Archived: Crossways Community - 71 London Road

Updated 25 January 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

This inspection was carried out by one inspector.

Service and service type

Crossways Community - 71 London Road 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. The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

Before the inspection, we reviewed information we held about the service. the local authority and other agencies and health and social care professionals. The provider was not asked to complete a provider information return prior to this inspection. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We spoke with the registered manager, the deputy manager leader and one member of support staff. We reviewed people’s care and medicine records. We spent time talking with two people who lived at the service. We visited some people’s bedrooms. Due to a positive COVID-19 case in the home, all people were choosing to self-isolate in their rooms during our visit. This meant we were only able to observe people interacting and being supported by staff for very short periods of time.

After the inspection –

We reviewed copies of people’s care and medicine records, training records, rotas, policies, staff information, incident reports and quality assurance records. We spoke with the registered manager, two staff and one relative of a person using the service via telephone. We obtained feedback from four health and social care professionals who worked with staff and people at the service via email.

Updated 25 January 2022

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

Systems to assess, monitor and manage risks were not always effective. Risks associated with people’s behaviours that may challenge required improvement. Other risks to people’s health and well-being were being managed safely. We have made a recommendation about the provider assessing, monitoring and managing risks associated with people’s behaviours that may challenge.

There were several quality assurance and governance processes which were working well to identify and act within a reasonable time to address most risks and quality issues and to develop the service. However, some areas of people’s support we identified as needing improvement at this inspection had consistently not been recognised through the provider’s quality assurance processes.

Some statutory notifications about safety incidents and people’s needs had not always been sent to CQC by the registered manager and provider as required. This had not impacted on people’s safety and the registered manager took action to ensure they understood their responsibilities.

There were systems and process to help prevent abuse occurring. People told us they felt safe from abuse at the service. Staff knew how they should act if there were safeguarding concerns and who to contact to help keep people safe if this was necessary.

There was an inclusive, positive and open culture in the home. People and staff’s differences were respected and supported. Staff and the registered manager worked well with relatives and other health and social care professionals to be able to provide good support to people. 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 had received effective support to achieve good outcomes such as having their healthcare needs met quickly, being more independent in their daily lives, going to new places, doing chosen social activities, learning new skills and starting volunteer work.

People were supported in a kind and compassionate way by staff. People told us they thought staff listened to them and that their opinions mattered. Staff communicated in accessible ways with people. People were involved in planning their care, and staff worked well with other relevant people such as health and social care professionals and relatives to deliver responsive person-centred support to people.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture (RSRCRC) is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

Staff had not considered current evidence-based best practice guidance when assessing one person with a learning disability and/or autism needs. This had not had a known significant impact on the person, but there was an increased risk their needs may not be being met as effectively as they could be. We have made a recommendation about the provider being aware of statutory guidance about supporting people with a learning disability and/or autistic people.

Right support:

• The model of care and setting maximised people’s choice, control and Independence

The service was a domestic style property in a residential street. There were no signs on the outside of the service to indicate this was a care home.

Staff did not wear name badges or uniforms when supporting people.

Staff encouraged people to become active members of the local community.

Right care:

• Care was person-centred and promoted people’s dignity, privacy and human Rights

People were supported to make their own choices and be as independent as possible.

Staff treated people with kindness and respect.

Staff supported people in the least restrictive ways and in their best interests.

Right culture:

• Staff and management promoted ethos, values, attitudes and behaviours to ensure people

using services lead confident, inclusive and empowered lives.

There was an open and positive culture that respected people’s differences and treated everyone equally.

People and staff were encouraged to be involved in sharing their views and ideas about how to develop the service.

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

This service was registered with us on 1 May 2020 and this is the first inspection.

Why we inspected

This was a planned inspection based on the amount of time the service had been registered with CQC.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

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.