Attention: The information on this website is currently out of date and should not be relied upon..

Care Services

carehome, nursing and medical services directory


Alexander House - Dover, Dover.

Alexander House - Dover in Dover is a Residential home specialising in the provision of services relating to accommodation for persons who require nursing or personal care, caring for adults over 65 yrs and dementia. The last inspection date here was 14th July 2018

Alexander House - Dover is managed by Nicholas James Care Homes Ltd who are also responsible for 5 other locations

Contact Details:

    Address:
      Alexander House - Dover
      140-142 Folkestone Road
      Dover
      CT17 9SP
      United Kingdom
    Telephone:
      01304212949
    Website:

Ratings:

For a guide to the ratings, click here.

Safe: Good
Effective: Good
Caring: Good
Responsive: Good
Well-Led: Good
Overall: Good

Further Details:

Important Dates:

    Last Inspection 2018-07-14
    Last Published 2018-07-14

Local Authority:

    Kent

Link to this page:

    HTML   BBCode

Inspection Reports:

Click the title bar on any of the report introductions below to read the full entry. If there is a PDF icon, click it to download the full report.

15th May 2018 - During a routine inspection pdf icon

The inspection took place on 15 May 2017 and was unannounced.

Alexander House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. Alexander House accommodates up to 46 people in one adapted building. At the time of the inspection 30 people were living at the service.

The premises are two large detached properties that are connected by two conservatories. The accommodation is provided on each of the three floors and all of the bedrooms are single occupancy. There is a small enclosed garden area at the rear of the premises and a large paved courtyard between the two main buildings, which is shielded from the main road by gates.

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

We last inspected Alexander House in April 2017 when the service was rated Requires Improvement with no breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. However, some improvements were required in the management of medicines records and additional information was needed about how to support people living with diabetes.

We asked the provider to take action. They sent us an action plan telling us what action they would take to improve the service. The provider had taken appropriate action with regard to these issues and the majority of the improvements had been made.

People received their medicines safely but records were not always clear to confirm this. Medicines were being stored at the correct temperature to ensure they were safe to use. Some people were living with diabetes. Staff knew what action to take if people’s blood sugar levels became unstable. Details in people’s care plans had improved, however, although staff knew what food or drink people preferred if they might need to increase their sugar levels, this was not always recorded.

Checks on the premises were not always detailed enough to show that the water temperatures and fire testing points had been consistently checked to ensure they were in good working order. The registered manager took immediate action to rectify these issues during the inspection.

Equipment, such as hoists, were serviced and checked to ensure they were working properly. Plans were in place in case of an emergency such as a fire or flood. Accidents and incidents were recorded and analysed to look for patterns and trends to reduce the risk of further events.

Staff had received safeguarding training and were clear on what action they should take if they suspected any abuse. People’s finances were protected. Risk associated with people’s care had been assessed and clear guidance was in place to make sure risks were mitigated. This included when people needed support with their behaviour or mobility needs.

There was sufficient staff on duty to ensure people received the care they needed and new staff were recruited safely. The service was clean with effective procedures in place to ensure that people were protected from the risk of infection. The premises had appropriate design and adaptation to support people living with dementia.

When people came to live at the service they had a thorough care needs assessment in line with current guidance and practice. This information formed a detailed personalised care plan which covered all aspects of their care. Staff responded to people’s needs promptly. Staff continuously observed people’s behaviour and found ways to reduce anxieties. People’s health was monitored and people wer

13th April 2017 - During a routine inspection pdf icon

The inspection took place on 13 April 2017 and was an unannounced inspection.

The service is registered to provide accommodation and personal care to 46 older people who may also be living with dementia. At the time of this inspection there were 30 people receiving the service. The premises are two large detached properties that have been connected by means of two conservatories. The accommodation is provided on each of the three floors and all of the bedrooms are single occupancy. There is a small enclosed garden area at the rear of the premises and a large paved courtyard between the two main buildings, which is shielded from the main road by gates.

The service did not have a registered manager in post. There was an acting manager in post who had applied to the Care Quality Commission to be registered as the manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 the previous unannounced inspection of this service on 26 and 31 August 2016 requirement notices were served as the provider had not ensured that care plans were person centred, were updated with people’s current needs and were not planned to include the Deprivation of Liberty (DoLS) recommendations made by the local authority. People were not being treated with dignity and respect. There was not sufficient guidance for staff to follow to show how risks were mitigated when moving people or supporting people with their behaviour. People had not been protected from abuse as appropriate referrals to the local safeguarding authority had not been made in line with safeguarding protocols. Action had not been taken to mitigate risks and improve the quality and safety of services. Staff had not been deployed in sufficient numbers to meet people’s needs. Feedback about the service from relevant people had not been sought and acted on to continually evaluate and improve the service. Records were not completed or accurately.

