Alexander Lodge is a care home service without nursing, and is registered to accommodate up to 12 older people some of whom may be living with dementia. The accommodation is a converted period property; and is arranged over two floors with six bedrooms on each floor. There is a private garden with a patio at the rear of the property. Communal space consists of a lounge area and a small dining room/kitchen. At the time of our inspection seven people lived here.

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.

The home was decorated and adapted to meet people’s needs. Flooring was smooth and uncluttered to aid people’s mobility needs. The home had a homely feel and reflected the interests and lives of the people who lived there. Some of the decoration looked tired, such as doors and skirting boards; the management had a plan to address this once building work on a room was completed.

The inspection took place on 14 July 2017 and was unannounced.

There was positive feedback about the home and caring nature of staff from people who live here.

People were safe at Alexander Lodge. There were sufficient staff deployed to meet the needs and preferences of the people that lived there. Staffing levels changed to reflect the support needs of people.

Staff understood their duty should they suspect abuse was taking place, such as notifying the local authority safeguarding team or the police. This would ensure action was taken to protect people.

Risks of harm to people had been identified and clear plans and guidelines were in place to minimise these risks, without restricting people’s freedom. As a result people were able to take part in ‘risky’ activities that they enjoyed.

The provider had carried out appropriate recruitment checks to ensure staff were suitable to support people in the home. Staff received a comprehensive induction and ongoing training, tailored to the needs of the people they supported.

People received their medicines when they needed them. Staff managed the medicines in a safe way and were trained in the safe administration of medicines.

Staff understood the support that each person would need to get safely out of the building in an emergency. Regular safety checks were completed on fire detection systems, and equipment used to support people.

Staff had regular training to keep their skills up to date. They felt supported in their roles, which enabled them to give effective care to people.

People’s rights under the Mental Capacity Act (2005) were met. Assessments of people’s ability to make specific decisions had been completed. Staff asked people for their permission before they provided care.

The staff had an understanding of the requirements of the Deprivation of Liberty Safeguards (DoLS). The registered manager had submitted applications in accordance with the act, due to the fact that some people were under constant supervision, and could not leave the home if they wanted to.

People had enough to eat and drink, and received support from staff where a need had been identified.

People were supported to maintain good health as they had access to relevant healthcare professionals when they needed them. People’s health was seen to improve due to the care and support staff gave, such as recovering from illness and operations.

The staff were kind and caring and treated people with dignity and respect. Good interactions were seen throughout the day of our inspection, such as staff talking with them and showing interest in what people were doing. People’s knowledge and experience were valued by staff. People looked relaxed and happy with the staff. People could have visit

Alexander Lodge is a care home service without nursing, and is registered to accommodate up to 12 older people some of whom may be living with dementia. The accommodation is a converted period property; and is arranged over two floors with six bedrooms on each floor.

The inspection was unannounced and took place on the 30 April 2015

The home had a registered manager in place. 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 living at the home because of the care staff provided. Their relatives told us the staff were caring and respectful and met people’s needs. Our observations confirmed this and we found there were systems in place to protect people from the risk of harm.

The provider had an effective recruitment system in place. We looked at records which showed us staff had completed all relevant recruitment checks prior to starting work. There was enough staff with the appropriate skills and experience to keep people safe.

Systems were in place to ensure that medicines were stored, administered and managed safely. Staff had received the required training, and there were enough experienced staff to manage medicines appropriately to meet people’s needs safely.

Staff told us they were supported by the registered manager and had the relevant training to do their jobs well, and meet people’s care needs. Staff spoke positively about the support they received from the registered manager. Staff told us there was a good level of communication within the home, which helped them to be aware of any changes. People and their relatives told us they could speak with the staff and the registered manager to raise any concerns, and they knew how to raise complaints if they needed to.

The registered manager and the staff understood their responsibilities under the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). There were records in place to show who could represent people and act in their best interest if complex decisions were needed about their care and treatment.

People and their relatives spoke positively about the home and the care that people received. People and their relatives said that the staff were caring. Staff supported people with all their nutritional needs. People were supported to have healthy diets, and people that required a personalised diet, had their needs monitored and had access to health care professionals who supported staff to meet their dietary needs. Staff understood people’s needs and we observed that care was provided in and caring manner.

Staff told us they received on-going training and we found they were appropriately trained and understood their responsibilities. Staff understood the values of the home, and respected people’s diverse needs. They told us they had received training to ensure the care provided to people was safe and met their needs. Staff told us they received regular supervision and support to assist them to deliver care that met people’s needs. We observed that people received support around their nutritional and personal needs.

We observed that people were encouraged to remain independent and were supported to access activities they enjoyed at home and in the community. People were supported in taking part in their favourite interests such as board games, reading, and going to various places of interest. The registered manager told us they would discuss this with people with a view to introducing additional activities.

The service was well led and the staff were supported by the registered manager to do their jobs well. The registered manager and senior staff monitored and reviewed the quality of care. There were systems in place to obtain people’s views about the service. These included residents meetings and questionnaires to identify, plan and make improvements to the service.

People who used the service told us that they made choices every day that included choosing their bedtimes, the food they would like to eat and the clothes they would like to wear. They told us that the care and support they received from staff at the service was also excellent. People told us that they had a care plan and staff would discuss this with them every month.

People who used the service told us that they had never felt unsafe with staff that looked after them. One person told us “I do feel safe here and the staff are very kind to me.” Another person told us “I have never been hurt or abused by any staff here.”

We noted that regular supervision and annual appraisals had not taken place for the staff who worked at the service. This meant that staff were not provided with the opportunity to review their performance from the previous year or identify any training needs they may require.

People told us that they liked living at Alexander Lodge and chose to live there because it was small and friendly. They told us that staff were kind and respectful and nothing was too much trouble for them.

They told us that they are consulted about their care and how this is delivered. They are aware of care plans and are involved in reviews of care.

Relatives were satisfied with care outcomes and someone told us that they choose the home because they had experienced very good respite care. There was good feedback about the food provided and people said it is like being at home, good tasty food.

Some people told us that they enjoyed the activities provided and that the music sessions were very entertaining.

During our inspection we had discussions with five people who used the service, two members of staff and the cook. On the first day of our visit the registered manager was not present at the service; however, we spoke with the registered manager when we returned on the following day to view the staff training records. We also had a telephone conversation with a care manager from the local authority.

People who used the service told us that staff asked for their consent before they undertook any tasks with or for them. One person told us, “I can make decisions about myself and what I want to do.” Another person told us, “Staff helped me to shower but they always ask me if I am ready for their help.”

People we spoke with were aware of their care plans and that they could make changes to these if they wanted to.

People told us that they liked the food provided and they were able to choose the food they wished to eat. One person told us, “The food here is very nice, it is always freshly cooked.”

People told us they knew what their medicine was for and that staff would remind them if they forgot. They stated that they always received their medicines at the appropriate times. They told us that staff always treated them with respect.

People told us that they thought the staff were trained as they were very good at what they did. People were aware of how to make a complaint.

We found the service was compliant with the six outcomes we looked at.