Archived: Alexandra House - Oxted

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.

Alexandra House is a small private owned residential home which offers care and treatment for up to five people with learning and physical disabilities. At the time of our inspection there were four people living at the home. People living at the home were older and most had lived together for a long time.

There were two registered managers in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At our last inspection in October 2015, the provider was found to be in breach of four regulations of the Health and Social Care Act (Regulated Activities) Regulations 2014.

We carried out this fully comprehensive inspection to see what action the provider had taken in response to the shortfalls we had previously identified. We found during this inspection that the provider had made the improvements needed and was now meeting the regulations.

Staff training was tailored to the individual needs of people who lived at the home. Staff told us that they had good access to training. Staff benefitted from regular supervision where they could discuss their practice and any training needs they had.

People’s medicines were stored and administered safely by trained staff. Staff worked alongside healthcare professionals when needed to ensure that people’s health needs were met.

Risk assessments promoted independence whilst also ensuring people were kept safe from known hazards. Systems were in place to report incidents and staff knew their responsibility to do so. Staff understood their roles in safeguarding people.

Staff provided care in line with the Mental Capacity Act (2005) (MCA). Records demonstrated that people’s rights were protected as staff acted in accordance with the MCA when being supported to make specific decisions. Where people had restrictions placed upon them, these were applied for appropriately.

People were supported by sufficient numbers of staff to keep them safe whilst enabling them to participate in their chosen activities. The provider undertook checks to ensure that staff were suitable for the job.

People were supported by kind, compassionate staff who knew them well. Staff promoted people’s privacy and dignity when working with people.

People’s care plans contained information for staff on their needs, wishes and what was important to them.

People were supported to eat meals that they enjoyed in line with their dietary requirements. Care plans were person centred and reflected people’s needs and preferences. Reviews happened regularly to identify changes in people’s needs.

People lived in an inclusive atmosphere where they were involved in decisions about their home. A complaints policy was in place so people could be supported to make a complaint. People had access to a range of activities in line with their interests. People went on regular outings of their choice.

Staff felt supported by management and were involved in making decisions about the home. People’s views were sought by management and systems were in place to ensure care was of a good quality.

There were three people living in the home on the day of our inspection. As part of this visit we spoke with the registered manager and three staff. We were unable to speak to any relatives on this occasion. However we were able to have a short conversation with one people who lived at Alexandra House. The other two people who used the service were unable to communicate with us verbally, so we used observation to reach our judgements.

We reviewed records relating to the management of the home which included, care files, policies and daily records.

Below is a summary of what we found. The summary describes what people who used the service, their relatives and the staff told us, what we observed and the records we looked at.

Is the service safe?

We saw that people were cared for in a clean and safe environment. People were able to move around the building in a way that was safe and free from hazards.

We saw that staff had received training in safeguarding vulnerable adults which ensured they knew what they should do if they suspected abusing was taking place.

Is the service effective?

We saw that people who used the service seemed happy and calm. It was clear that staff knew the needs of the people living at Alexandra House well.

Is the service caring?

We saw that people were supported by staff when necessary. We saw that people were able to make their own choices that related to food or what activity they wished to do.

Is the service responsive?

Records showed us that people had been able to indicate their preferences, likes and dislikes and they had access to activities that were important to them. We saw that various health care professionals were involved in people's care.

Is the service well-led?

We saw that staff met with everyone who lived in the home on a regular basis to share information. These meetings were done in a way that people could understand.

Staff told us they were encouraged to make suggestions and that when they did they were listened to.

We looked at people's care plans, which were person centred and they were written from the person's perspective.

People were provided with varied and nutritious meals. We observed that people were offered choice and they were provided with good support with eating and drinking. A person told us that they enjoyed their meals.

We looked at the home's medication administration practices and we found that medicines were safely administered.

Systems were in place to gather the views and experiences of people who used the service, their representatives and staff. We saw that an action plan had been implemented which ensured that people's views were acted upon.

The service had a complaints procedure in place. This information was also presented in an accessible format.

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