Background to this inspection
Updated
22 April 2023
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
This inspection was carried out by one inspector.
Service and service type
Alexandra House is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Alexandra House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
This inspection was unannounced.
What we did before the inspection
We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make.
We reviewed information we had received about the service since the last inspection. This included CQC notifications. These describe events that happen in the service that the provider is legally required to tell us about.
We used information gathered as part of monitoring activity that took place in December 2022 to help plan the inspection and inform our judgements.
We used all this information to plan our inspection.
During the inspection
We spoke with 4 people who lived at the service and 8 staff. This included the registered manager, deputy managers, and nominated individual, as well as staff at all levels. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
As part of the recent monitoring activity, we received feedback from a total of 12 relatives. We also received feedback from 5 professionals who had contact with the service.
The views of everyone we spoke with have been incorporated into this report.
We viewed a range of records and documents. This included 4 people’s care plans and a selection of medicines records. We looked at 4 staff files in relation to recruitment, training and staff supervision. We checked a variety of records relating to the management of the service. This included policies and procedures, quality assurance and health and safety documents. We considered this information to help us to make a judgement about the service.
Updated
22 April 2023
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
About the service
Alexandra House is a care home providing personal care to up to 16 people. At the time of our inspection, 15 people were living at the service. The service supports autistic people and people with learning disabilities or mental health needs.
Alexandra House is located in a large, converted property in a well-connected part of Bristol. Accommodation in the main house includes communal spaces and en-suite bedrooms, and there are 2 self-contained bungalows in the garden.
People’s experience of using this service and what we found
Right Support
People felt safe living at the service and staff worked with them to ensure the least restrictive option was in place to keep people safe. Staff supported people to make decisions and to have as much choice, control and independence as possible. Plans were regularly reviewed to ensure people continued to have goals and aspirations.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People received care and support in a safe, clean, and well-maintained environment that met their needs. People had choices about their living environment.
Staff worked in close partnership with a number of other agencies and professionals to provide people with high quality, responsive support that met their needs and improved their quality of life. Staff managed medicines safely to ensure the best outcome for people.
Right Care
People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. Staff promoted individual preference, equality and diversity in their support for people. They were sensitive to people’s unique needs and worked alongside specialist services to meet these.
Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so. Staff had training on how to recognise and report abuse and were confident in this.
The service had enough appropriately skilled staff to meet people’s needs and keep them safe. Staff worked with people to assess risks people could face. Where appropriate, staff encouraged and enabled people to take positive risks. People received care that supported their needs and aspirations, was focused on their quality of life, and followed best practice.
Right Culture
People led inclusive and empowered lives because of the ethos, values, attitudes and behaviours of staff and managers. There was a core staff team who knew people well and supported people to receive consistent and responsive care.
Staff placed people’s wishes, needs and rights at the heart of everything they did. Staff understood best practice to ensure they provided compassionate and empowering care to each individual.
Staff very regularly evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate. People were encouraged to be involved in developing aspects of the service and share their views.
There was a culture of continuing improvement. There were effective systems and checks, and staff received training to ensure they remained up to date and improved people’s quality of life with the support they provided.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 26 November 2018).
Why we inspected
This inspection was prompted by a review of the information we held about this service.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has remained good. This is based on the findings at this inspection.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.