Alexandra Nursing & Residential Home

Updated 2 December 2022

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 carried out by 2 inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Alexandra Nursing and Residential Home 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 Nursing and Residential Home is a care home with nursing care. CQC regulates both the premises and the care provided. 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 reviewed information we had received about the service since the last inspection. We received feedback from the local authority and local Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. 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 11 people who lived in the home and 2 relatives about their experience of care and support. We spent time observing staff interacting with people. We heard from 23 members of staff including nurses, care staff, the domestic team, the catering team, the maintenance team and the registered manager. We looked at a range of records. This included 4 people’s care plans, 3 medication records and 3 staff files. We also looked at audits, policies and safeguarding records.

Updated 2 December 2022

About the service

Alexandra Nursing and Residential Home is a residential care home providing personal and nursing care for up to 46 people. At the time of our inspection there were 43 people using the service.

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

People were protected from the risk of abuse and avoidable harm. People told us that they felt safe in the home and risks in relation to people's care were identified and managed to keep them safe.

Staff had been recruited safely and during the inspection we observed there were enough staff to respond to people's needs. 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’s medicines were administered and managed safely. Infection prevention and control (IPC) risks were well managed throughout the home and there were plentiful supplies of personal protective equipment (PPE).

Accidents and incidents were recorded and monitored to ensure trends and patterns were identified and action taken to reduce risks occurring. The registered manager kept a record of lessons learned and took appropriate actions to improve the service.

People’s care plans were detailed and included information about family, social history, children, childhood and siblings. People were involved in the running of the home and some were champions for specific aspects of the service. This was clearly displayed for people, staff and visitors to see.

There were systems in place to monitor the service and a range of meetings and audits were in place to support the management of the home.

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 September 2019) and there was a breach of regulations. 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

We carried out an unannounced comprehensive inspection of this service on 6 August 2019. A breach of legal requirements was found. The provider completed an action plan after the last inspection to show what they would do and by when to improve governance.

We undertook 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.

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 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 and Residential Home 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.