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Inspection carried out on 4 July 2018

During a routine inspection

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