• Care Home
  • Care home

Alexandra Nursing Home - Poulton-le-Fylde

Overall: Good read more about inspection ratings

Moorland Road, Poulton Le Fylde, Lancashire, FY6 7EU (01253) 893313

Provided and run by:
Alexandra Nursing Home Limited

All Inspections

9 November 2023

During an inspection looking at part of the service

About the service

Alexandra Nursing Home - Poulton-le-Fylde provides residential and nursing care for up to 117 people. The service has four units for people with different levels of need, including people who require nursing care and people living with dementia. At the time of the inspection visit there were 80 people who lived at the home.

People’s experience of using this service and what we found

A new senior management team and a new manager for the service had been appointed since we last inspected. They were in the process of reviewing and implementing systems to effectively assess, monitor and improve the service. People, their relatives and staff we spoke with told us they had seen positive changes. Staff understood their roles and responsibilities and were caring and person-centred in their approach.

Management of risk and quality of record keeping had improved since we last inspected the service. We have made a recommendation around record keeping for 1-to-1 care and support.

The service had systems to protect people from abuse and improper treatment and plans to follow in case of emergencies. Staff continued to be recruited safely. The new management team were in the process of reviewing staffing levels and implementing systems to ensure there were sufficient staff deployed at all times. The service was clean, tidy and maintained.

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.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 11 August 2023).

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

The inspection was prompted in part due to concerns received about pressure care and wound management. A decision was made for us to inspect and examine those risks. As a result, we carried out a focused inspection to review the key questions of safe and well-led only.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe section of this full report.

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 changed from requires improvement to good based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Alexandra Nursing Home on our website at www.cqc.org.uk.

26 April 2023

During an inspection looking at part of the service

About the service

Alexandra Nursing Home - Poulton-le-Fylde provides residential and nursing care for up to 117 people. The service has four units for people with different levels of need, including people who require nursing care and people living with dementia. At the time of the inspection visit there were 81 people who lived at the home.

People’s experience of using this service and what we found

Risks were not consistently managed and records relating to people’s care were not always accurate. The provider monitored the quality of the service using a range of systems. However, these had not always been operated effectively.

The management of medicines had improved since our last inspection. We have made recommendations around ensuring person-centred medicines information is up to date and ensuring topical medicines are recorded consistently.

The service had systems to protect people from abuse and improper treatment and plans to follow in case of emergencies. Staff continued to be recruited safely. The registered manager took a systematic approach to ensuring there were enough staff on duty to meet people's needs safely. The service was clean, tidy and maintained, with the exception of one bathroom. We have made a recommendation about this.

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.

The service was led by a registered manager who was described as approachable and supportive. The culture at the service was open and inclusive. Staff understood their roles and responsibilities.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 8 November 2022) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made in relation to medicines management. However, we found the provider remained in breach of regulation in relation to records.

The last rating for this service was requires improvement (published 8 November 2022). The service remains rated requires improvement. This service has been rated requires improvement for the last four consecutive inspections.

Why we inspected

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.

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Alexandra Nursing Home on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to risk management and the management of records at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

18 August 2022

During a routine inspection

About the service

Alexandra Nursing Home - Poulton-le-Fylde provides residential and nursing care for up to 117 people. The service has four units for people with different levels of need, including people who require nursing care and people living with dementia. At the time of the inspection visit there were 93 people who lived at the home.

People’s experience of using this service and what we found

The service had improved in terms of safety at this inspection, but some aspects of safety still required improvement. The provider had not addressed all the issues from the last inspection. Although we found no evidence anyone had been harmed, we found the systems in place to manage people's medicines were not always safe which placed them at risk of harm. Records of the care people received were not always accurate.

The service had systems to protect people from abuse and improper treatment and plans to follow in case of emergencies. Staff were recruited safely. The registered manager took a systematic approach to ensuring there were enough staff on duty to meet people’s needs safely. The service was clean, tidy and maintained.

Staff supported people with their healthcare needs and worked well with external healthcare professionals. People were cared for by staff who were well supported and had the right skills and knowledge to meet their needs effectively, following good practice guidance. The service met people’s nutritional needs and accommodated their preferences.

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 were treated well, with kindness and compassion by staff who respected their privacy and dignity and promoted inclusion. The service supported people to be independent. We received positive feedback about the caring approach of staff.

