25 January 2022
During a routine inspection
Alexandra Lodge Care Centre is a care home registered to provide accommodation with nursing and personal care. The home can accommodate up to 38 people in a large, adapted house. At the time of our inspection there were 34 people living at the service.
People’s experience of using this service and what we found
Following our last inspection, the provider has made improvements around managing medicines safely. However, we continued to identify concerns in this area. For example, there were occasions where people did not receive their medications as they were out of stock. There was a lack of guidance around supporting people with diabetes.
Necessary improvements to the environment had not been completed in a timely way. The home requires further refurbishment works, due to the wear of some of the carpets and the water damage caused by leaks.
There were appropriate risk assessments in place for people using the service. People were supported to eat and drink in line with their abilities. Staff received appropriate training to meet the needs of the people living at the home.
Staff knew people well. We observed kind and caring exchanges between staff and people living at Alexandra Lodge Care Centre. People gave positive feedback about staff at the home. People were supported with dignity and respect.
Staff regularly engaged people in activities which they enjoyed. Staff supported people in activities, within groups and on a one to one basis. People knew how to make a complaint and any complaints received were appropriately responded to by the registered manager. Person centred care plans had been developed for people living at the service. Care plans included people’s preferences relating to their care, food and activities they engaged in. Staff knew people well and were able to communicate effectively with people.
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. The registered manager maintained an accurate log of people who had a deprivation of liberties safeguarding in place.
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 of this service was requires improvement (published 5 August 2021) and there were breaches of the 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, although some improvements had been made, the provider remained in breach of regulation. This service has been rated requires improvement on the last three consecutive inspections under this provider.
Why we inspected
This inspection was carried out in response to the concerns previously identified and to review if improvements had been made, to assist with capacity in the local area. We also followed up on action we told the provider to take at the last inspection. Following the previous focused inspection, this comprehensive inspection was carried out to see if there had been an improvement to change the overall rating of the service.
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. This included checking the provider was meeting COVID-19 vaccination requirements.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified breaches in safe care and treatment and good governance. Please see the action we have told the provider to take at the end of this report. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good.We will request an action plan from the provider to understand what they will do to improve the service.
We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.