- Homecare service
Cross House
Assessment report published 14 July 2025
Contents
Ratings
Our view of the service
Date of assessment 12 May 2025 to 22 May 2025. Cross House, which is also known as Headzpace, provides personal care and support to children and young adults in their own homes within the community. Many of the young people have a learning disability, autism or both and/or mental health needs. Not everyone who used the service received personal care. CQC only assess where people receive personal care. Personal care is help with tasks related to personal hygiene and eating. At the time of our assessment, there were 14 people using the service, 3 people receiving the regulated activity of personal care. We assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted.This assessment included 4 site visits, 1 to the main office and 3 visits to people’s homes. Cross House was last rated requires improvement (published 11 February 2023). This assessment was undertaken due to the receipt of information of concern in relation to poor management, risk management, governance and oversight. We found concerns were substantiated.The provider was in breach of the legal regulation relating to good governance. Concerns were significant and widespread.
The service was not well-led. We found there was poor oversight of the service by the provider and registered manager to identify risks or concerns to make necessary improvements at the service. Checks and audits completed by the management team were ineffective to drive improvements. We were not assured the management team were suitably trained to complete their roles effectively because they failed to identify concerns and risks throughout their auditing processes. Systems and processes for safe care and treatment were ineffective and placed people at risk of avoidable harm. Care plans and risk assessments were not person-centred, accurate or up to date. The provider failed to ensure people were appropriately protected from avoidable risk of harm by ensuring staff had clear written guidance on how to support them with known complex health conditions. Staff had used physical restraint with a lack of written guidance to follow, therefore we were not assured people were safely restrained in line with an agreed care plan and risk assessment. People at risk of showing distressed and/or agitated behaviour did not always receive the support they needed to manage their behaviourial needs. Other risks relating to weight management and personal hygiene had not been managed well by staff. People’s medicines were not managed safely. Systems to ensure accidents, incidents and safeguarding concerns were logged, and action to reduce risks to people, were not effective. Staff documentation and oversight of accidents and incidents was not effective. The provider failed to demonstrate they had sought consent or enabled people to make decisions in line with the legal framework. Where court of protection conditions had been placed, the provider had failed to ensure these were met. Standards of cleanliness were not always maintained, and infection control procedures were not always implemented. Environmental risks were not monitored or managed effectively, and people were placed at avoidable risk of harm through lack of risk mitigation. Staff were very caring towards people. We observed good interactions between staff and the people they supported. Staff spoke about the people they supported with kindness and respect.
Immediately after this assessment, we took action to ask the provider to mitigate urgent risks. Whilst the provider responded and addressed urgent risks, we found significant shortfalls in safe care delivery. We have taken action to ask the provider to make significant improvement. We had asked the provider for an action plan in response to the concerns found at this assessment. In instances where CQC have decided to take civil or criminal enforcement action against a provider, we will publish this information on our website after any representations and/or appeals have been concluded. This service is being placed in special measures. The purpose of special measures is to ensure that services providing inadequate care make significant improvements. Special measures provide a framework within which we use our enforcement powers in response to inadequate care and provide a timeframe within which providers must improve the quality of the care they provide.
People's experience of this service
People were not able to tell us about the care and support they received, so we obtained views of care from relatives. This assessment found people did not always experience good outcomes. People’s known risks were not always risk assessed, or care planned to ensure they were supported appropriately. We received mixed feedback from relatives. One relative told us, “[person] has a regular team of six carers, [staff] love [person] and it’s not just a job. They know [person] so well, recognising [person] moods.” Another relative told us, “Some carers appeared lazy and did not perform some basic duties such as cleaning, cooking, or maintaining [person] hygiene to the proper standard. These issues have been reported several times. Household maintenance problems take long to resolve, creating safety concerns”