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Archived: Alexandra House Requires improvement

The provider of this service changed - see new profile

Inspection Summary

Overall summary & rating

Requires improvement

Updated 14 May 2016

This inspection took place on 12 and 13 April 2016 and was announced. We gave the provider 48 hours’ notice so people would be available to speak with us at our visit.

Alexandra House provides an extra care service of personal care and support to people within a complex of 40 apartments. Staff provide care at pre-arranged times and people have access to call bells for staff to respond whenever additional help is required. The complex is spread over three floors with a lift and stairs to each floor. People have access to communal lounges and a dining room where they can have a lunchtime meal.

At the time of our visit 29 people were receiving personal care support. The provider does not own the property and people have tenancies with a landlord. This was the first time the service had been inspected.

The service had a registered manager. 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.

At the time of our visit there was a new manager in post, who was in the process of registering with us. We refer to them as the new manager in this report. They were being supported by the current registered manager who is also the locality manager for other of the provider’s locations in the area.

People received varying levels of support from staff, depending on their needs. Some people only required a ‘wellbeing’ check or minimal assistance with personal care. Other people required assistance with taking medicines, continence care, nutritional support and with mobility.

People told us they felt safe with the staff who delivered their care. Staff were aware of the action they needed to take if they had any concerns about people’s safety, or health and wellbeing. However, we found that safeguarding concerns were not consistently reported correctly to the local safeguarding team so that investigations could take place if required.

The staff allocation sheets showed us there were sufficient staff to cover the scheduled calls to people. People told us they received their care on time and staff stayed the allocated time to complete tasks. New staff had been recruited and were awaiting the outcome of checks to ensure they were safe to work with people before starting work at the service. The provider had reduced the use of agency staff, so that people received care and support from consistent staff that knew them.

Staff received a detailed induction and training when they started working at Alexandra House. Some training was out of date, but there were plans to ensure all staff completed the required training to ensure their work reflected good practice. Staff received supervision and support and told us the new manager was approachable and had made significant improvements since taking up their position.

Care plans did not always include important information about risks to people’s health, but staff were able to talk confidently about how they managed those risks, as they knew people well. Care plans were written in a ‘person-centred’ way that supported staff in delivering care and assistance that met people’s individual needs.

People were happy with the care they received and said staff were caring and friendly. Staff respected people’s privacy and maintained people’s dignity when providing care. The manager and staff understood the principles of the Mental Capacity Act (MCA) and gained people’s consent before they provided personal care.

All the people we spoke with clearly recognised that due to the support and care provided by staff, they were able to enjoy living relatively independently in their own homes.

There were processes to monitor quality of the service provided through feedback from people and a programme of checks and audits.

Inspection areas


Requires improvement

Updated 14 May 2016

The service was not consistently safe.

The provider did not consistently follow correct procedures to report safeguarding concerns in order to ensure these were properly investigated if required. Staff told us they understood their role and responsibility to report concerns about people�s emotional and physical well-being, but did not consistently follow guidelines. Medicines were stored and administered safely but some charts were not completed correctly.

There were sufficient numbers of staff to support people. Staff understood the risks associated with people�s care, and plans were in place to minimise risks identified however some lacked detail.



Updated 14 May 2016

The service was effective.

Staff received training and had the knowledge and skills to effectively support people. Staff understood the principles of the Mental Capacity Act (2005) and how to support people with decision making. People made choices about their food and drink and were supported to maintain a healthy diet. People received on-going support from a range of external healthcare professionals when required.



Updated 14 May 2016

The service was caring.

People were supported by staff who they considered kind and caring. People were encouraged by staff to be as independent as possible. Staff ensured they respected people�s privacy and dignity. People received care and support from staff who understood their individual needs and supported them in ways they preferred.



Updated 14 May 2016

The service was responsive.

People received a service that was based on their personal preferences. Care records contained detailed information about people�s likes, dislikes and routines. People and their relatives were encouraged to be involved in reviews of their care. People were given opportunities to share their views about the service and the registered manager responded to any concerns raised.


Requires improvement

Updated 14 May 2016

The service was not consistently well-led.

The provider had failed to send us statutory notifications about incidents that had occurred. The service had changed managers twice in the last year and there had been a lack of consistent oversight at the service. However positive feedback was received about the new management team in place.

People and relatives were happy with the service and felt able to speak with the management team if they needed to. Staff were supported to carry out their roles, and considered the new manager to be approachable and responsive. The provider had systems to review the quality and safety of service provided, however these had not identified some of the issues we found.