Alexander House - Dover

Updated 10 January 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

The inspection was undertaken by one inspector.

Service and service type

Alexander 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. Alexander House is a care home without nursing care. The Care Quality Commission (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 CQC 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 reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. 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 used all this information to plan our inspection.

During the inspection

We spoke with 3 people and 2 relatives about their experience of living at the service. We observed staff interactions with people in the communal areas. We spoke with 8 members of staff including the registered manager, the nominated individual, deputy manager, head of care, senior carer, carer and activities co-ordinator. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included 5 people’s care plans and associated medication records. We looked at 2 staff files in relation to recruitment. A variety of records relating to the management of the service, including checks and audits were reviewed.

Updated 10 January 2023

About the service

Alexander House is a residential care home providing personal care to up to 46 people. The service provides support to older people who maybe living with dementia in 2 adjoining adapted buildings. At the time of our inspection there were 32 people using the service.

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

People told us they felt safe living at the service. Potential risks to people’s health and welfare had been assessed and there was guidance for staff to mitigate risk. There were effective systems in place to protect people from discrimination and abuse.

People were supported by staff who had been recruited safely. There were enough staff to support people in the way they preferred. People received their medicines as prescribed.

Staff were following the current infection control guidance; visitors were encouraged to spend time with people and take them out. People and staff were asked their opinions on the service and their suggestions were acted upon.

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.

Checks and audits were completed on all areas of the service and these had been effective in identifying shortfalls, action had been taken to rectify these. Relatives told us they were confident to raise concerns with the registered manager and they would take action.

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 14 July 2018).

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.

We received concerns in relation to risk management and staffing levels. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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 based on the findings of this inspection.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the effective, caring and responsive sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Alexander House - Dover on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.