You are here

Reports


Inspection carried out on 16 August 2018

During a routine inspection

This inspection took place on 16 August 2018 and was unannounced.

Crossways Community is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Crossways Community is registered to provide support with personal care and accommodation for up to 17 people who either have or are recovering from a mental health problem. 15 people were using the service at the time of the inspection.

At our last inspection we rated the service as Good. At our last inspection we found the service was Outstanding in the responsive domain, at this inspection we found this domain to be Good. The service had continued to implement the good practice, however, there was no evidence of any additional good practice being used. At this inspection, we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

At this inspection we found the service remained Good.

There was 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.

There continued to be enough staff who had the skills and knowledge they needed to support people living in the service. Staff were appropriately supervised. Safe recruitment practices were followed to help ensure potential staff were of good character.

Staff received regular support which included individual supervisions and team meetings. Staff felt supported in their roles. Staff completed an induction when they started work at the service and had access to a range of on-going training. Staff were positive about the training they received.

People continued to be protected from abuse. Risks were appropriately assessed and mitigated to ensure people were safe. Staff understood how to identify and report concerns. Medicines were managed safely, and people received their medicines when they needed them.

People were happy with their care and support. Staff had built up good relationships with people. The service provided good quality care and support to people enabling them to live dignified lives.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People had choices of food at each meal time. People were supported and encouraged to have a varied and healthy diet which met their needs.

The provider and registered manager had good oversight of the service. Effective systems were in place to enable the provider to assess, monitor and improve the quality and safety of the service. Incidents were recorded, investigated and acted upon.

The service was clean and the environment was welcoming. The Kitchen had been adapted to support the food champion.

Services are required to prominently display their CQC performance rating. The provider had displayed the rating in the entrance hall. The rating can be found on their website.

Further information is in the detailed findings below.

Inspection carried out on 12 May 2016

During a routine inspection

This inspection took place on 12 May 2016 and was unannounced. The previous inspection of the service was in May 2014 and they were found to be meeting all the standards we looked at during that inspection.

Crossways Community is registered to provide support with personal care and accommodation for up to 17 adults who either have, or are recovering from a mental health problem. The philosophy of the support offered is based on Christian values. 15 people were using the service at the time of our inspection.

The service had a registered manager in place. 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.

The service had appropriate safeguarding procedures in place which staff understood. Risk assessments were in place which included information about how to support people in a safe manner. There were enough staff working at the service and robust staff recruitment procedures were in place. Medicines were stored, administered and recorded safely.

Staff were well supported and received regular training and supervision. The service was operating within the principles of the Mental Capacity Act 2005 and people were able to make choices about their daily lives. This included choices about what they ate and drank. People had routine access to health care professionals.

People told us they were treated with respect and in a caring manner by staff. The service promoted people’s independence and privacy.

People’s needs were assessed before they moved into the service. Care plans were in place which set out how to meet people’s individual needs. People were supported to engage in a wide variety of employment, educational and leisure activities. The service had a complaints procedure in place and people knew how to make a complaint.

People and staff told us they found the registered manager to be approachable and helpful. The service had various quality assurance and monitoring systems in place. Some of these included seeking the views of people that used the service.

Inspection carried out on 23 May 2014

During a routine inspection

There were 17 people living in the home at the time of our visit. The inspection was conducted by one inspector. We set out to answer our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Our report is based on our observations during the inspection, speaking with people who used the service, the staff supporting them and from looking at records.

Below is a summary of what we found. If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

Policies and procedures were in place to make sure that unsafe practice was identified and people were protected.

People were assessed for any risks associated with the support they received and the environment in which they lived. This reduced the risks to people and helped the service to continually improve. People’s care plans and support reflected a balance between their safety and choice.

The service had policies and procedures in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards although no applications had needed to be submitted. Relevant staff were trained to understand when an application should be made, and how to submit one. This meant that people were safeguarded as required.

The environment, equipment and facilities were well maintained, checked and audited regularly; therefore people were protected from risk associated with this aspect of the care.

Is the service effective?

People’s needs were assessed before they moved into the service. This helped to give a comprehensive picture of the person and make sure they received the right care and support to meet their needs.

Support for people was planned and delivered in line with their individual care plan. The care plans gave staff clear and current guidance about how to support each person with their personal, social, mental health and health care needs. Specialist support had been identified in care plans and provided where required.

People’s health and care needs were assessed with them, and they were involved in writing their plans of care. Care plans were reviewed regularly and reflected people’s current needs.

Staff were appropriately qualified and trained to support people with their individual needs, wishes and preferences.

Is the service caring?

People were treated with respect and dignity by the staff. People were supported by kind and attentive staff. Staff were clear about their responsibilities and showed a good knowledge and understanding of how to meet people’s needs. People told us that staff were kind and always available if they needed help with any problems.

People who used the service, their relatives and other professionals were involved with their support.

People’s preferences, interests, aspirations and diverse needs were recorded and support was provided in accordance with people’s wishes. We saw that people’s rooms were highly personalised with their own belongings and according to their interests.

Is the service responsive?

Staff supported people to take part in social and recreational activities of their choice. People completed a range of activities both in and outside of the service regularly. People went out independently or with staff support where necessary. The service had its own vehicle, which helped to keep people involved with the local community.

Staff supported people to keep appointments or contacts with health and social care professionals to make sure their needs were met. People experienced support, which improved their skills towards living independently.

Regular meetings were held and satisfaction surveys completed, from which staff listened to people and took action about their views.

We saw that people were relaxed and able to easily communicate their wishes to staff, who acted upon these. People we spoke with were happy with the service provided.

Is the service well-led?