The service put people at the centre of the care they received. Staff identified people’s needs and preferences and worked to ensure people were happy with the care they received. The service made sure people were supported to communicate and planned activities to enhance people’s wellbeing. The registered manager was working to improve activity provision in the Brambles unit, for people living with dementia.

The service was led by a registered manager who was described as approachable, supportive and caring. The culture at the service was open and inclusive. Staff understood their roles and responsibilities. The provider monitored the quality of the service using a range of systems.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 7 April 2021).

The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made. However, the provider remained in breach of regulations.

The service remains rated requires improvement and has been rated requires improvement for the last two consecutive inspections.

Why we inspected

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.

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Alexandra Nursing Home – Poulton-Le-Fylde on our website at www.cqc.org.uk.

Enforcement and Recommendations

We have identified breaches in relation to the safe and proper management of medicines and records at this inspection.

We have made a recommendation about recording best interests decisions.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

18 February 2021

During an inspection looking at part of the service

About the service

Alexandra Nursing Home - Poulton-le-Fylde provides residential and nursing care for up to 117 people. The service has three units one with a separate dementia unit which is purpose built. This building adjoins the main home and provides dedicated care for people with a specified dementia condition. At the time of the inspection visit there were 71 people who lived at the home.

People’s experience of using this service and what we found

The service had improved in terms of safety, but more improvements were required. We found medicines management and management of risks related to behaviours which could challenge needed to be improved. We noted improvements in relation to fire safety and environmental risks, as well as improvements to infection prevention and control. The provider had introduced a systematic approach to ensuring staffing levels were sufficient.

Records were not always up to date and accurate. The provider had introduced new quality assurance measures. These had only just begun to be used at the time of our inspection, but had identified some shortfalls in standards and could be used effectively to assess, monitor and improve the quality of the service. New senior staff had been recruited to support the registered manager. The provider worked with external professionals to ensure people’s healthcare needs continued to be met. People and staff were asked for their opinions on the service through meetings with the management team.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 08 January 2021). The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

We carried out an announced focussed inspection of this service on in November 2020. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve staffing, safe care and treatment, and good governance.

We carried out this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Alexandra Nursing Home – Poulton-le-Fylde on our website at www.cqc.org.uk.

We have found evidence that the provider needs to make improvement. Please see the Safe and Well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to medicines management, management of risks related to behaviours which may challenge and the quality of records at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

6 November 2020

During an inspection looking at part of the service

About the service

Alexandra Nursing Home - Poulton-le-Fylde provides residential and nursing care for up to 117 people. The service has three units one with a separate dementia unit which is purpose built. This building adjoins the main home and provides dedicated care for people with a specified dementia condition. At the time of the inspection visit there were 93 people who lived at the home.

People’s experience of using this service and what we found

The service was not safe. We found staffing levels were not adequately assessed and documented. Not all staff had completed the necessary training to keep people safe. Where people had risks to their personal safety identified and recorded documentation to lessen the risk was, at times, conflicting. We found concerns with the cleanliness and maintenance of the environment. We observed staff not following good practice guidance around infection prevention and control including the use of personal protective equipment. We have made a recommendation around safeguarding training for staff as not all staff had received safeguarding training.

The service was not always well-led. At this inspection we found failures in the provider's quality and assurance systems. Records relating to care and the management of the service were either incomplete, inaccurate and/or not kept up to date. This could have compromised the quality and safety of the service provided.

We found the management team receptive to feedback and keen to improve the service. The registered manager and provider worked with us in a positive manner and provided all the information we requested. Additionally, they responded promptly to our concerns during and after the inspection.

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 05 December 2018).

Why we inspected

As part of CQC’s response to care homes with outbreaks of coronavirus, we are conducting reviews to ensure that Infection Prevention and Control (IPC) practice is safe, and in line with best practice guidance and government guidance, in respect of the management of IPC risks during the Covid-19 pandemic.

We inspected and found there were concerns with IPC practices and quality assurance, so we widened the scope of the inspection to become a focused inspection which included the key questions of safe and well-led.

The ratings from previous comprehensive inspections for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Alexandra Nursing Home - Poulton-le-Fylde on our website at www.cqc.org.uk

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We identified breaches in relation to staffing, safe care and treatment and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The provider submitted an action plan after this inspection to show what they would do and by when to mitigate the risks and improve.

