Crossley Place

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• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

This means we looked for evidence that the service met people’s needs.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s needs were met through good organisation and delivery.

The design, layout, and furnishings of the ward supported patients’ treatment, privacy and dignity. Staff supported patients with activities outside the service, such as work, education and family relationships. The service met the needs of all patients including those with a protected characteristic. Staff helped patients with communication, advocacy and cultural and spiritual support. The service treated concerns and complaints seriously, investigated them and learned lessons from the result. Patients and carers were encouraged to be involved in making decisions about the service.

We have not awarded this service a score for Responsive.

Find out about when we will not publish a key question score and what we look at when we assess Responsive.

We scored the service as 3. The evidence showed a good standard. The service made sure people were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

The model of care was person centred and recovery focused. Staff were developing the model further to become trauma informed. Before a patient was admitted, staff considered how they could work with the patient and developed a bespoke package of care that was tailored to their individual needs. All patients had at least one member of staff allocated to them, and this could be used to determine what care and support the person needed. Each patient had their own apartment, which was decorated or adapted to both their personal preferences and any restrictions that may be needed because of risk.

Staff worked with patients to make decisions about their care. Some patients were able to engage with staff more than others, and this could lead to very collaborative care plans. All patients had an individualised positive behavioural support (PBS) plan, that was tailored to their specific needs, and the support that worked for them.

We scored the service as 3. The evidence showed a good standard. The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

Staff ensured that patients had access to education and work opportunities. Some patients had jobs within the service, which included working in the kitchen, car valeting, volunteering and dog walking. There were currently 5 patients who were accessing education, ranging from access courses to those leading to vocational and academic qualifications.

Staff told us they could support patients to access their chosen place of worship within the community if they wished, but there were no patients currently expressing an interest in doing this.

We scored the service as 3. The evidence showed a good standard. The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Staff ensured that patients could obtain information on treatments, local services, patients’ rights, and how to complain. Information was on display or could be provided by staff or through the advocacy service. Information on display throughout the service included information about the model of care, trauma informed care, advocacy and people’s rights.

The information provided was in a form accessible to the particular patient group. Staff used communication cards or easy-read information with some patients. Staff told us that information could be provided in different languages if required, but this had not been needed for the current patient group.

Staff ensured carers and families were regularly updated about the patient’s progress, with the consent of the patient. Carers were provided with a carers handbook when their relative first came to the service. Staff sent out information newsletters and other information to carers. This included the carers’ survey action plan and invitations to events. The carers’ forum provided detailed information to carers about the service.

Staff made notifications to external bodies as needed. This included to regulatory bodies such as CQC or other regulators, and safeguarding referrals to the local authority when necessary.

Staff provided information to commissioners of the service who purchased individual care packages for patients, and to host commissioners from the local area. Patients had their care commissioned by different organisations from across England, Wales, Scotland, Northern Ireland and the Republic of Ireland, depending on where the person lived. Staff worked with the multiple commissioning bodies to provide feedback and information about individual clients and the wider service.

Information governance systems included confidentiality of patient records. Electronic care records and paper records were stored and accessed securely. Information governance and UK General Data Protection Regulation (GDPR) had been completed by 98% of staff.

We scored the service as 3. The evidence showed a good standard. The service made it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. They involved people in decisions about their care and told them what had changed as a result.

The service had received no formal complaints in the 12 months prior to our inspection.

Patients we spoke with knew how to complain or raise concerns. Information was on display about how to make a complaint. The service had a complaints form that staff completed with patients if they wanted to raise a concern, even if they did not want to make a formal complaint. Concerns that patients had raised had been looked into and addressed. For example, if patients had raised issues about the staff member who was observing them. Patients were specifically asked if they wanted to make a complaint about these issues, but they had declined.

Staff knew how to handle complaints appropriately. The provider had a complaints policy that included how people could make a complaint, what the process would be, and when they should expect a response. If a complaint needed further action a manager would investigate and then respond to the complainant. If appropriate, a manager from outside the service would investigate.

Patients were involved in decision-making about changes to the service. Patients had regularly community meetings, that were attended by managers and the consultant psychiatrist. Patients could raise concerns and discuss what activities or trips they wanted, which included on special occasions such as bonfire night and Christmas. Patients were asked for their input into changes to the environment, such as the replacement of furniture and chairs, and for feedback about food. A joint community meeting with staff was held on each ward to discuss and review restrictions.

The service had a co-production action plan to encourage and support patient and carer involvement within the service. Managers told us that a patient representative should attend the clinical governance meeting, but there had recently been a gap in this role. It was expected by the service that another patient would take this up shortly after the inspection.

The service was collaborating with an artist as part of a tree-planting project within the hospital grounds. Patients were engaged in discussions about what they wanted from the grounds, and it was expected that patients from Crossley Place and other Elysium Healthcare hospitals would be involved in the planting.

The service had a carers’ lead and a carers’ forum that took place every 6 months. The carers forum was still developing and took place online to encourage attendance. Staff provided detailed information about the service and requested feedback. A forum happened during the inspection and included discussion about ‘The Triangle of Care’, a national initiative to promote carer involvement.

We scored the service as 3. The evidence showed a good standard. The service made sure that people could access the care, support and treatment they needed when they needed it.

Staff ensured the needs of patients with mobility issues were met. The service could support and make adjustments for people with mobility problems. All patients had an individual apartment with a lounge area, bedroom and ensuite bathroom that were accessible by people in a wheelchair. Orchard ward was on one level, and Meadow ward was on two floors but had a key-operated lift. Managers told us that they took account of people’s needs and how the service could meet them as part of the pre-admission assessment process. All patients had a detailed pre-admission assessment, and staff developed a bespoke package of care that was tailored to the individual needs of the patient, including any adjustments.

There was adequate medical cover day and night, and a doctor could respond to the service quickly in an emergency. The service had a full-time consultant psychiatrist who was the responsible clinician or equivalent for all patients. Out of hours medical support was provided by the regional out of hours cover system. The service had a practice nurse, who provided physical health care, and an Advanced Nurse Practitioner from a local GP practice where all patients were registered. There were local acute hospitals within a reasonable travelling distance when required.

We scored the service as 3. The evidence showed a good standard. Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Staff within the service and the wider organisation promoted a culture in which the people using the service felt empowered to give their views. Patients were encouraged to give feedback about the service. This was supported by staff and an independent advocate. Patients had community meetings where they could share their views.

Staff were trained in equality, diversity, inclusion and human rights. All staff had completed diversity, equity and inclusion training. Introduction to culturally appropriate care training had been completed by 94% of staff.

The provider had undertaken equality impact assessments of their policies and procedures to ensure they did not place vulnerable people or people with protected characteristics at a disadvantage.

We scored the service as 3. The evidence showed a good standard. People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Staff supported patients to make decisions about their care and treatment and their future. The service did not routinely care for people who were nearing the end of their life or required palliative care. However, if patients became unwell staff worked with other services to support the needs of the patient. Staff created personalised care plans to account for the person’s needs, wishes and feelings.