Cross House

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement. This meant people’s needs were not always met.

This service scored 57 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs. Professionals involved in people’s care and support told us there was not always a consistent approach from the staff team to ensure people received person centred care. One professional told us, “On the whole staff tend to choose activities. However, staff should be more led by [person] for example [staff] might offer an activity and if [person] refuses it, they don’t offer it again, and not all staff understand [person’s] needs.” Another professional told us, “After my visit I made recommendations regarding the level of engagement from some staff.” However, relative’s spoke positive about people’s care. One relative told us, “Staff really understand my [family member] needs. I have never had to raise any concerns because [family members] home is very safe and everything is supervised, for example [family member] loves to cook, and staff allow them to stir the ingredients with support.”

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity. Whilst contact was made at times with health professionals for their input such as incontinence or speech and language therapist assessments; people’s records lacked detail of all the health services who were involved in peoples care and lacked any advice that had been shared through their health assessments. The lack of information and guidance meant care was not always responsive to allow joined up care. This did not meet right support, right care and right culture guidance; policies and procedures were not in line with current best practice.

The provider had supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Since 2016 all organisations that provide publicly funded adult social care are legally required to follow the Accessible Information Standard (AIS). The standard was introduced to make sure people are given information in a way they can understand. The standard applies to all people with a disability, impairment, or sensory loss and in some circumstances to their carers. The provider had processes in place to ensure they matched people’s communication. Staff had completed Makaton training to communicate with people in their preferred method and staff used photo cards or object of reference to help with choice making. Easy read records of routines were used to support people to understand. This meant the provider was working in line with the accessible information standards. This did meet right support, right care and right culture guidance; procedures were in line with current best practice.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not always involve professionals indecisions about people’s care or tell them what had changed as a result.

Professionals told us they had raised concern multiple times and they were continuing to find the same concerns, or it had taken the provider a long time to take reasonable action. One professional told us, “It took several visits to impress upon staff the importance of not leaving their processions in [person’s] lounge, these conversations lasted from summer to autumn 2025. We spoke to support staff and management regarding the issue and eventually we were listened to.” This meant there was not always a listening culture in place.

The provider told us they had individual phone messaging chats with relatives and a staff group chat to enable quick and easy involvement from relatives and staff and to share information in a timely manner. Relatives felt they were kept up to date and were provided with information when needed. One relative told us, “They [staff] are brilliant everything I ask them they will do. They [Staff] will email or call if there is anything we need to discuss. They [Staff] respond quickly to me or my wife. We receive messages every day, so we know what our [family member] is doing.” Another relative told us, “I will also send emails, and I have some evidence that I am listened to because my suggestions will be in the group chat.”

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it. People were not always supported to access health appointments in line with best practice. The provider did not always remove barriers to promote equality to overcome the barriers to ensure all people had equal access. For example, one person did not have their annual learning disability health review, and we were told this was because of their health diagnosis. We found no evidence of the provider trying to access these health services or taking reasonable steps to remove the barriers such as home visits.

Staff and leaders actively listened to information about people who were most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this. Where people required support with their mental health and emotional support such as when experiencing anxiety, staff proactively sought out ways to address these barriers to improve people’s experience, act on information about people's experiences and outcomes and allocate resources and opportunities to achieve equity. A staff member told us, “I've supported individuals with various social needs, such as accessing community activities, building relationships, and developing social skills. For instance, I have supported [person] to parks and outdoor areas. One of the celebrated supports I have been involved in is supporting [person] to slowly overcome social anxiety. When we started supporting, [person] couldn’t go to places with many people, but with assurance and encouragement, we can take [person] to fun activities and even sit-in public places for coffees.”

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life. Whilst people had just started their adult life at Cross House; relatives had told us they did not have discussions about planning for the future or discussed any wishes or preferences. However, relatives felt that they would be involved in all decisions about people’s future.