14 July 2020

During an inspection looking at part of the service

About the service

Alexandra Nursing Home - Poulton-le-Fylde provides residential and nursing care for up to 117 people. The service has three units one with a separate dementia unit which is purpose built. This building adjoins the main home and provides dedicated care for people with a specified dementia condition. At the time of the inspection visit there were 85 people who lived at the home.

People's experience of using this service and what we found

People were protected by suitable procedures for the recruitment of staff. The registered manager had carried out checks to ensure staff had the required knowledge and skills, and were of good character before they were employed at the home. The checks included written references from previous employers. Checks on new care workers had been carried out with the Disclosure and Barring Service (DBS).

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 5 December 2018)

Why we inspected

We undertook this targeted inspection to make sure that the right staff are recruited to support people to stay safe. This was because concerns had been raised with us about recruitment practices. This report only covers our findings in relation to recruitment. The overall rating for the service has not changed following this targeted inspection and remains good. This is because we have not assessed all areas of the key questions.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

30 October 2018

During a routine inspection

The inspection visit at The Alexandra Nursing Home was undertaken on 30, 31 October and 02 November 2018.

The home provides residential and nursing care for up to 112 people. The service has three units one with a separate dementia unit which is purpose built. This building adjoins the main home and provides dedicated care for people with a specified dementia condition. At the time of the inspection visit there were 91 people who lived at the home.

A registered manager was in place. A registered manager is a person who has registered with the Care Quality Commission (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 Alexandra is a ‘care home.’ People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

At the last inspection in October 2017 we rated the service as ‘Requires Improvement’. This was because recommendations were found. These related to care plan records and medication processes. Furthermore, the management team failed to properly assess the quality assurance of the service provided. We made a recommendation to improve quality assurance systems.

During this inspection, we found the management team had made improvements to recommendations from the previous inspection CQC made in terms of medication processes and quality assurance systems. However further improvements were required in recording of people’s care documentation in order to make them person centred and accurate. We made recommendations to ensure the safety of people was maintained.

We made a recommendation the provider seeks guidance about care planning.

We spoke with people who lived at The Alexandra and relatives. Comments were positive in relation to care and support provided by the staff team. One person who lived at the home said, “A very good home with excellent staff.” A relative said, “Always made welcome and offered a tea or coffee. It is very homely.”

We observed staff interacted respectfully with people in ways that demonstrated they knew how best to support them. For example a person who lived at the home said, “I am treated with respect and they know what I need to make me happy.”

The service had systems in place to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff had received safeguarding training and understood their responsibilities to report unsafe care or abusive practices.

Staff had been appropriately recruited, trained and supported. They had skills, knowledge and experience required to support people who lived with dementia and care for people with nursing needs.

We observed staff administered medication with a skilled and secure approach, which the registered manager strengthened through training and competency checks. They had good oversight of relevant procedures through regular auditing to ensure they remained safe.

Care records included an assessment of the level of risk and actions to guide staff to manage people’s safety. The registered manager retained an accident record and analysed patterns to assess control measures reduced the risk of incidents.

Those who lived at The Alexandra and their relatives told us staff were skilled and experienced. One person who lived at the home said, “The staff are well trained.”

We saw staff supported people with their meals sensitively and respected their dignity. They also checked they had enough to eat and what assistance they desired. Comments were positive and one person said, “Loads of choice and we have very good cooks here, nothing wrong with the food at all.”

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the service supported this practice.

We spoke with the registered manager about access to advocacy services should people in their care require their guidance and support. The service had information details for people if this was needed.

People who lived at the home told us they enjoyed a variety of activities and regular outside entertainers which were organised for their enjoyment. One person said, “I have a good laugh here. [Staff member] makes life fun. There is always something going on.”

There was a complaints procedure which was made available to people and their family when they commenced using the service. People we spoke with told us they were happy with the support they received from staff and the registered manager and had no complaints.

The management team used a variety of methods to assess and monitor the quality of the service. These included staff and ‘resident’ meetings and satisfaction surveys to seek their views about the service provided. In addition, daily ‘handover’ meetings were held to discuss the day’s events and any issues in relation to people who lived at the home. Audits were carried out on a regular basis to ensure the home continually improved.

22 August 2017

During a routine inspection

This inspection visit took place on 22 and 24 August 2017 and was unannounced.

