Archived: Alexander Court Care Centre

Updated 11 August 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

We carried out this unannounced inspection on 5, 6 and 8 June 2017. Three inspectors, a specialist nurse advisor and an expert-by-experience carried out the inspection on day one. A specialist advisor is a person who has professional experience in caring for people who use this type of service. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. Two inspectors visited the service on the second inspection day and one inspector visited the service on the third inspection day.

Before the inspection, we looked at the evidence we already held about the service. This included the last inspection report and notifications the provider had sent us. We also contacted the local authority to obtain their views about the service.

During the inspection, we spoke with 15 people and two relatives of people who used the service. We spoke with 20 members of staff. This included the regional manager, registered manager, the deputy manager, two activity coordinator, two domestic staff members, maintenance person, the chef, three nurses and eight care staff.

During our inspection we observed how the staff interacted with people who used the service and also looked at people's bedrooms and bathrooms with their permission. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk to us. We reviewed nine care records relating to people who used the service, twelve staff files and records relating to the management of the service including menus, medicines, staff training, quality assurance, complaints and policies.

Updated 11 August 2017

Alexander Court Care Centre provides accommodation with personal care and nursing care for up to 82 adults who may be living with dementia or have physical needs. The premises consist of a large purpose built property arranged across five units over three levels. There are three units for people living with dementia and one unit for young people with physical disabilities, all providing nursing care. There is also a residential unit for older people. At the time of this inspection there were 60 people using the service.

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 last inspection on 28 and 29 November and 5 December 2016 we found six breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and the service was placed in Special Measures. We found the provider did not ensure risks to people were minimised when receiving care. The service did not have suitable arrangements to manage medicines safely. People’s preferences and choice of activity were not consistently accounted for when planning care. The provider was not providing care in line with the principles of the Mental Capacity Act (2005). People’s dignity was not consistently respected. The provider did not always ensure people received treatment in a timely manner. People using the service and their relatives told us they did not think there were enough staff to meet their needs and they waited for unacceptable periods of time for assistance. Staff were not always given appropriate support through training opportunities to enable them to fulfil their role. Quality monitoring systems had not identified the issues identified in our inspection.

This inspection took place on 5, 6, and 8 June 2017 and was unannounced. We found improvements had been made. Although the service is no longer in special measures we found there continued to be three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. However since the inspection a new provider has taken over the registration of this service and conditions have been attached to their registration to ensure the breaches are rectified.

Risk assessments did not always correspond to the care plans or how care was delivered. Some care plans were missing information or contained contradictory information. Although medicines management had improved we found a few issues of concern. People’s choices and dignity were not consistently respected. The provider’s quality and audit systems did not identify the issues picked up on at inspection.

The building was safe in accordance with building safety regulations. Domestic staff worked hard to maintain cleanliness of the environment. Staff appropriately followed infection control procedures.

The provider and staff were knowledgeable about what was required of them to work within the legal framework of the Mental Capacity Act (2005), Deprivation of Liberty Safeguards and when they needed to obtain people’s consent. People had access to healthcare as they required it. The service offered nutritious meals and there were choices of food and drink for people.

We observed staff were caring and were knowledgeable about how to develop positive relationships with people who used the service. Staff were knowledgeable about maintaining people’s independence.

Staff had awareness of giving personalised care and care plans were personalised. The service had a variety of activities to offer people. The provider dealt with complaints in accordance with its policy.

Staff received support through supervision, meetings and training. Relatives and staff spoke positively of the service and management. The provider had a system in place to obtain feedback from people who used the service.