We asked the provider to take action. They sent us an action plan telling us what action they would take to meet legal requirements in relation to the breaches of regulations. We undertook this inspection to check that they had followed their plan and to confirm that they now met legal requirements. The provider had taken appropriate action with regard to these issues and improvements had been made. The service was now compliant with the regulations; however in some areas further improvements were required.

People were receiving their medicines safely. Storage facilities had improved and medicines were being stored at the correct temperature to ensure they were safe to use. However, further guidance was required to ensure that people received their ‘as and when’ required medicines consistently. On two occasions people had received their medicines but staff had forgotten to sign the medicines record. At the time of the inspection there was sufficient staff on duty to ensure people’s needs were fully met, however, some people, relatives, staff and health care professionals commented that sometimes staffing levels could be improved. The manager told us that staffing levels would be reviewed in line with these comments. New staff had been recruited safely.

People living with diabetes had generic information in their care plans about the condition, however this was not personalised to each person, such as the required blood sugar level range and what drink or food they might need to increase their blood sugar levels.

Although there was no registered manager in place the current manager had applied to become the registered manager and their registered manager interview with CQC was cairned out after the inspection, therefore they were waiting for the de

26th August 2016 - During a routine inspection pdf icon

The inspection took place on 26 and 31 August 2016 and was an unannounced inspection.

The service is registered to provide accommodation and personal care to 46 older people who may also be living with dementia. At the time of this inspection there were 30 people receiving the service. The premises are two large detached properties that have been connected by means of two conservatories. The accommodation is provided on each of the three floors and all of the bedrooms are single occupancy. There is a small enclosed garden area at the rear of the premises and a large paved courtyard between the two main buildings which is shielded from the main road by gates.

The service has an established registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 the previous unannounced, inspection of this service on 29 and 30 June 2015, a requirement notice was served as the provider did not have sufficient guidance for staff to follow to show how risks were mitigated when moving people or supporting people with their behaviour. We asked the provider to take action and the provider sent us an action plan. After the inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breaches. We undertook this inspection to check that they had followed their plan and to confirm that they now met legal requirements. The provider had not taken appropriate action with regard to these issues and remained in breach of this regulation.

Since the last inspection there had been some staffing issues. The registered manager and deputy manager had been dealing with the staffing issues with support from the provider. The provider agreed that, on reflection, this had taken the managers away from the day to day management of the service. The registered manager and management team were reviewing and trying to improve the day-to-day culture in the service, including the attitudes, values and behaviour of staff.

When people needed support with their behaviours potential risks had not been fully assessed and measures were not in place to reduce the risks to keep people as safe as possible.

Care plans did not always have up to date moving and handling risk assessments to ensure people were moved safely in line with their current needs.

People were not fully protected from harm or abuse as the registered manager had failed to report incidents between people living at the service to the local safeguarding authority in line with safeguarding protocols. Accidents and incidents were recorded but there was no further analysis to reduce the risk of further events.

There was insufficient staff on duty to ensure people’s needs were fully met. On the day of the inspection the registered manager confirmed that staffing levels were not up to the optimum levels due to staff sickness.

People were at risk of harm as they were not always receiving their prescribed medicines. The storage room for medicines was not the correct temperature to ensure the medicines were safe to use.

People’s mental capacity had been assessed and when required authorisations to deprive people of their liberty (DoLS) had been processed through the local authority. However, the registered manager had failed to ensure that specific recommendations made by the local authority to guide staff how to care for a person were included and followed when planning their care.

People’s privacy and dignity was not always upheld. There were two occasions when staff were disrespectful to people, one of which caused some distress to a person. Relatives told us the staff were kind and caring. People were supported by their relatives to be involved in

5th December 2013 - During an inspection in response to concerns pdf icon

We visited Alexander House after concerns had been raised with regard to there being no heating and hot water for two weeks and because, the lift did not work. We were told this had resulted in two people staying in their rooms as they relied on the lift to come downstairs. We were also informed that there had been two people who had suffered falls with serious consequences over a short period of time. We contacted social services and informed them of the concerns that had been raised.

The manager showed us the records that included information about two people who had fallen and been injured as a result. There were falls risk assessments and these had been followed and the incidents had been clearly documented. Both incidents had been documented and where risk assessments were in place regarding falls, we saw evidence that showed these had been adhered to.

On the day of our visit we found that the heating was working and the home was pleasantly warm. We checked to see if there was any hot water and found it was available throughout the service. The manager had already informed us about the lift and what procedures had been followed regarding the two people who stayed in their rooms which were appropriate. The lift engineer attended the service to reactivate the lift following its repair during our inspection so this situation was resolved.

15th August 2013 - During a routine inspection pdf icon

We spoke with three members of staff, five people who used the service, and the manager.

