Crossways Nursing Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. At our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The service was in breach of the legal regulation in relation to safeguarding. The provider had not always supported people in line with the Mental Capacity Act (MCA).
 

This service scored 58 (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 had not always effectively assessed people's needs. People's care plans had not assessed all known risks about people when they experienced emotional distress, and how staff should support them. Although there were systems in place to review people's care plans, this had not always resulted in accurate and consistent information within them. For example, regarding the consistency of fluids a person should drink to ensure they were safe. The provider was responsive to our feedback and took action to review and rewrite people's care plans.

Where people had specific health or mobility needs, these were well assessed and planned for by the provider.
 

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. Tools, such as the Waterlow assessment, were used to assess the risk of skin tissue breakdown and Malnutrition Universal Screening Tools (MUST) were completed to identify and act in response to people’s health risks.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. Records showed people had seen health professionals such as GPs and community nurses.

The provider supported people to manage their health and wellbeing. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support. Care records showed people had access to exercise based activities. People’s nutritional needs were assessed and met. A person told us, “I eat well here, good food and tasty.”

The service did not always effectively monitor people's care and treatment to continuously improve it. We identified incidents that were not always documented appropriately and unexplained injuries that were not always escalated or investigated appropriately. The provider's systems to monitor the environment had not been effective in managing increased fire, IPC and water-related risks. These increased risks relating to people's safety and wellbeing and the provider's ability to promote consistently positive outcomes.

However, we found risks relating to people’s medical needs were monitored and there was evidence of the provider following up on new or emerging health concerns appropriately.
 

People had not always been supported in line with the MCA. Where there were known risks relating to 2 people's ability to consent to care, the provider had not acted in line with the MCA to carry out mental capacity assessments and ensure decisions made on behalf of people were the least restrictive and in their best interests. Staff told us and records showed a person had experienced restraint for the delivery of essential care that had not been assessed or planned for. This increased the risk that people's rights were not always upheld.

Aside from this finding, other mental capacity assessments such as those relating to people’s ability to consent to take medicines or using bedrails had been completed appropriately and in line with the MCA.