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Alexandra View Care Centre Requires improvement

The provider of this service changed - see old profile

Inspection Summary


Overall summary & rating

Requires improvement

Updated 23 November 2018

The inspection took place on 8 and 16 October 2018 and was unannounced. We last inspected the home between 10 and 15 August 2017 and found the provider had breached the regulation relating to staffing. We rated the home as Requires Improvement. This was because insufficient staff were deployed to enable people’s needs to be met in a timely way.

Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key question; is the service safe, to at least good.

During this inspection we noted improvements had been made. There was a visible staff presence with communal lounges supervised most of the time to maintain people’s safety. We also noted the provider monitored staffing levels to check they were appropriate for people’s needs and dependencies. However, we still continued to receive mixed views about staffing levels.

Alexandra View 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 View accommodates 68 people across three separate units, each of which have separate adapted facilities. One of the units specialises in providing care to people living with dementia. When we inspected 37 people were living at the home.

The registered manager left their employment at Alexandra View at the end of September 2018. An experienced manager had been recruited and was due to commence their employment on 29 October 2018. 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.

Medicines were not always managed safely. We noted some people had experienced delays in receiving their medicines. Although these issues had been resolved there was no evidence to confirm lessons had been identified and action taken to prevent future occurrences. The recording of medicines given only ‘when required' was inconsistent and ‘when required’ protocols required further detail relating to each person’s specific needs. We have made a recommendation about this.

People told us they received good care at Alexandra View. They told us staff were kind and treated them with dignity and respect. We observed many positive interactions between people and staff during our time at the home.

People, relatives and staff felt the home was a safe place. Staff had a good understanding of safeguarding and the whistle blowing procedure, including how to report concerns. Previous safeguarding concerns had been investigated thoroughly.

Staff were recruited safely with pre-employment checks completed to ensure new staff were suitable to work at the home.

Health and safety checks were up to date. The Fire Risk Assessment was being completed during our inspection. The provider supplied us with an action plan to address the findings from the risk assessment.

Incidents and accidents had been fully investigated. A new system had been implemented which allowed a more thorough analysis to be carried out to help ensure people remained safe and lessons were learnt.

Staff were well supported and received the training they needed for their role. Records confirmed supervisions, appraisals and training were up-to-date.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People gave us mostly good feedback about the meals provided at the home. People received the support they needed to ensure they had enough to eat and drink.

Staff supported people to access external he

Inspection areas

Safe

Requires improvement

Updated 23 November 2018

The service was not always safe.

The management of medicines required further improvement.

Staff knew how to identify and report safeguarding concerns.

There were usually enough staff deployed to meet people’s needs. Staff were recruited effectively.

Risk assessments and other checks were completed to maintain a safe environment.

Effective

Good

Updated 23 November 2018

The service was effective.

People’s needs had been assessed.

Staff were well supported and received the training they needed to support people’s needs.

Staff supported people with the nutritional and healthcare needs.

Adaptations had been made to the home to meet the needs of people living with dementia.

Caring

Good

Updated 23 November 2018

The service was caring.

People felt well cared for and said the staff were kind.

People were treated with dignity and respect.

Staff supported people to be as independent as possible.

Responsive

Good

Updated 23 November 2018

The service was responsive.

Most care plans were detailed and personalised. They had been reviewed regularly to keep them up to date.

People had opportunities to be involved in a range of activities of they wished.

People knew how to complain if they were unhappy with their care. Previous complaints had been fully investigated.

Well-led

Requires improvement

Updated 23 November 2018

The service was not always well led.

A new manager had been appointed and was due to start their employment imminently.

People and staff described management as approachable and supportive.

The provider had a structured approach to quality assurance. Although most audits were effective, medicines checks required further improvement.

People and staff had regular opportunities to provide feedback about the service and the care provided.