Before people received any care or treatment they were asked for their consent and this was respected. A person who used the service who we spoke with told us that, "Help and support I recieve is of a good standard." Another person we spoke with went on to tell us that the standard of care delivered was, " Of a high standard. “The staff treat you as an individual and speak to you kindly.”

All of the people that were spoken with were very satisfied with the standard and quality of their support, care and treatment. People's health and safety risks were assessed and effective measures were taken to minimise these risks. People were supported to maintain their health and wellbeing by being supported to access health care professionals and to engage in social activities of their choosing.

People had sufficient amounts to eat and drink. People said that they liked the food and there were menu choices made available to them.

Most areas of the accommodation were decorated and furnished to make them into comfortable spaces. However, in some parts there were shortfalls that detracted from the overall standard achieved.

Members of staff told us that they enjoyed their work, which they found rewarding. They said that they felt supported by the provider to progress in their careers and that there were plenty of training opportunities available.

6th December 2012 - During a routine inspection pdf icon

We met and spoke with some of the people who use the service and everyone we spoke with expressed that they were very happy living at Alexander House. We observed interactions between the people who used the service and the staff. For example, we observed to see how people responded and reacted with the staff and we looked to see how people indicated that they were happy, bored, discontented, angry or sad. There were 33 people using the service at the time of our visit.

People told us that they had the care and support they needed to remain well and healthy. They said they were involved in decisions about their care and support. We were told, “It is wonderful here and the staff are great”.

People told us they liked living at the service and felt safe. One person said, “I have been here for three years and always feel very safe”.

We saw that staff engaged with people in a warm and positive way and supported people where needed.

Staff told us that they were happy working at the home and felt supported in their roles.

1st January 1970 - During a routine inspection pdf icon

The inspection took place on 29 and 30 June 2015, and was an unannounced inspection. The previous inspection on 5 December 2013 found no breaches in the legal requirements.

The service is registered to provide accommodation and personal care to 46 older people who may also be living with dementia. At the time of this inspection there were 35 people receiving the service. The premises are two large detached properties that have been connected by means of two conservatories. The accommodation is provided on each of the three floors and all of the bedrooms are single occupancy. There is a small enclosed garden area at the rear of the premises and a large paved courtyard between the two main buildings which is shielded from the main road by gates.

The service has an established registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Potential risks to people were identified regarding moving and handling and behaviour but full guidance on how to safely manage the associated risks were not always available. Plans for behaviours that challenge did not support positive behaviour but made judgements about people’s behaviour. This left people at risk of not receiving the support they needed to keep them as safe as possible.

People felt safe in the service. There were safeguarding procedures in place and staff had received training in these. Staff demonstrated an understanding of what constituted abuse and how to report any concerns in order to keep people safe.

Accidents and incidents were recorded and analysed to prevent further occurrences. Checks were done to ensure the premises were safe, such as fire safety checks. Equipment to support people with their mobility had been serviced to ensure that it was safe to use. Plans were in place in the event of an emergency.

Some refurbishment of the premises had been carried out and plans were in place to improve the environment by December 2015. People’s rooms were personalised to their individual preferences.

There was enough staff on duty to meet people’s needs. Staff were allocated their duties, on each shift, to ensure the right skill mix and experience of staff was deployed to make sure people’s needs were met. Staff received regular supervision and a yearly appraisal to support them in their role. Staff were recruited safely and there was a training programme to ensure that staff had the skills and competencies to carry out their roles. New staff received an induction and shadowed experienced staff until they were confident to perform their role.

Medicines were stored and administered safely. Staff had been trained and demonstrated good practice in medicine administration by carefully ensuring that the right person received the correct medicines.

People were supported to make their own decisions and choices and these were respected by staff. CQC is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DoLS) which apply to care homes. The manager understood when an application should be made and was aware of the recent Supreme Court Judgement which widened and clarified the definition of a deprivation of liberty. There were no DoLS applications required at the time of this inspection.

People had choices of food and specialist diets were catered for. Staff understood people’s likes and dislikes, dietary requirements and promoted people to eat a healthy diet.

People were supported to maintain good health and received medical attention when they needed to. Appropriate referrals to health care professionals were made when required.

Staff treated people with kindness, encouraged their independence and responded to their needs. People told us their privacy and dignity was maintained, and the staff were polite and respectful.

People and relatives had been involved in planning their own care. Care plans had been regularly updated and relatives told us that they were invited to the care plan reviews when required.

People were being supported to engage in activities of their choice. Visitors were able to visit any time and the service welcomed lots of family and friends.

The registered manager asked people for their opinions on the quality of care they received and responded to comments and complaints in a timely and appropriate way. There were quality assurance systems in place. Audits and health and safety checks were regularly carried out.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of this report.

 

 

Latest Additions: