Crosshill Nursing Home

We found the following examples of good practice.

¿ Systems were in place to prevent visitors from spreading and catching infection. Only essential visits could take place at the time of inspection. Visitors were screened for COVID-19 before entering the main home. Visitors were required to wear appropriate PPE and wash their hands in a separate allocated washroom.

¿ The home supported people and staff as far as possible with social distancing. Seating in the communal areas was spaced apart. Staff break times were staggered and there was signage in place limiting the number of staff who could enter the staff room at any one time.

¿ People were isolated appropriately in their rooms when needed and in line with government guidance. A reduced number of staff were allocated to care for someone who was isolating, to minimise the risk of cross-infection.

¿ Robust contingency plans were in place to ensure people’s needs were safely met during an outbreak. For example, an outside caterer had been arranged to prepare meals if the home’s kitchen staff were unable to complete their duties due to COVID-19.

¿ The home had ample supplies of PPE which was conveniently located for staff at various points throughout the home. Staff were observed to be wearing appropriate PPE, were bare below the elbow, and were practicing good hand hygiene. Systems were in place to safely dispose of used PPE.

¿ People and staff were taking part in the COVID-19 testing and vaccination programme.

¿ The home was clean throughout. A cleaning schedule was in place which included additional cleaning of frequently touched areas such as door handles. The home had a number of ozone machines which enabled them to carry out deep cleaning.

¿ The home had comprehensive and up to date Infection Prevention and Control (IPC) and COVID-19 policies in place. The manager spoke positively about the staff team’s hard work and strong team spirit. The manager had a good relationship with the provider who offered support and assistance throughout the pandemic.

Crosshill Nursing Home provides accommodation, nursing and personal care for up to 30 older people with. On the day of our visit there were 28 people using the service.

People’s experience of using this service and what we found

Medicines were administered safely. People were protected from abuse by staff who understood how to identify and report any concerns. The risks to people’s health, safety and welfare had been assessed, recorded and plans put in place to reduce these. Staffing levels enabled people’s needs to be met safely, and ensured people received consistent and reliable support. The management team sought to learn from any accidents or incidents involving people.

Staff were recruited safely and received appropriate training to enable them to carry out their role effectively. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People were happy with the food provided.

We have made a recommendation about the dining experience for people and the lack of a dining audit.

Staff were caring and treated people with kindness and respect.

Staff were responsive to people’s needs and went to great lengths to ensure people felt valued and had opportunities for social stimulation and to continue with their hobbies. People had clear, detailed and person-centred care plans, which guided staff on the most appropriate way to support them. People were confident to raise any concerns.

There was a clear management structure and staff were supported by the registered manager. Quality assurance systems were completed. The management of records needed revising.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was good (published 29 March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Crosshill Nursing Home provides care and accommodation for up to 30 people with residential and nursing care needs. On the day of our inspection there were 29 people using the service.

The service had a registered manager in place. 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.

We last inspected the service in October 2014 and rated the service as ‘Good.’ At this inspection we found the service remained ‘Good’ and met all the fundamental standards we inspected against.

Accidents and incidents were appropriately recorded and risk assessments were in place. The registered manager understood their responsibilities with regard to safeguarding and staff had been trained in safeguarding vulnerable adults.

Appropriate arrangements were in place for the administration and storage of medicines.

The home was clean, spacious and suitable for the people who used the service and appropriate health and safety checks had been carried out.

There were sufficient numbers of staff on duty in order to meet the needs of people who used the service. The registered provider had an effective recruitment and selection procedure in place and carried out relevant checks when they employed staff. Staff were suitably trained and received regular supervisions.

The registered provider was working within the principles of the Mental Capacity Act 2005 (MCA) and was following the requirements in the Deprivation of Liberty Safeguards (DoLS).

People were protected from the risk of poor nutrition and staff were aware of people’s nutritional needs. Care records contained evidence of visits to and from external health care specialists.

People who used the service and family members were complimentary about the standard of care at Crosshill Nursing Home.

Staff treated people with dignity and respect and helped to maintain people’s independence by encouraging them to care for themselves where possible. Care plans were in place that recorded people’s plans and wishes for their end of life care.

Care records showed that people’s needs were assessed before they started using the service and care plans were written in a person centred way.

Activities were arranged for people who used the service based on their likes and interests and to help meet their social needs.

The registered provider had an effective complaints procedure in place and people who used the service and family members were aware of how to make a complaint.

Staff felt supported by the management team and were comfortable raising any concerns. People who used the service, family members and staff were regularly consulted about the quality of the service.

Before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes. Where people did not have the capacity to consent to care and treatment, the provider acted in accordance with legal requirements.

We found people's needs were assessed. Care was planned and delivered in line with their individual needs. Staff personalised their approach when supporting people, to ensure they were meeting individual needs.

The provider had taken steps to provide care in an environment that was suitably designed and adequately maintained. At the time of our visit, work was ongoing to redecorate the home, and improve the layout of bedrooms. Improvements were also being made to staff areas within the home.

We found there were effective recruitment and selection processes in place.

Comments and complaints people made were responded to appropriately.

Our previous inspection had resulted in a compliance action due to the way in which people's care plans were written. Following this the provider had implemented a new care plan system which ensured people's care plans had more information in relation to the level of care required.