Cross Street Residential Care Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people were safe and protected from avoidable harm.

This service scored 75 (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 a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

The provider had developed a positive learning culture within the care home. People were encouraged and supported to raise safety concerns with managers and staff. Managers and staff understood the importance of reporting safety concerns. Systems were in place to support staff to report and record safety concerns and events when they arose. Any safety concerns or incidents that did occur were investigated and when lessons needed to be learnt this was used to continually improve staff practice. A manager told us, “We are continually learning lessons when incidents and events happen to try and improve how we do things here.”

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

Managers gathered information about people’s individual needs and wishes, and risks to their safety, prior to them using the service. This information was used to develop person-centred care and risk management plans which were shared with staff to help them provide safe and appropriate care to people from the moment they started living in the care home. Managers and staff worked closely with all the relevant family members where applicable and external health and social care professionals and bodies to ensure care plans and risk assessments reflected people’s current needs and wishes.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People told us they felt safe living in the care home. A relative said, “My [family member] is happy and safe living at Cross Street.” An external care professional added, “My clients are safe and well-cared at the home.” Managers and staff understood how to safeguard people. They knew how to recognise and report abuse and were able to articulate how they would spot signs if people were at risk of abuse or harm. A member of staff told us, “I would report abuse straight away to the managers if I ever saw or heard about it happening here.” Managers worked proactively with the relevant agencies, when a concern was raised, and took appropriate action to safeguard people from further risk, when this was required. An external care professional said, “We have no safeguarding concerns or any other concerns about this service.”

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Systems were in place to ensure risks people might face were routinely assessed, monitored and reviewed. People’s care records contained sufficiently detailed information for staff to follow to ensure risks to people were mitigated, so people remained safe when taking part in activities and events of their choice. Managers and staff were fully aware of the potential risks people might face and the steps they needed to take to reduce or safely manage them. Throughout our site visits we observed staff were visibly present, attentive and aware of people’s whereabouts in the care home and any changes that might indicate they needed additional support. For example, we saw staff always remained close to people whenever they decided to use their walking aid to move around the care home. Risk assessments and management plans were reviewed at regular intervals and updated according to reflect any changes in people’s needs.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

People told us the care home was a comfortable place to live. The environment was free from unnecessary slip or trip hazards. which enabled people to move freely and safely around the care home. An external care professional told us, “Cross street is a comfortable and homely building. My clients’ rooms are personalised and suitably adapted to meet their individual needs and tastes. The home is kept clean and safe making it easy for people with mobility needs or who are sensory impaired to safely navigate their home.” Safety systems and equipment people needed was in place and serviced at regular intervals to support the safe delivery of care. Staff had clear guidelines available to help them deal with emergencies.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

The provider employed enough qualified, skilled and experienced staff which ensured they were not reliant on temporary agency staff. This meant people received their care and support from staff who were familiar with their individual needs, preferences and daily routines. Staffing rotas were based on people’s dependency and individual needs. Staffing levels matched the staff duty rota and managers and staff were visibly present throughout the service during our site visits. We observed staff were always prompted to respond to people’s questions and requests for support. An external care professional told us, “The house is well staffed.”

Staff were supported with their learning and development needs and encouraged to continually improve in their role. They received the right mixture of e-learning and in-person practical and theoretical training and competency-based assessments which were being routinely refreshed and updated. An external care professional told us, “The staff are well trained.” A manager added, “All staff have received their Oliver McGowan training to support people with a learning disability which is co-delivered by a person with a lived experience.”

Staff had ongoing opportunities to reflect on their working practices and to identify any further training, learning or support they might need. Staff had regular individual and group meetings with their managers and co-workers.

The provider operated safe recruitment practices and only suitable staff were employed to work at the service.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

People lived in a clean, hygienic environment. Staff followed current best practice to reduce the risk of infections spreading. Staff were provided with relevant training to help them prevent and control the risk and spread of infection in the care home. They had access to resources and equipment to help them reduce infection risks and used this appropriately, which included adequate supplies of personal protective equipment [PPE]. A manager told us, “Staff appropriately maintain cleaning and food safety records to provide a clear audit trail of measures taken to reduce infection risks at the service.”

The provider made sure that medicines were safe and met people’s needs, capacities and preferences.

The services medicines systems were well-organised and safely managed. Medicines stocks, balances and records showed people consistently received their medicines as prescribed. Care records contained detailed guidance for staff about how people needed and preferred their prescribed medicines to be administered. Sufficiently detailed risk assessments and protocols for use were in place to guide staff including, 'as required' medicines. Managers told us the provider had signed up to STOMP (NHS program to - Stop The Over-Medication of People with a learning disability) and were actively working with external health care professionals to review prescribing practices and to reduce the use of psychotropic medicines where possible in line with STOMP principles. Staff received relevant medicines training and their competency to continue managing medicines safely was routinely assessed. There were regular internal and external audits of the care homes medicines practices.