Alexandra Lodge 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. Alexandra Lodge is registered to accommodate 19 people in one building. There are two floors. On the ground floor there is a large communal and a smaller dining area. There is a small garden that people can access. At the time of our inspection 11 people were using the service. This is the first inspection under this registration.

The service did not have a registered manager as this is not required as they are the sole provider. 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 told us they felt safe and staff knew how to recognise and report potential abuse. Risks to people and the environment were identified and managed in a way to keep people safe. There were enough staff available to meet people’s needs and the provider ensured their suitability to work within the home. Medicines were managed in a way to protect people from the risks associated to them. There were infection control procedures in place and these were implemented throughout the home.

When people were able to consent, capacity assessments had been completed and decisions had been made and recorded in people’s best interests. When people were being unlawfully restricted, this had been considered and application to the local authority had been made.

People were offered a choice of food and drinks and enjoyed what was available. When needed people had access to input from health professionals. People and relatives were happy with the staff. They were able to make choices about their day and encouraged to be as independent as possible. People enjoyed the activities offered. Friend and families were free to visit when they chose. Staff knew people well including their likes and dislikes and people received care in their preferred way. People’s cultural needs had been considered.

Quality monitoring checks were completed to bring about improvements. The provider sought the opinion of people and relatives to bring about positive changes. People knew who the manager was and felt they were approachable. If people wanted to complain they were confident this would be dealt with. The provider had a system in place to ensure that when things went wrong, lessons were learnt. They also understood their registration responsibilities and notified us of any significant events that occurred within the home.