This inspection was carried out on 5th June 2009.
CQC found this care home to be providing an Excellent service.
The inspector found no outstanding requirements from the previous inspection report,
but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.
Random inspection report
Care homes for older people
Name: Address: Alexandra Nursing Home Moorland Road Poulton Le Fylde Blackpool Lancashire FY6 7EU three star excellent service The quality rating for this care home is: The rating was made on: A quality rating is our assessment of how well a care home, agency or scheme is meeting the needs of the people who use it. We give a quality rating following a full review of the service. We call this review a ‘key’ inspection. This is a report of a random inspection of this care home. A random inspection is a short, focussed review of the service. Details of how to get other inspection reports for this care home, including the last key inspection report, can be found on the last page of this report. Lead inspector: Christopher Bond Date: 0 5 0 6 2 0 0 9 Information about the care home
Name of care home: Address: Alexandra Nursing Home Moorland Road Poulton Le Fylde Blackpool Lancashire FY6 7EU 01253893313 01253899819 info@alexandracarehome.co.uk Telephone number: Fax number: Email address: Provider web address: Name of registered provider(s): Type of registration: Number of places registered: Conditions of registration: Category(ies) : Alexandra Nursing Home Limited care home 75 Number of places (if applicable): Under 65 Over 65 0 38 0 dementia old age, not falling within any other category physical disability Conditions of registration: 35 0 2 The registered person may provide the following categories of service only. Care home with Nursing - code N to service users of the following gender:- Either. Whose primary care needs on admission to the home are within the following categories: - Old age not falling within any other category - Code OP, (maximum number of places: 38) Dementia - Code DE (maximum number of places: 35) Physical disability - Code PD (maximum number of places: 2) The maximum number of service users who can be accommodated is: 75 Date of last inspection Care Homes for Older People Page 2 of 9 Brief description of the care home The Alexandra is a listed building and stands in its own grounds on the outskirts of Poulton-le-Fylde. The main building is most attractive and contains many of its original features, including wall and ceiling paintings, stained glass windows and a broad open staircase leading up from the hallway. The gardens are well managed and there are lots of places for residents to sit out in good weather. The main railway station is quite close and bus services run from close by. There are plenty of parking spaces close to the home and within its grounds. There are local shops not far from the home as well as places of worship and other amenities. The main building has a lift and some of the bedrooms are en-suite. A new dementia unit has since been added to the home. This building adjoins the main home and is registered for 35 people who have dementia. This facility has a dedicated staff team. All rooms have en-suite facilities and the rooms are arranged over three floors. At the time of this visit, (05/06/09) the information given to the Commission showed that the fees for care at the home are from GBP 496.50 to GBP 624.50 per week for residential and nursing care, with added expenses for hairdressing and chiropody. Fees for the dementia unit are GBP 518.50 per week with added expenses for chiropody and hairdressing. Care Homes for Older People Page 3 of 9 What we found:
This was a random inspection that took place over a period of three hours on the 5th June 2009. We spoke to three residents during our visit about their care and support. We also spoke to the manager of the service, the deputy manager, two senior carers and one night carer. We looked at the care records of two people who lived within this unit. These included care plans, risk assessments, accident records, weight charts and daily records. Observations were made regarding the care of the residents and how they were addressed by the carers. We looked at the outlay of the home and how this affected the residents. We looked at the care records of some of the people who live at this home in response to a concern that was passed to us. We found that people were being looked after properly and that the numbers of care staff were enough to help ensure that peoples care needs were being met. There were three night staff on duty when we arrived at the home and people were being helped to get up. The residents that we saw were being treated with dignity and respect and were well dressed. We spoke to three residents who felt that they were being cared for well. There were concerns that people who had dementia were being left to their own devices and were allowed to travel between floors on the lift unattended, causing disorientation and confusion. Although the manager told us that this had happened, a key system had been used for some time on the lift, meaning that care staff must be in attendance when the lift was being used. This made the lift safer to use, and less disorientating for those wishing to travel between floors to their bedrooms. Although there had been incidents of residents falling, each person was properly risk assessed, and the residents had aids that would help them with their mobility. There were enough care staff employed to minimise this risk and those residents who were prescribed medication had this reviewed to help ensure that his did not contribute to people losing their balance. We looked at the records of two people who lived within this service and both had been reviewed. One resident had had his medication reduced to reduce the risk of falling. We were told that a resident was sometimes locked in his room to prevent another resident from entering, causing upset and concern. We found that the option of locking a gentlemans door had been considered to prevent another person from entering. This had been discussed with the gentlemans family and a decision had been taken not to proceed with this. Care staff had been helping to ensure that peoples rooms remained private by being vigilant and guiding other residents to their own rooms. This helped to ensure that residents did not enter the wrong room.