At the last inspection in July 2015 the service was rated Good. At this inspection we found the service Required Improvement.

The Alexandra Nursing Home is a listed building and stands in its own grounds on the outskirts of Poulton-le-Fylde. The service has their own car parking facility within the grounds. The service has three separate units that provide nursing care and support for people who live with dementia. There is lift access to the two floors in the main building. Alexandra Nursing Home is registered to provide care for 117 people.

During this inspection we made recommendations for the management team to improve people’s safety and welfare. These issues related to safe medication recordkeeping, care plan information for people who lived at the home and recruitment procedures. In addition we recommended the management team continued to develop their quality assurance systems to ensure the home was continuously monitored.

When we undertook our inspection visit the manager had applied to be registered with the Care Quality Commission. 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. The manager informed us the process was ongoing and the registration team at CQC was processing the application. The manager is already a registered manager with another location within the organisation.

We found medication procedures at the home were not consistently safe. However the new management team was in the process of implementing more robust systems in relation to medication procedures. Medicines were safely kept with appropriate arrangements for storing in place. However recording systems required improvement to ensure people received their medication correctly and on time.

We have made a recommendation about safe medicine procedures.

Care plans had changed and were altered by staff. However they were not identified as to who changed and updated the care plan. This could cause concerns if problems occurred in a person’s care and the management team were unable to identify the staff who changed the caring support. Although care plans were up to date we saw gaps in information which put people at risk of unsafe care. The management team had started to implement new care plan documents to ensure all care and nursing information was in place for staff to support people with their assessed needs as required.

We have made a recommendation about record keeping.

Recruitment procedures required improvement and this had been identified by the management team and additional administration staff were now in place. However one record had not explored gaps in employment and two records did not contain photographs of the new staff member. These checks were required to reduce the risk of employing unsuitable staff to work with vulnerable people.

We have made a recommendation about recruitment.

New auditing systems had recently been introduced and improved. However audits had not identified issues that had we had highlighted during this inspection visit. For example care plan audits did not always identify any mistakes and ensure people who lived at the home were kept safe.

We have made a recommendation about efficient monitoring and quality assurance systems.

Staff told us the management team were supportive in their work and approachable should they wish to discuss any issues. They felt part of the team to improve the home for people who lived at the Alexandra Nursing Home.

Staff spoken with had received safeguarding training and understood their responsibility to report unsafe care or abusive practices.

We looked around the building and found it had been maintained, was clean and hygienic and a safe place for people to live. We found equipment had been serviced and maintained as required

We observed staff providing support to people throughout our inspection visit in all three units. We saw they were kind and patient and treated people with dignity and respect.

Staff received regular training and were knowledgeable about their roles and responsibilities. They had the skills, knowledge and experience required to support people with their care and social needs.

Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. A staff member said, “We are getting there with care and risks assessment plans, the new ones are much better.”

People who lived at Alexandra Nursing Home told us they had choices of meals and there were always alternatives if they did not like what was on the menu. We observed at lunchtime in all units people who required support were attended to in a sensitive, caring manner. Comments about the quality of food included, “The food is very good. “ And, “The food is good we do get a choice.”

People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

People who lived at the home told us staff were all caring, kind and respectful. Relatives also commented in surveys how caring staff were.

Staff knew people they supported and provided a personalised service in a caring and professional manner.

The service had a complaints procedure which was made available to people on their admission to the home and their relatives. People we spoke with told us they were happy and had no complaints.

The manager used a variety of methods to assess and monitor the quality of the service. These included, staff and resident meetings. In addition relative surveys were collected to seek their views about the service provided.

08 July 2015

During a routine inspection

The inspection visit took place on 08 July 2015 and was unannounced.

The Alexandra Nursing Home is a listed building and stands in its own grounds on the outskirts of Poulton-le-Fylde. The service has their own car parking facility within the grounds. The service provides nursing care for up to seventy-seven people. The service has a separate dementia unit that is purpose built. This building adjoins the main home and provides dedicated care for people living with dementia. There is lift access to the two floors.

There was a registered manager in place. 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 last inspection on 27 November 2013 the service was meeting the requirements of the regulations that were inspected at that time.

People who lived at the home and relatives told us they felt safe because there were sufficient staff on duty to meet their needs. We found people’s care and support needs had been assessed before they moved into the home with risk assessments in place to ensure peoples safety. Care records we looked at contained details of people’s preferences, interests, likes and dislikes.

