• Care Home
  • Care home

Archived: Crossways Nursing Home

Overall: Good read more about inspection ratings

17 Overton Road, Sutton, Surrey, SM2 6RA (020) 8642 0955

Provided and run by:
Hopelit UK Limited

Important: The provider of this service changed. See new profile

All Inspections

21 November 2017

During a routine inspection

This inspection took place on 21 and 24 November 2017. The first date of the inspection was unannounced.

Crossways Nursing Home provides residential and nursing care for up to 40 older people, some of whom were living with dementia or other mental health difficulties. At the time of the inspection there were 39 people living in the home.

At our last inspection in March 2015, we gave the provider an overall rating of Good. At this inspection we found the provider to be Good overall and Outstanding in caring.

The service had 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 protected from avoidable harm. Staff assessed people’s risks and implemented plans to reduce the possibility of their occurrence. Management and staff were trained to safeguard people from abuse and neglect. Medicines were administered safely and the environment of the home was safe and hygienic. There were enough staff to deliver care and support and there was collective learning following incidents when things had gone wrong to ensure the service improved and people were safe.

Trained and skilled staff met people’s assessed needs. Staff were supervised by their managers although not always at the frequency identified in the provider’s policy. Staff received appraisals each year to evaluate their skills and performances. People were treated in accordance with the Mental Capacity Act 2005. People’s nutritional needs were met and people enjoyed the meals they chose. Staff supported people to access the health services they required to remain healthy and the service participated in a pioneering programme supporting people in the event of their admission to hospital.

The service was exceptionally caring. Staff went to great lengths to support people’s wishes. Creative methods were used to gather and present personalised information about people and their lives that was meaningful to them. The service liaised extensively with a wide range of faith organisations to ensure people’s spiritual needs were met. The expertise of healthcare professionals was sought to enable staff to protect people’s dignity where their behaviours may have otherwise compromised it.

The care people received was responsive to their individual needs. A range of activities were available for people to engage in as groups and individuals. The service provided an intermediate care service through which people were supported for short periods of time before returning home. People benefited from this service as an alternative to being in hospital. People were actively supported to plan their end of life care which was delivered compassionately.

The service had an open culture. The registered manager was visible and accessible to people and their relatives, and staff said she led by example. The service engaged in an exemplary level of partnership working and public engagement within the local community and nationally. The quality of the service was checked and the provider was reviewing its auditing procedures to ensure that shortfalls identified were acted on promptly.

31 March 2016

During an inspection looking at part of the service

The last inspection of this service was carried out on 03 March 2015 when we found the provider was not meeting the regulations we inspected. This was because the provider had failed to ensure staff who worked at Crossways Nursing Home always received the appropriate support, supervision and appraisal to effectively carry out the duties of care they were employed to perform.

After the unannounced inspection we undertook in March 2015, the provider wrote to us to say what they would do to meet legal requirements in relation to the support staff received from the home’s management. We carried out this focused inspection on 31 March 2016, to follow up the improvements the provider had stated in their action plan they would take to meet legal requirements.

This report only covers our findings in relation to this topic. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for ‘Crossways Nursing Home’ on our website at www.cqc.org.uk’.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act and associated Regulations about how the service is run.

During our focused inspection we found that the provider had followed their action plan, which they had said would be completed by March 2016. We saw legal requirements had been met because the provider had improved its arrangements for supporting its staff team. This meant staff were routinely supported, supervised and appraised by the homes management to effectively carry out the duties of care they were employed to perform.

3rd March 2015

During a routine inspection

This inspection took place on 3 March 2015 and was unannounced.

At the last inspection, which we carried out on 13 December 2013, we found the service was meeting all the regulations we had looked at.

Crossways is a nursing home that provides accommodation for up to 40 people with nursing or personal care and support needs. There were 38 people using the service when we visited. The home specialises in supporting older people living with dementia. Approximately three-quarters of the people using the service were living with dementia when we visited. In addition, 14 of the home’s beds were funded by the local authority to provide intermediate care. These are short stay rehabilitation beds which people can use for up to six weeks after leaving hospital.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Although people receiving services told us they were happy with the care and support provided by staff who worked at the home, we found staff were not always adequately supported by their line managers and senior staff at the home. Staff working practices were not appraised at regular intervals and nor did they have enough opportunities to attend team and individual meetings with their fellow peers and line managers. This meant staff were not always given the support they needed to continually review their own working practices, discuss the health and welfare of people using the service and consider what they could do better.

You can see what action we told the provider to take at the back of the full version of the report.

We have also made a recommendation about the homes environment and design not being as dementia ‘friendly’ as it could be.

