Queen Alexandra Cottage Homes

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Staff were kind and caring and committed to providing people with good quality care. People were supported to maintain their independence and staff enabled them to make their own decisions and choices, Visitors were always welcomed at the home. Some improvements were needed to communication and support to enhance staff well-being. We asked the provider to review the processes for supervision as this was not consistent across the staff team.

This service scored 70 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Kindness, compassion and dignity during this assessment. The score for this quality statement is based on the previous rating for Caring.

We did not look at Treating people as individuals during this assessment. The score for this quality statement is based on the previous rating for Caring.

People told us they were able to make their own choices each day. One person gave details of going to bed and getting up. They told us they had slept in that day which was unusual for them and were woken at 8.30am for tablets. (This was acceptable to the person). Another person told us they did not join in activities as they had their own interests. They said, “I like to keep busy, I can’t sit here and do nothing.” When asked about joining in activities the person said, “Not much to talk about when I go downstairs, we all live in a care home.” Another person said they did not take part in activities. They were not bored, they enjoyed TV. Relatives spoke positively about the home and support their loved ones received from staff. One relative told us how staff had enabled them to feel like Queen Alexandra Cottage Homes was their loved one's home and they should treat it accordingly. They said, “It’s not like a business here, it’s like a home, a family.” Feedback from other relatives was also positive around caring and promoting independence. Another relative told us their loved one’s admission to a care home had been a difficult time for them as a family, but the home provided a whole package and looked after the family as much as their loved one. They told us their loved one’s independence was still promoted and encouraged. They were always offered activities even though they would often decline. A further relative told us their loved one reported they were staying in their room all day. This was discussed with staff who now take photographs of their loved one involved in activities and going out for a walk to demonstrate that they were engaging. Relatives told us they were able to visit whenever they wished. One relative said, “We can turn up at any time day or night, we’ve got to know staff by name, they are interested in us as well as [name].

All staff spoke about people with genuine care and compassion. Staff knew people well and were able to speak about people as individuals. They knew people’s likes, dislikes, and history in addition to their care and support needs. They told us how they ensured they supported each person as an individual. Staff told us how they continued to promote people’s independence through supporting them to make their own decisions and respecting choices. This included times people wanted to get up and go to bed, supporting mobility through the use of appropriate aids. For example, where a person’s mobility was variable then staff would assess what support was required each time, rather than always using a hoist. Similar examples were given for personal hygiene and mealtimes. All staff told us that Queen Alexandra Cottage Home was people’s home. “It’s people’s home, we want to make them feel happy to live here.” We asked staff what the best thing was about working at QACH, and they all said it was the people they looked after. “It feels like a home for residents and me. I think that the care provided is to a standard that’s very good.”

Care plans were reviewed monthly. Care plans included information to show whether people (and/ or relatives) wanted to be involved in the reviews and updated in changes to care and support needs. One person had stated they did not wish to be involved and did not want relatives involved either. Another person did not want to be involved themselves but wanted their relatives to be involved. Reviews showed when and who was involved and informed about any changes. There was an open visiting policy at the home.

We did not look at Responding to people’s immediate needs during this assessment. The score for this quality statement is based on the previous rating for Caring.

Meetings with staff including staff meetings, handovers and daily head-of-department meetings were not always recorded. Staff receive paid breaks, a separate staff room and refreshments including tea, coffee and snacks. Rotas were arranged to support staff home commitments. Breaks were assigned at the start of the day and organised so that staff had these separately to benefit the people who live at the service. Staff had completed on-line training. There was 1-2-1 support for staff with computer skills. Although the training was available in different languages the test was in English. Staff had access to additional training such as diplomas and given time to spend with an external assessor. Staff received a training enhancement if all training was completed. There were a lack of systems in place for monitoring, improving and promoting staff wellbeing. Improvements are needed to ensure these processes are fully developed and embedded into everyday practice.

Staff told us they did not always feel supported by the senior managers and felt management were removed from what was happening on the floor. They told us communication was poor. One staff member said, “Senior managers spend a lot of time in the office and some days we don't see them at all". Another staff member told us, “Support is there but you have to ask for it.” Staff said they would like managers to have more observational oversight to see how the shift is running and oversee the skill mix. Some staff said they felt there was a divide between the care side and the independent side. One staff member said, “They don't feel that the independent and care side are equal." Staff also told us, “A lot could be done to improve the care wing but the focus is always on the independent side, communication is not good from higher management, and we feel left to it.” Staff also said, “There’s a lot of gossip around the home.” Staff did not all receive regular supervision. Staff we spoke with did not feel confident raising issues with their supervisor as they were, “Not sure how confidential it would stay.” We received mixed feedback about staff meetings. Some staff told us they did not attend meetings. One staff member said, “There is no point in bringing anything up, nothing gets done.” Other staff said they did attend. One staff member said, “All staff meetings are very good. All staff are asked for feedback. Management say if you feel improvements are needed, you need to say things. Don’t say things outside the meeting and not report to the management. Meetings are used to discuss things that have been done well and could be done better.” We identified improvements were needed to ensure staff well-being was enabled and developed.