Crossways Nursing Home

Updated 15 March 2022

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

As part of CQC’s response to the COVID-19 pandemic we are looking at how services manage infection control and visiting arrangements. This was a targeted inspection looking at the infection prevention and control measures the provider had in place. We also asked the provider about any staffing pressures the service was experiencing and whether this was having an impact on the service.

This inspection took place on 24 February 2022 and was announced. We gave the service 24 hours’ notice of the inspection.

Updated 15 March 2022

About the service: Crossways is a nursing and residential care home. It is registered to provide care for up to 30 people. The management of the home are making plans to reduce this number as they eventually plan to stop providing double occupancy rooms. Crossways provides personal care and nursing care for adults.

People’s experience of using this service: One person told us, “I tell staff if I feel unwell, they ask if I need a tablet and then say we’ll keep an eye on you. They do and then call the doctor if they think best.”

One person’s relative also told us their views of the home, “The staff seem to work together as a team. There’s always people about and the manager is always about. I am always made welcome. It’s bright and airy in here, some of the areas could do with an update. I can get [relative] out into the garden in their wheelchair but I think others have difficulty getting out.”

People received a good standard of nursing care at the home. We were told by relatives how their relatives’ health had significantly improved since they moved to Crossways. When people were unwell or needed more specialist health support, referrals were made to these professionals in a timely way. Actions were then taken in the meantime to promote people’s physical health.

People had good risk assessments in place and received their medicines as prescribed. There were good levels of staff to meet people’s physical care and nursing needs. However, some people and their relatives felt that staff worked too long and too many shifts and were tired. The management team had not reviewed the potential impact this had on the quality of care delivery.

There were various safety checks completed in relation to the building to ensure people were safe. Safe staff recruitment checks were in place. Staff had a good understanding about what potential harm or abuse could look like. But they lacked the knowledge of how to share concerns outside the service.

Staff including the nurses received regular competency checks and training. Staff felt supported in their role and comfortable approaching the registered manager and one another for support.

Good systems were in place to respond and support people who were at risk of choking when eating and for those who needed to gain weight. However, people did not always have a positive dining experience, especially those who stayed in their rooms. Choice for people who were living with dementia was not promoted in relation to their food and drinks. The management team had not meaningfully assessed this aspect of people’s day to day life. We saw some poor practices in relation to staff assisting people to eat in their rooms.

People spoke positively about the staff. Referring to them as caring and kind. We saw some kind interactions from staff during the inspection. However, we also found that staff practice was not always personable to people. There was not a culture of staff spending time with people, talking with them, checking they were comfortable, or promoting their social wellbeing.

People told us that they enjoyed the activities that took place. We saw an activity co-ordinator spending time with some people during the inspection. However, there were people who spent all their time in their bed or bedrooms. There was little consideration given to these people. The management team had not completed any checks and in a meaningful way to see if people were okay with spending all their time in their bedrooms, or if they wanted more from their daily experience. We found that there were missed opportunities during our inspection of staff engaging with people or trying to improve their experience at the home.

People, their relatives, and we noticed that the environment of the home looked tired. There was a renovation plan in place, which was slowly being completed. The registered manager told us that the work will have finished by Christmas 2019.

The management team were completing audits and checks on elements of the care delivery. However, they had not fully considered people’s daily experiences living at the home, and if this could be improved upon. The registered manager was responsive to all the issues we raised. However, the registered manager and the provider’s own quality monitoring systems had not identified these shortfalls and they had not taken action to try and correct them.

There were breaches of the Health and Social Care Act 2008.

Rating at last inspection: Good (this report was published on 13 October 2016)

Why we inspected: This was a scheduled and planned inspection based on previous rating.

Follow up: We have asked for an action plan and will return to the home to check for improvements.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.