Care Homes for Older People Page 4 of 9 We looked a the menus for this home. We found that there was a good choice of food for the residents and a close eye was being kept on peoples nutrition and weight. We looked at the weight charts for two of the residents and found that action was taken when it was found that someone was losing weight. The advice of the persons family had been sought and food that the person was familiar with was offered. We were told that the dining area on the ground floor had two toilets that led directly off the room. It was said that sometimes people would use the toilets without closing the door. This meant that their dignity was being affected, and also those dining would sometimes be affected by odours. We looked at the toilets in question and found that this would indeed cause a problem during mealtimes. The manager told us that this problem had been identified and that another toilet, close to the dining area, was now being used to preserve dignity and help ensure that the people who used the service could eat their meals without being affected by this. We found that staffing levels were appropriate for the number of residents who lived at this home. There were enough night carers and day staff to help ensure that the assessed needs of the residents were properly addressed. There were three night carers working when we arrived and some of the residents were being assisted to get up. We spoke to one of the night carers and it was felt that the numbers of staff on duty at that time was adequate, considering the needs of the residents. A handover took place between the night carers and day staff, ensuring that important information was passed on and recorded regarding important events during the previous shift. What the care home does well: What they could do better:
The manager of the home needs to ensure that the Care Quality Commission are notified of all incidents that occur within the home. We found that there were toilets that led directly off the main dining area. The manager should ensure that the residents dignity is preserved when care staff are assisting residents in this area. Another toilet was being used that was positioned close to the dining area and this should be used at mealtimes whenever possible to ensure that dignity is maintained and that the people who use the service can dine in comfort.
Care Homes for Older People Page 5 of 9 Information regarding incidents and injuries should be passed on to relatives of the residents as soon as possible after these occur to ensure that people are fully aware of their condition at all times. If you want to know what action the person responsible for this care home is taking following this report, you can contact them using the details set out on page 2. Care Homes for Older People Page 6 of 9 Are there any outstanding requirements from the last inspection? Yes £ No R Outstanding statutory requirements
These are requirements that were set at the previous inspection, but have still not been met. They say what the registered person had to do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards.
No. Standard Regulation Requirement Timescale for action Care Homes for Older People Page 7 of 9 Requirements and recommendations from this inspection:
Immediate requirements: These are immediate requirements that were set on the day we visited this care home. The registered person had to meet these within 48 hours.
No. Standard Regulation Requirement Timescale for action Statutory requirements These requirements set out what the registered person must do to meet the Care Standards Act 2000, Regulations 2001 and the National Minimum Standards. The registered person(s) must do this within the timescales we have set.
No. Standard Regulation Requirement Timescale for action 1 37 37 The manager must supply the commission with reports of occurences and incidents that happen at the home. This is to ensure that the commission has knowledge of all incidents that may affect the well being of the people who use the service. 29/06/2009 Recommendations These recommendations are taken from the best practice described in the National Minimum Standards and the registered person(s) should consider them as a way of improving their service.
No Refer to Standard Good Practice Recommendations 1 21 The toilets that adjoin the dining area, wherever possible, should only be used when meals are not being taken. Care Homes for Older People Page 8 of 9 Reader Information
Document Purpose: Author: Audience: Further copies from: Inspection Report Care Quality Commission General Public 0870 240 7535 (telephone order line) Our duty to regulate social care services is set out in the Care Standards Act 2000. Copies of the National Minimum Standards –Care Homes for Older People can be found at www.dh.gov.uk or got from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering from the Stationery Office is also available: www.tso.co.uk/bookshop Helpline: Telephone: 03000 616161 Email: enquiries@cqc.org.uk Web: www.cqc.org.uk We want people to be able to access this information. If you would like a summary in a different format or language please contact our helpline or go to our website. Copyright © (2009) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Homes for Older People Page 9 of 9 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!