We observed medication being dispensed and administered in a safe manner. We looked at how medicines were managed and found appropriate arrangements for their recording and safe administration.

People were happy with the variety and choice of meals available to them. Regular snacks and drinks were provided between meals to ensure people received adequate nutrition and hydration. The cook had information about people’s dietary needs and these were being met. One person who lived at the home said, “There is a pleasant atmosphere and the food is always good.”

Staff we spoke with had a good understanding of how people should be treated in terms of respect and dignity. During our observations we saw examples of staff being respectful, caring and sensitive towards people who lived at the home.

We found examples where the service had responded to changes in people’s care needs. We found evidence in records where referrals had been made to external professionals. Records were up to date and reviewed providing information for staff to deliver quality care.

People who lived at the home were encouraged and supported to maintain relationships with their friends and family members. Relatives we spoke with told us they were always made welcome at any time.

We found a number of audits were in place to monitor quality assurance. Records demonstrated identified issues were acted upon in order to make improvements. The registered manager had systems in place to obtain the views of relatives and people who lived at the home.

27 November 2013

During a routine inspection

On the day of our visit we spoke with the deputy manager, staff, relatives and residents. We also had responses from external agencies including social services .This helped us to gain a balanced overview of what people experienced living at Alexandra Nursing Home.

During the inspection we looked at meal preparation, care planning, recruitment and staff induction training records. We also observed care practices during the day and talked with residents and relatives about the home.

We were supported on this inspection by an 'expert by experience'. This is a person who has personal experience of using or caring for someone who uses this type of care service.

The expert by experience spoke with a number of people. Comments received were positive about the care being provided. They included, 'The staff are very nice and helpful.' Also, 'The staff are lovely.'

People who lived at the home told us they could express their views and were involved in making decisions about their care. One resident said, 'The staff are fantastic and always listen to what I have to say.' Residents were positive about the food provided at the home. One person said, 'The food is very good we have excellent cooks.'

We observed the staff team providing sensitive and flexible personal care support. Staff were kind and patient and showed a good understanding of the needs of people in their care.

There were a range of audits and systems in place to monitor the quality of the Home.

13 February 2013

During a routine inspection

This is a large home which is divided into two separate units. One unit is for people who have a dementia condition. The other unit is for residential and nursing residents. We spent time in both units in order to have an overview of the service in general.

We spoke with a range of people about the home. They included the manager, deputy manager, nurses, staff members, relatives and people who lived at the home. We also asked for the views of external agencies in order to gain a balanced overview of what people experienced living at the Alexandra Nursing Home.

We observed staff assisting people who required care and support with personal care. Staff treated people with respect and ensured their privacy when supporting them. They provided support or attention as people requested it. Comments from residents included, 'It's a big home but the staff are really good. They are kind and do a fantastic job.' Also, 'Plenty of people around which I like. They are polite and nothing is too much trouble.' Relatives comments about the care provided included, 'The manager and staff do a wonderful job, the best care home around. ' Also, 'They keep us informed all the time about mums care.'

People we spoke with told us they could express their views and were involved in decision making about their care. One resident said, 'We looked at a few homes but this was by far the best."

24 November 2011

During an inspection in response to concerns

This is a large home which is divided into two separate units. We spent time equally in each unit in order to gain an overview of the service in general.

We found people we spoke to were very welcoming, this included residents, staff and visitors. We also spoke to the registered manager and had a brief discussion with the registered provider.

People we spoke to told us they like living there, comments included, "Oh yes everybody is very helpful,' and, 'It's a busy home there's always something going on.' Also, 'It's going to get busy, always does at Christmas.'

In addition to gaining the views and comments of people experiencing the service, we asked other external agencies including social services contracts team. They told us there has been some involvement with the service and the manager worked closely with social services to address some concerns raised. The infection control practitioner told us the home is compliant with their standards.

We spoke to a range of staff working in the home and they all demonstrated an awareness of individual care/nursing needs of people living there, and the importance of treating people with respect and dignity. A relative told us, "Staff are very kind, they are always respectful.'

All the staff we spoke to told us this is a good care home to work for and staff felt supported in carrying out their roles. One staff member said, "The manager is supportive and is always around.' Also, "We work really well as a team.'