The service worked well with other agencies and services to make sure that people received their care in a joined up way.

The service had a quality assurance system, records seen by us showed that identified issues were addressed promptly. The structure within the service for decision making and accountability made sure that people’s care and support needs were met consistently.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the service. This helped to ensure that people received a good quality service at all times.

The manager had an effective system in place to identify, assess and manage risks to the health, safety and welfare of people who used the service and others.

People had their needs met, as the service was managed by an appropriate person with the necessary qualifications, skills and experience.

Inspection carried out on 3 May 2013

During a routine inspection

People experienced support that met their needs, improved their skills towards living independently and ensured their safety and welfare. We spoke with seven out of sixteen people who used the service. People told us they were happy with the support they received and said “Everyone’s really nice here and staff are good.”

People were protected from the risk of abuse. The provider responded appropriately to any allegation of abuse.

People benefitted from safe and comfortable accommodation. Each person had their own room and people were able to choose where to spend their time from a variety of shared communal areas. People told us “I really like my room” and “I like the lounge, we’ve got a new settee and TV.”

People who used the service, stakeholders and staff were asked for their views about the service provided and these were acted on. People told us “Staff are very kind, I get on with them and have no problems.”

In this report, the name of the registered manager appears who was not in post and not managing the regulatory activities at the service at the time of our inspection. Their name appears because they were still registered with us at the time of our inspection. The provider had taken appropriate steps towards recruiting a new manager. People’s needs were met, as the service was managed in the interim by appropriate people with the necessary qualifications, skills and experience.

Inspection carried out on 28 September 2012

During a routine inspection

People told us about the support available to them and said they could ask staff for help whenever they wanted to. Their wishes, choices and the support they received were recorded in their care plans.

People described how they spent their time both at Crossways and in the local community. People’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. Each person who used the service had an individual care plan.

We saw people were relaxed with staff who listened to their views and concerns. People told us that they could speak with staff if they had a problem or were worried about something.

People told us that staff supported them with their medication. Appropriate arrangements were in place for obtaining, storing, administering and disposing of medication. Staff we spoke with knew about the medication procedures involved and records confirmed this.

People told us the staff were kind and caring and were always there if they needed to talk to someone. People described how their key workers helped them. Staff received appropriate training relevant to meeting peoples’ needs. Staff were able, from time to time, to obtain further relevant qualifications. Staff received appropriate support relevant to the roles they undertook.

Inspection carried out on 10 December 2010

During a routine inspection

People told us that before they moved in, they were able to visit Crossways to see if they liked it. People explained they make choices about their lives both on a day to day basis and about plans for the future.

“Staff support me well.” “Sometimes I get a bit lonely but can talk to staff who support me – I can talk about my problems.” “Staff care a lot; I get on well with my key worker.” “I know all about my care plan and talk to staff about it. I go to review meetings about my care plan.” “I’m supported by professionals.” “My medication is now being reviewed; I thought I was on too much before, I’m on a low dose now and building up.”

Everyone said that they knew how to and would feel able to make a complaint if they needed to. One person told us they didn’t like living at Crossways and described how they had made various complaints. Another said “I like living here, the staff are good.”

People described how they chose to spend their time. “I’m looking for paid work and supported by the home…I like the gym, swimming and walking club.” “I’m out during the day as I work in a charity shop as a volunteer…when I’m not working I like to go to…the Resource Centre.” “I like gardening, although sometimes it’s not as spontaneous as I’d like.” “I’m not sure about groups; I can choose not to go to any.”

“I talk to staff about the support I need with menu plans and cooking. I eat fruit salad and fresh fruit.” “Today I’ve had a pasty, I like pastry. I had a big meal last night. I used to do my own meals but…staff cook for me now. They cook what I like – I don’t eat meat, I’m a vegetarian.”

People are involved in how Crossways is run. People described regular meetings in which various issues are discussed and decisions made.

“I like the house and my room. I’ve recently moved rooms – it has an ensuite and is a bigger room.” “There is too much stuff in my room at the moment – I’m going to clear it out.”

People told us that before they moved in, they were able to visit Crossways to see if they liked it. People explained they make choices about their lives both on a day to day basis and about plans for the future.

“Staff support me well.” “Sometimes I get a bit lonely but can talk to staff who support me – I can talk about my problems.” “Staff care a lot; I get on well with my key worker.” “I know all about my care plan and talk to staff about it. I go to review meetings about my care plan.” “I’m supported by professionals.” “My medication is now being reviewed; I thought I was on too much before, I’m on a low dose now and building up.”

Everyone said that they knew how to and would feel able to make a complaint if they needed to. One person told us they didn’t like living at Crossways and described how they had made various complaints. Another said “I like living here, the staff are good.”

People described how they chose to spend their time. “I’m looking for paid work and supported by the home…I like the gym, swimming and walking club.” “I’m out during the day as I work in a charity shop as a volunteer…when I’m not working I like to go to…the Resource Centre.” “I like gardening, although sometimes it’s not as spontaneous as I’d like.” “I’m not sure about groups; I can choose not to go to any.”

“I talk to staff about the support I need with menu plans and cooking. I eat fruit salad and fresh fruit.” “Today I’ve had a pasty, I like pastry. I had a big meal last night. I used to do my own meals but…staff cook for me now. They cook what I like – I don’t eat meat, I’m a vegetarian.”

People are involved in how Crossways is run. People described regular meetings in which various issues are discussed and decisions made.

“I like the house and my room. I’ve recently moved rooms – it has an ensuite and is a bigger room.” “There is too much stuff in my room at the moment – I’m going to clear it out.”

Reports under our old system of regulation (including those from before CQC was created)