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Inspection Summary


Overall summary & rating

Good

Updated 8 August 2018

The inspection took place on 4 July 2018 and was announced. We gave the provider 24 hours’ notice of our intended visit as this was a small home and we wanted to ensure there would be someone available. This was the first inspection of the service since registering in 2017.

Alexandra House 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 House accommodates seven people in their own flats in one adapted building with additional communal spaces. At the time of our inspection there were six people using the service who had a learning disability.

The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The service did not have a registered manager. A registered manager is a person who has registered with the CQC 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. The manager at the home had submitted an application to become the registered manager and was waiting for an interview with the CQC. The manager had extensive experience of working in the social care sector

Staff were trained in safeguarding, first aid, the Mental Capacity Act and infection control. Additional training was in place or planned in areas specific to people’s individual needs. However, we received mixed feedback from staff regarding the training on offer and the lack of time set aside to complete it.

Effective procedures were in place for managing medicines and we found that all aspects of medicines management, storage, administration and recording were safe.

People’s needs were assessed before they moved into the service. Care plans were then developed to meet people’s daily needs on the basis of their assessed preferences.

People were supported to have choice and control over their own lives from being supported by person centred care. Person centred care is when the person is central to their support and their preferences are respected.

Care plans were person centred regarding people’s preferences and were updated regularly.

People’s nutrition and hydration needs were met and were supported to maintain a healthy diet, and where needed records to support this were detailed.

Accidents and incidents were monitored by the registered manager to highlight any trends and to ensure appropriate referrals to other healthcare professionals were made if needed.

A programme of audits was carried out by the manager which were effective at improving the service.

People who used the service were regularly asked for their views about the support they received and this was recorded and acted upon. People’s relatives and other healthcare professionals were asked for their views via questionnaires or feedback forms.

The home was clean, tidy, well presented and infection control was carried out to a high standard.

People were supported to take risks safely and personalised risk assessments were in place to ensure people were protected against a range of risks.

Staff had received safeguarding training and were able to describe types of abuse and what they would do to report concerns and protect people.

Staff recruitment was carried out safely with robust safety checks in place for new staff.

New staff received induction training and were supported by other staff members until they could work alone.

Support for people was person centred this meant their preferences and dislikes were

Inspection areas

Safe

Good

Updated 8 August 2018

The service was safe.

Medicines were stored, managed, administered and recorded safely.

Infection control protective measures were in place.

People had individualised risk assessments in place.

Staff were trained in safeguarding and were able to spot and report signs of abuse.

Staff recruitment was carried out safely with robust checks on staff in place.

There was enough staff to meet people�s needs individually and safely.

Effective

Good

Updated 8 August 2018

The service was effective.

People were supported by trained staff.

Staff were supervised regularly.

New staff were supported to complete shadowing and their induction.

Peoples nutrition and hydration needs were met and preferences respected.

Peoples healthcare needs were met.

Caring

Good

Updated 8 August 2018

The service was caring.

People were encouraged by staff to maintain their independence.

People's rights to dignity and privacy were respected by staff.

Staff had kind and caring attitudes and were patient.

People took part in self advocacy groups and advocacy support was available for individual support.

People were encouraged and supported to take part in empowerment activities with the local government.

Responsive

Good

Updated 8 August 2018

The service was responsive.

Staff understood people�s individual needs and respected people�s preferences.

People and their relatives knew how to complain if they needed to and this was supported and well managed.

People�s care was person centred and tailored to their needs.

Information was tailored to meet people�s requirements.

Well-led

Good

Updated 8 August 2018

This service was well led.

There was no registered Manager at the service but the manager was in the process of registering with CQC.

Audits were in place and were effective.

The manager submitted notifications to the CQC of serious events in a timely manner.

People were confident to approach the manager to raise any concerns.

Staff told us they felt supported by the manager.