire. It is in its own grounds in a quiet, residential area, but close to public transport links. The home accommodates up to 47 adults with both nursing and residential care needs. At the time of the inspection, 39 people were using the service.
At the time of the inspection, 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 and associated Regulations about how the service is run.
At the last inspection in August 2017, the service was rated Requires Improvement. At this inspection we found the service still Required Improvement. We found that the provider's arrangements in for obtaining and acting in accordance with people’s consent did not meet legal requirements. We also found that although there was an audit system in place, but it did not always identify shortfalls in service provision.
During the inspection we found staff were kind and warm in their interactions with people, and people experienced care which met their needs from staff who understood them well.
Staff understood their responsibilities in relation to safeguarding, and had received appropriate training.
Medicines were safely managed, and there were suitable risk assessments in place to protect people from the risk of harm.
People told us there were plenty of activities at the home, and said they enjoyed day to day life there.
The provider managed complaints appropriately, however, changes were required to the provider’s complaints policy so that complainants understood how to make complaints to the correct bodies.
People experienced a good standard of nutrition and hydration, and told us they enjoyed the meals at the home.
Staff received a good level of training which they told us supported the in carrying out their role.
There was a registered manager in place, and most staff told us they felt supported by senior staff and the registered manager.
Alexandra Nursing and Residential Home is a 47 bed service providing nursing and residential care to older people with a range of support needs including dementia. It provides accommodation on either a long term basis, or on a short term respite basis. At the time of our inspection, 41 people were using the service.
Alexandra Nursing and Residential Home is located in the Thrybergh suburb of Rotherham, South Yorkshire. It is in its own grounds in a quiet, residential area, with parking and public transport links.
The provider 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.
People were treated with kindness and received support in a patient and considerate way. People were treated with respect and their privacy, dignity and independence were protected. Staff had a good understanding of the care people required, and knew how to deliver this care and a way that upheld people’s dignity.
People were offered a choice of nutritious meals which they told us they enjoyed. Their health in relation to nutrition and hydration was well-monitored.
People gave informed consent to their care and treatment. The provider had appropriate arrangements in place for acting in accordance with the Mental Capacity Act 2005, and ensured that the Act was adhered to in relation to people who lacked the capacity to make decisions about their health and welfare.
There was a range of activities available, both within the home and in the wider community. People told us they regularly went on trips organised by the home, and outside entertainers often visited.
There was a complaints system within the home, and on the small number of occasions a complaint had been received, the provider took appropriate steps to investigate it and provide a remedy.
Risks to people were assessed and steps were put in place to reduce these risks. Staff had received training in protecting vulnerable adults and recognising abuse, although the provider had not correctly notified incidents of suspected abuse to the Care Quality Commission (CQC).
The condition of the premises was poor in parts, meaning that it presented a risk of cross-infection as areas could not be hygienically cleaned to a safe standard.
The arrangements in place for monitoring the quality of the service were not robust enough to identify or address shortfalls in service quality. We noted a number of occurrences that the provider was required to have notified to CQC but it had failed to do so.