Alexander Court Care Centre Also known as 1-3977761030

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Lessons were learnt when things went wrong. Safeguarding allegations, complaints, accidents and incidents were all recorded and reviewed to see what actions could be taken to reduce the risk of similar events occurring again. Information was communicated through staff meetings so that all staff were aware of any learning needs and people’s care plans and risk assessments were updated to reflect learning.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

People’s needs were assessed before they started using the service to help with a smooth transition into the home. The assessment process included working with health and social care staff from other agencies along with the person themselves and their relatives. This helped ensure that people’s needs were met when they first moved to the service. Relatives told us people received good care.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

Staff understood what safeguarding meant and the types of abuse which might occur. They knew who to report concerns to and were confident that if they were worried that their managers would listen. The provider had a safeguarding adults’ policy in place and we found safeguarding allegations had been dealt with in line with the policy. People and relatives said the service was safe. One relative told us, “[Person] is definitely safe, I wouldn’t leave them there if they weren’t.”

The provider did not always work well with people to understand and manage risks. Staff did not always provide care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Risk assessments were in place for people. These were detailed and person centred, setting out the risks people faced and including information about how to mitigate those risks. However, we found some instances of risk assessments not being followed. For example, some people were assessed as being at risk of developing pressure ulcers and required pressure relieving mattresses. We found that although people had the right mattresses, these were not always set at the correct setting. One person’s care plan stated their blood glucose levels should be checked twice a day to ensure staff detected any adverse changes. Care records did not reflect that these checks happened and there were times the checks were not completed. We discussed both these issues with the registered manager.

We found no evidence that people had been harmed as a result of the shortfalls we found. Shortly after the inspection they sent us plans they had put in place to make sure there were more robust systems in place for checking the issues we highlighted.

The provider did not always detect and control potential risks in the care environment. They did not always make sure equipment, facilities and technology supported the delivery of safe care.

During the inspection we observed a fire exit gate within the garden area was padlocked on both sides, thus meaning people could not exit through there in an emergency. We discussed this issue with the registered manager. Shortly after our inspection they informed us they had removed the padlocks so that the exits were now accessible. They also said they had contacted the London Fire Service to seek guidance on fire safety matters within the home.

We also found that there were a number of items around the shed that were not secured stored and that the shed door was broken. We raised these concerns with the manager during the inspection, and they confirmed they had addressed this shortly after our visit. We

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

There were enough staff to support people in a way that was safe. People told us they did not have to wait long for staff support. One person said, “They come straight away [when the person sounded their alarm call].” A relative told us, “I believe there are enough staff. If I need assistance someone is there in a couple of minutes.” Staff told us they had enough time to carry out their duties and that they always got their beaks. We observed staff were able to support people in a prompt manner as required.

The provider carried out checks on prospective staff to help ensure they were suitable to work in a care setting. Checks included proof of identification, employment references and criminal records check. Staff were supported in their role through regular training and supervision.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

The service assessed and managed the risk of infection. We observed that overall standards of hygiene and cleanliness throughout the service were good. The service kept records to evidence that regular cleaning took place. There were adequate stocks of Personal Protective Equipment (PPE) throughout the home. Staff demonstrated an understanding of when they were expected to use PPE.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Medicines were managed in a way that was safe. There were arrangements in place for the safe storage, administration and recording of medicines. Where people required their medicines to be administered covertly, this was done in line with relevant policies and procedures. There were guidelines in place for the administration of medicines that were prescribed on an ‘as required’ basis. Relatives told us people were supported to take their medicines. One relative said, “My [relative] takes their medication 9 times out of 10. If they refuse, then they give me a ring, and I go and manage to get [person] to take them.”