People and their relatives told us they felt safe with the care and support provided by the service. Staff knew what action to take to ensure people were protected if they suspected they were at risk of abuse or harm. Risks to people’s health, safety and wellbeing had been assessed by the services management. Staff were given appropriate guidance on how to minimise identified risks and keep people safe from avoidable harm or injury.

There were enough staff to meet the needs of people using the service. Staff received appropriate training and support and the registered manager ensured their skills and knowledge were kept up to date. People told us, and we saw that staff had built up good working relationships with people and were familiar with their individual needs and preferences.

People told us Crossways nursing home was a comfortable place to live. We saw the environment was well maintained.

People’s consent to care was sought by the service prior to any support being provided. People and their relatives were supported to make decisions and choices about their care and support needs. People agreed to the level of support they needed and how they wished to be supported. Where people's needs changed, the provider responded and reviewed the care provided.

The registered manager understood when a Deprivation of Liberty Safeguards (DoLS) application should be made and how to submit them. This helped to ensure people’s rights were safeguarded. DoLS provides a process to make sure that people are only deprived of their liberty in a safe and correct way, when it is in their best interests and there is no other way to look after them.

People had a choice of meals, snacks and drinks and staff actively encouraged and supported people to stay hydrated and to eat well. Staff supported people to keep healthy and well through regular monitoring of their general health and welfare. Where they had any concerns they sought appropriate medical care and attention promptly from other healthcare professionals. People received their medicines as prescribed and staff knew how to manage medicines safely.

People and their relatives told us staff looked after them in a way which was kind, caring and respectful. Our observations and discussions with people using the service and their relatives during our inspection supported this. People’s rights to privacy and dignity were respected and maintained particularly when receiving personal care from staff. When people were nearing the end of their life they received compassionate care. People were supported and encouraged to take part in social activities and to maintain social relationships that were important to them.

The registered manager encouraged an open and transparent culture and people and their relatives felt able to share their views and experiences of the service and how it could be improved. People and their relatives felt comfortable raising any issues, concerns or complaints with staff. The service had arrangements in place to deal with people’s concerns and complaints appropriately.

The service had a clear management structure in place. We observed an open and inclusive atmosphere in the service and the manager led by example. There were systems in place to monitor the safety and quality of the service and the registered manager took action where shortfalls were identified.

16 December 2013

During an inspection looking at part of the service

At our last inspection of this service we had seen that there were some omissions in the recording process in place for medication administration. Nurses had not always signed the records to show that medication had been given. Also they had not always used the right codes where medication had not been administered. The internal audit systems in use had not highlighted these errors and we could not be assured that people were always given their medication as it had been prescribed. We undertook this inspection to check that improvements had been made. We were able to see that the manager of the service had provided staff with training and introduced additional monitoring procedures. This helped to ensure that medication within the service was handled appropriately.

3 September 2013

During a routine inspection

On the day that we inspected Crossways Nursing Home there were 40 people using the service. This included ten people using the Intermediate Care Unit. Some people were unable to talk with us due to their cognitive impairment however, the feedback that we had from other people was all positive. They told us 'staff are really good here', 'everyone is very kind', and 'I wouldn't have been able to manage if I hadn't come here'. All of the people we spoke with said they felt very well cared for. They were able to make choices about how they spent their days and about how they chose to be supported with their care needs. People knew that if they had a concern they would be able to talk to the manager or business manager although we received several comments such as 'why would I want to complain' and 'I haven't got anything to complain about'.

We looked at the way the service employs new staff. We found that all of the appropriate checks were in place to make sure that those people who were judged as not being suitable to work with vulnerable people were prevented from doing so.

We looked at medication procedures. We found that although medication had been stored and disposed of appropriately, administration had not always been properly recorded. We could not be sure that people had all received their medication as it had been prescribed. We have asked the service to address this issue.

11 December 2012

During a routine inspection

Many of the people who used this service had a degree of cognitive impairment which made communication difficult. However they told us 'staff are very kind', 'they (staff) are respectful, and they knock on the door or call out before they come in' and 'if I had a complaint I could tell them, it would be sorted out'. People confirmed that they could spend their days as they preferred, in their own rooms if they wanted to. Those who were mobile were free to walk around as they wished.

Everyone we spoke with said that they enjoyed the meals in the home and people were supported to receive adequate nutrition and hydration.

The service had developed ways to gain feedback from people who use the service such as customer satisfaction surveys and 'residents meetings'. This provided an assurance that the service was meeting people's needs and allowed people an opportunity to feedback their views and suggestions.

5 October 2011

During a routine inspection

The residents we spoke with when we visited the home all told us they felt they were looked after very well. They said 'this is a really nice place to live', I feel really lucky to be living here, they're all so good', and 'you only have to ask if you need anything, its perfect'.

People told us that they feel quite safe living in the home and that staff are always very kind 'they're all lovely' and 'I feel so lucky to be here, they're all so kind'.