This inspection took place on 21 August 2018 and was unannounced. The service provides accommodation and personal care for up to 43 people. At the time of our visit there were 30 people living at the service.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Why the service is rated good

People continued to receive a service that was safe. The registered manager and staff understood their role and responsibilities to keep people safe from harm. People were supported to take risks, promote their independence and follow their interests. Risks were assessed and plans put in place to keep people safe. There was enough staff to safely provide care and support to people. Checks were carried out on staff before they started work to assess their suitability to support vulnerable people. Medicines were well managed and people received their medicines as prescribed.

The service remained effective in meeting people’s needs. Staff received regular supervision and the training needed to meet people’s needs. Arrangements were made for people to see a GP and other healthcare professionals when they needed to do so. The registered manager and staff understood the principles of the Mental Capacity Act (MCA) 2005 and, worked to ensure people's rights were respected. People were supported to enjoy a healthy, nutritious, balanced diet whilst promoting and respecting choice.

We were introduced to people throughout our visit and they welcomed us. They were relaxed, comfortable and confident in their home. The feedback we received from them was positive throughout. Those people who used the service expressed great satisfaction and spoke highly of all staff. Staff had a good awareness of individuals' needs and treated people in a warm and respectful manner. They were knowledgeable about people's lives before they started using the service. Every effort was made to enhance this knowledge so that their life experiences remained meaningful.

The service was responsive to people’s needs. People received person centred care and support. Staff monitored and responded to changes in people’s needs. One health professional told us, “I have visited Alexandra Way to visit residents and have also had contact over the phone with members of staff. I have never had any cause for concern and, when I visit the residents always appear happy with their care. Staff always appear engaged and involved with client care and will request for me to visit when required”. They were offered a range of activities both at the service and in the local community. People were encouraged to make their views known and the service responded by making changes.

People benefitted from a service that was well led. The registered manager and staff team maintained a clear focus on continually seeking to improve the service people received. Good quality assurance systems were in place and based upon regular, scheduled audits which identified any action required to make improvements. This meant the quality of service people received was monitored on a regular basis and, where shortfalls were identified they were acted upon.

Further information is in the detailed findings below.

This inspection took place on 26 and 27 January 2016 and was unannounced. There were no concerns at the last inspection of May 2013. Alexandra Way provides accommodation for up to 43 older people. At the time of our visit there were 31 people living at the service.

There was a registered manager 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.

People were very happy living at “Alex Way” and we received positive comments about their views and experiences throughout our visits. People told us they felt safe because the staff were “caring and enjoyed what they did”. The registered manager listened to people and staff to ensure there were enough staff to meet people's needs. They demonstrated their responsibilities in recognising changing circumstances within the service and used a risk based approach to help ensure that staffing levels and skill mix was effective.

The home had been in a pilot project for 18 months which was funded by the NHS. A number of beds (referred to as pathway beds or enablement beds) were used for people referred by community health services. This was to prevent potential hospital admissions or for rehabilitation purposes after hospital care where people were not ready/fit to go home. A community occupational therapist had been deployed at the home for two and half days per week. Part of their role was to train and support staff in areas that would help rehabilitate people so that they had the skills and support with a view to going home. This included promoting independence in daily living skills, improving mobility and wellbeing and identifying and assessment for basic equipment needs.

The registered manager and staff told us how they had enjoyed being part of the pilot. It had been “gratifying to help people get back on their feet and enable them to go home”. In addition staff felt it had enhanced their skills which in turn had a positive impact on those people who permanently lived at the home. The occupational therapist had enjoyed working alongside staff at Alex Way and felt the pilot had improved confidence and knowledge for future practice in rehabilitation and promoting independence.

Staff had the knowledge and skills they needed to carry out their roles effectively. They enjoyed attending training sessions and sharing what they had learnt with colleagues. The provider supported staff and the registered manager at all times.

