Keychange Charity Alexander House Care Home

We undertook this unannounced inspection because we had rated them requires improvement for the well-led key question at their last inspection as they did not have a registered manager in post. We also received information of concern about how the service managed risk, medicines and staff training.

This responsive onsite inspection was conducted by a single Adult Social Care inspector. We reviewed all 15 quality statements related to the 2 key questions, Is the service safe and well-led? For those key questions not inspected, we used the ratings awarded at their last inspection to calculate the overall rating.

Based on the findings of this inspection we continue to rate the service good overall.

We found the service had made improvements. At their last inspection, the service did not have a registered manager in post. At the time of this inspection, although the service was still without a registered manager, a new manager had been appointed and had submitted an application to register with us. This application has been received by the CQC and is currently being assessed.

However, we also found 1 breach of the legal regulations in relation to the safe management of medicines. In addition, we identified new concerns in relation to the way the service managed formal staff support and operated their quality monitoring systems. We discussed these issues with the managers at the time of our inspection, who agreed to take appropriate steps to address them.

These issues described above notwithstanding, the service continued to have a good learning culture. People were able to raise their concerns and have their voices heard. Managers investigated incidents thoroughly. People were protected from abuse. Staff understood and managed risks well. The facilities and equipment met the needs of people, were clean and well-maintained and any risks mitigated. There were enough staff with the right skills, qualifications and experience. Infection risks were managed well.

Managers and staff had a shared vision and culture based on listening, learning and trust. The service had a culture of inclusivity which had led to people experiencing positive outcomes. Managers were visible and knowledgeable, helping staff develop in their roles. Staff were treated equally, free from bullying or harassment. Staff understood their roles and responsibilities. Managers and staff worked closely with the local community to deliver the best possible care and were receptive to innovative ideas.