Alexander House Care Home

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 75 (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.

Systems were in place for staff to learn from incidents within the service and from the provider’s other services. Incidents and safeguarding events were discussed at staff meetings so that all staff were aware of what had happened and how lessons could be learned to prevent recurrence of the incident or accident. Following an incident, care documents for people involved were reviewed to make sure any additional measures to support their safety were included in the care plan and risk assessment. Safety events were reported to the local authority safeguarding team and, where appropriate, people’s families were informed.

Monthly audits of accidents and incidents were followed up with quarterly analysis to make sure any themes or patterns of incidents were identified and addressed to improve safety within the service.

Outcomes of all inspections including infection control and environmental health were shared to support staff learning and to drive improvement within the service.

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.

Where applicable, social workers assessments known as a ‘Living Well’ assessments were taken into consideration prior to the registered manager meeting the person and completing an assessment of their needs to make sure they could be met safely at the service. People were offered the opportunity to visit the service to help them decide about going to live there. People’s families were involved where possible. One person’s relative told us, “They came and did an assessment at home, they said bring [person] to see what [person] thinks, the transition was lovely.”

The service offered respite care which, the registered manager explained, was also a way to get to know people and their needs and for the person to get to know the service before making the decision to move in.

Documents known as ‘Hospital Passports’ were in place. These documents are for people to take to hospital with them to help medical staff understand the person, their needs and the support they need to meet them. Hospital passports were reviewed as people’s needs changed.

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.

Safeguarding events were clearly recorded and referred to the local authority safeguarding team in a timely way. The registered manager maintained contact with the safeguarding team to promote a good working relationship.

The registered manager reviewed all safeguarding events and took action to safeguard people as needed. 3 monthly analyses of all safeguarding events were completed and shared with staff to identify any themes or patterns which could be addressed to lessen the risk of recurrence.

Staff understood their responsibilities in maintaining people’s safety. They received training and had access to information to enable them to contact the local safeguarding team independently if the need arose.

The Mental Capacity Act 2005 (MCA) outlines how decisions should be made for individuals lacking capacity. MCA principles were consistently followed with capacity assessments completed, and correct procedures followed in relation to making best interest decisions where people lacked capacity to make informed decisions about their care.

Systems were in place to make sure where people lacked capacity, the principles of the MCA were followed. Capacity assessments were completed as needed and, where people lacked capacity, best interest assessments were completed appropriately.

People told us they felt safe, one said, “Look, there are staff here to make sure I’m safe”. People’s relatives agreed their family members were safe. Their responses when we asked about this included, “Absolutely yes”, “Very safe, every time we see [person], we had a look round and were extremely happy with the place” and “[Person] is completely safe”.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

An overall risk assessment of people’s health and safety was completed. Where risks were identified, individual risk assessments were developed with the risk rated as high, medium or low after analysis of the likelihood of the risk occurring and possible consequences. Risk assessments were detailed, giving staff good information about how to provide care and support safely. Where possible, people had been involved in the development and review of their risk assessments, and the registered manager was addressing the lack of recorded involvement of families where they had lasting power of attorney for their family member.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Systems were in place to make sure people lived in a safe environment. Compliance checks to ensure the safety of the building and environment were up to date. Fire safety was promoted through an up to date risk assessment, staff training and documents known as PEEPs [Personal emergency evacuation plans] developed and reviewed regularly to support safe evacuation of people in the event of an emergency.

Environmental safety audits were completed and the call bell system and assistive technology used such as motion and bed sensors were reviewed weekly by maintenance staff to make sure they were working correctly.

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.

Staff were recruited safely and any specific training needs were identified during the recruitment process. For example, staff new to care and overseas staff were supported to access additional training and education to support success in their roles. There were enough staff available to people to make sure their needs were met.

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.

Infection prevention and control (IPC) was managed well within the service. A member of the domestic team took the lead in this area and had attended training provided by the local authority. Monthly infection control audits were completed and reviewed by the registered manager. The service had recently worked in partnership with the local authority to successfully manage and contain an outbreak of influenza.

People we spoke with were complimentary about the standards of cleanliness within the home. One relative told us, “I think it is spotless, I visited 13 care homes before I chose this one! [Person] has been a stickler for cleanliness and Alexander House is way in front of anybody else.”

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 stored, managed and administered safely. Some minor issues identified on the day of inspection such as inconsistent recording of patch application, were addressed immediately and processes put in place to make sure this was not repeated.

Staff received training in management of medicines and there were systems in place to check their competence.