Archived: Alexandra House - Oxted

Updated 28 December 2019

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was carried out by two inspectors.

Service and service type

Alexandra House Oxted is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had two managers registered with the Care Quality Commission. The registered managers were also the provider. This means that they are legally responsible for how the service is run and for the quality and safety of the care provided. One of the providers was present during the inspection.

Notice of inspection

The inspection was unannounced.

What we did before the inspection

The provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. The provider returned the PIR and we took this into account when we made judgements in this report. We reviewed other information that we held about the service such as notifications. These are events that happen in the service that the provider is legally required to tell us about. We used all of this information to plan our inspection.

During the inspection

As part of our inspection we were able to meet with the three people, however they were unable to tell us verbally about their experiences of life at the home. We therefore used our observations of people interacting with staff to help us form our judgements. We spoke with three members of staff and one of the registered managers [the provider]. We reviewed a sample of people’s care and support records. We also looked at records relating to the management of the service such as incident and accident records, training records, policies, audits and complaints.

After the inspection

We contacted two health and social care professionals who regularly visit the service and one person’s relative for their feedback.

Updated 28 December 2019

Alexandra House - Oxted is a small residential care home providing accommodation and personal care to a maximum of five adults with a learning disability. At the time of our inspection the service provided care to three people. All of the people and the staff have been at the service for a number of years.

The home is a semi- detached house situated in a residential area of Oxted, Surrey.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service and what we found

Some aspects of medicines management needed to be improved. Risks to people had been assessed and mitigated. Individual emergency plans had not been regularly reviewed, although people’s needs had not changed.

The systems in place to monitor the service needed to be improved. The providers policies needed updating to reflect current guidance and legislation. The providers current rating was not displayed within the home in line with regulatory requirements.

People were protected from potential abuse. Staff felt confident to raise concerns with the provider and were aware of external agencies where they could report concerns.

We reviewed staffing rotas that demonstrated there were enough staff available to meet people’s needs.

People made choices around their meals and were supported where they were at risk of losing weight. People’s healthcare needs were assessed and met by a range of healthcare professionals.

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 service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

We observed staff were kind and caring. Staff supported people in making decisions about their care. People accessed activities of their choosing.

People were encouraged to be involved in the running of their home as much as they were able to be. Staff commented positively about the support they received from the registered manager who was also the provider.

People’s care plans were detailed, and person centred.

We made one recommendation to the provider relating to the management of medicines.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published January 2017).

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.