Alexander House

The last rating for this service was good with a breach of regulations relating to governance. We undertook this assessment to check the provider had improved and followed the action plan we required them to complete after we had identified multiple breaches of regulations last time we visited the service. This onsite follow up assessment was unannounced and conducted by 3 adult social care inspectors. 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 assessment we have changed their overall rating from good to requires improvement. This was because the provider had not made enough improvements since their last assessment and remained in breach of regulations. This included 2 new breaches in relation to how the health and safety of the care homes environment and staff supervisions, work performance appraisals and support were managed. In addition, the provider was still failing to ensure they effectively operated their governance systems, despite this being identified as a breach at their last assessment.

We have asked the provider for an action plan in response to the concerns found at this assessment.

Despite the above, the service had improved some aspects of the environment since our last assessment. Furthermore, the service now had a suitably skilled, knowledgeable and experienced management team in place including, a newly registered service manager, deputy manager and a director. This new management team were all visible in the care home and had brought some much-needed stability to the service.

People were treated with kindness and compassion. Systems were in place to protect people from risk of abuse. Staff understood and managed risk well. There were enough staff to meet people’s needs. The provider continued to undertake checks to make sure staff they recruited were suitable for their role. There were enough staff with the right skills, qualifications and experience. Managers made sure staff were suitably trained and staff understood their roles and responsibilities. Infection risks were managed well and staff followed current best practice. Medicines were safely managed.

The new managers had a shared vision and culture based on listening, learning and trust. They were visible, knowledgeable and supportive, helping staff develop in their roles. Most staff felt more supported by the new management team. People and staff could raise concerns in confidence, and these were listened to and acted upon. Managers investigated incidents and complaints thoroughly. The provider understood their duty to collaborate and work in partnership with relevant external health and social care professionals and bodies.