Background to this inspection
Updated
19 February 2022
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.
As part of CQC’s response to the COVID-19 pandemic we are looking at how services manage infection control and visiting arrangements. This was a targeted inspection looking at the infection prevention and control measures the provider had in place. We also asked the provider about any staffing pressures the service was experiencing and whether this was having an impact on the service.
This inspection took place on 10 February 2022 and was announced. We gave the service 24 hours’ notice of the inspection.
Updated
19 February 2022
About the service:
Alexandra Grange is a residential care home for older people some of whom have some degree of dementia. The home is arranged over three floors with the middle floor dedicated to people who have a diagnosis of dementia. It can provide accommodation and personal care for up to 58 people at any one time. On the day of the inspection 50 people were using the service.
People’s experience of using this service:
¿The registered manager did not always ensure they maintained clear and consistent records when people had injuries and the Duty of Candour was applied. This means providers must act in an open and transparent way with people who use services and other ‘relevant persons’ (people acting lawfully on their behalf) in relation to care and treatment.
¿We made a recommendation to explore relevant guidance on how to ensure environments used by people with dementia were more dementia friendly.
¿We have made a recommendation about seeking guidance from a reputable source to ensure principles of the Accessible Information Standard are met.
¿There was an activities programme and some people were involved in activities. The registered manager took action to ensure all people had opportunities for social engagement and meaningful activities according to their interests to avoid isolation.
¿People felt safe living at the service. Relatives felt their family members were kept safe.
¿Staff understood their responsibilities to raise concerns and report incidents or allegations of abuse. They felt confident issues would be addressed appropriately.
¿Recruitment processes were in place to make sure, as far as possible, that people were protected from staff being employed who were not suitable.
¿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 observed kind and friendly interactions between staff and people. People and relatives made positive comments about the staff and the care they provided.
¿People told us staff were available when they needed them and staff knew how they liked things done most of the time. The registered manager reviewed and improved staffing numbers to ensure enough qualified and knowledgeable staff were available to meet people's needs at all times.
¿Staff training records indicated which training was considered mandatory by the provider. The registered manager had planned and booked training to ensure staff had appropriate knowledge to support people. Staff said they felt supported to do their job and could ask for help when needed.
¿There were contingency plans in place to respond to emergencies. The premises and equipment were cleaned and well maintained. The dedicated staff team followed procedures and practice to control the spread of infection and keep the service clean.
¿People had sufficient to eat and drink to meet their nutrition and hydration needs. Hot and cold drinks and snacks were available between meals.
¿People had their healthcare needs identified and were able to access healthcare professionals such as their GP. The service worked well with other health and social care professionals to provide effective care for people.
¿People received their prescribed medicine safely and on time. Storage and handling of medicine was managed appropriately.
¿People confirmed staff respected their privacy and dignity. The registered manager was working with the staff team to ensure caring and kind support was consistent.
¿We observed people were treated with care and kindness. People and their families were involved in the planning of their care.
¿The service carried out risk assessments and had drawn up care plans to ensure people's safety and wellbeing. Staff recognised and responded to changes in risks to people who use the service and ensured a timely response and appropriate action was taken.
¿The registered manager held residents and relatives' meetings as well as staff meetings to ensure consistency in action to be taken. The staff team had handovers and daily meetings to discuss matters relating to the service and people’s care.
¿Staff felt the management was open with them and communicated what was happening at the service and with the people living there.
¿People and relatives felt the service was managed well and that they could approach management and staff with any concerns.
¿The management and staff team had reviewed, assessed and monitored the quality of care. They encouraged feedback from people and families, which they used to make improvements to the service. The provider was taking steps proactively as part of the quality assurance to ensure people were protected against the risks of receiving unsafe and inappropriate care and treatment.
Rating at last inspection: At the last inspection the service was rated Good in all the domains (Report was published 02 September 2016).
Why we inspected: This was a planned comprehensive inspection based on the rating at the last inspection.
Follow up: We will continue to monitor all information we receive about this service. This informs our ongoing assessment of their risks and ensures we are able to schedule the next inspection accordingly.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk