The inspection took place on 12 April 2018 and was unannounced. Alexander House is a care home that provides personal care for up to 23 people. On the day of inspection there were 11 people living at the home. This was the first inspection of Alexander House; the home was registered with the Care Quality Commission on 13 April 2017.

The registered manager told us they were operating on half occupancy due to a variety of reasons. They wanted to ensure a safe takeover of the home and have time to understand the service and embed safe practices before increasing occupancy. The registered manager said they wanted to raise the profile of the home, they are working on advertisement, creating a website, integrating with the local community and working with the local authority to make the home more known to social workers. The nominated individual said they had a large refurbishment programme to undertake when they purchased the home and wanted to do this with minimal disruption to people. Strategies are in place to support more people moving into the home which include; using established working practices embedded in their other care homes; staging the number of people moving in and a team of staff that can support from their other homes which will ensure they have experienced staff to meet people's needs.

Alexander House 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 care home is one adapted building with private bedrooms, shared communal areas and bathrooms. Some people living at the home are living with dementia, frailty and physical disabilities.

Alexander House has a registered manager. ‘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.’

People said they felt safe living at the home. One person said "I feel safe here, I know that I can speak to the registered manager whenever I need to. Everything here is perfect”. Staff were knowledgeable about safeguarding and had received training. We saw safe moving and handling support being provided and the service had suitable staffing levels to meet people’s needs. The provider had a robust recruitment process which ensured people were safe to work prior to them starting. Risks were managed effectively to ensure people were kept safe. People had access to medicines as and when they needed them and trained staff administered these. The provider ensured the management, administration, storage and disposal of medicines was safe.

People’s needs were assessed when they moved into the home and regularly thereafter. Staff understood people's needs, choices and preferences. For example, one care plan said a person enjoyed ‘Music, activities and communication’ and the person wanted support to access 'Activities on a daily basis.' We observed this person having meaningful interaction and attending an activity with a guest musician, which they engaged in and appeared to enjoy. People and relatives said that they were involved in their care planning and decisions made about their care. People were assisted to eat healthy and balanced diets and were offered the appropriate support to meet their nutritional needs.

The registered manager and staff had a good understanding of the Mental Capacity Act 2005 (MCA). They supported people to make their own decisions and sought consent before delivering care and support. If people's care plans contained restrictions on their liberty, relevant applications had been made to legal bodies in line with current legislation. Staff received a range of training opportunities to su