People and their relatives told us staff were caring, kind and they “couldn’t fault them”. Staff had a good awareness of individuals' needs and treated people in a warm and respectful manner. It was very clear at the staff meeting we attended that all staff were truly committed to the people they supported. The registered manager and staff were knowledgeable about people's lives before they started using the service. Every effort was made to enhance this knowledge so that their life experiences remained meaningful.

People received appropriate care and support because there were effective systems in place to assess, plan, implement, monitor and evaluate people's needs. People were involved throughout these processes. This ensured their needs were clearly identified and the support they received was meaningful and personalised. Regular monitoring and reviews meant that referrals had been made to appropriate health and social care professionals and where necessary care and support had been changed to accurately reflect people's needs. People experienced a lifestyle which met their individual expectations, capacity and preferences.

Staff involved in this inspection demonstrated a genuine passion for the roles they performed and individual responsibilities. It was important to them

We spoke with 15 people who lived at Alexander Way. People told us that they were always asked for their consent and had been involved in decisions about their care. Their comments included: "The staff here are so nice and they always ask me for my opinion".

During our visit we saw that staff spoke to people in a kind manner and with respect. People told us that staff had asked them for their views about how they wanted their care to be delivered, what they wanted to do and where to go etc. This meant that people were involved in decisions about their life and showed that they had been given choices.

We spoke with 11 members of staff during our visit, including the registered manager, duty managers, care, catering and domestic staff. All of the staff were very motivated, caring and positive about working in the home and praised the teamwork and supportive atmosphere. We sat in during a staff handover and saw that staff communicated effectively and knew the needs of the people they supported.

We also spoke with two visiting healthcare professionals who provided positive feedback about the care, treatment and welfare of people living at the home.

Alexandra Way provided a comfortable, safe and homely environment for the people that lived there.Appropriate recruitment checks had been undertaken before staff began working at Alexander Way.

We spoke with 18 people receiving a service and four visiting relatives. Comments were highly positive about the care and support they received. One person told us "the staff here are wonderful, I could not wish for better care and I wouldn’t want to be anywhere else”.

People told us they had access to their care records and that they had been involved in how they would like their care to be provided. People told us that care staff had sat with them to discuss what was recorded. People using the service had signed their care documentation and it was evidenced that they had been fully involved in how they would like to be supported.

People confirmed that the service listened and acted appropriately to their requests. One person said "when I was grieving the staff took time to listen and to support me, both emotionally and physically, they couldn’t do enough for me”, another person told us “there is a mixed range of age and experience amongst the staff team and I believe that this works well in their approach in caring for us”.

Another person told us, “When I have been ill and a bit low, the care staff were wonderful, they took time to speak to me and to check that I was alright, this was over and above the call of duty and I am very thankful to them”.

People told us how staff had supported them to maintain their independence, one person told us “ the staff support me to keep mobile and encourage me to do as much as I can for myself, this motivates me and keeps me going”.

People told us the staff treated them with respect and were very caring. We observed staff spoke to people in a polite and respectful manner, asked people for their views and acted appropriately in response.

People using the service had information to enable them to make a decision on whether to move to the service. This included a statement of purpose and a service user guide.

People were registered with a local GP, dentist and opticians. A relative told us "this is an excellent service and would highly recommend it. The staff are really kind and caring and we are always made to feel welcome". “The staff make a point of caring for the relatives and have an understanding of our needs and the importance of our relationships with our loved ones”

People seen during the visit looked well cared for, we observed staff interacted with individuals in a positive and caring way.

People told us; “I have no worries, I have friends here and we all get along”, another person told us “I have no complaints, I am more than satisfied and could not ask for anything better”. Other people we spoke with assured us that they were happy. People gave us the names of staff they would tell if they had any concerns. Clear information was displayed within the home on how people could raise any issues or concerns they may have.

People told us the service obtained their views through one to one meetings and care

reviews. People also told us that they had been regularly consulted and asked for any ideas or suggestions that would improve the service. A member of staff told us “We are here to serve and support the people in our care, we want them to tell us how we can do a better job and how we can make their life a better one, it is important to us, no matter what role we are in we all have the opportunity to make a difference”.