Archived: Crossways Nursing Home

Updated 14 February 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Before the inspection we looked at all the information we had about Crossways Nursing Home. This information included the statutory notifications that the provider had sent to CQC. A notification is information about significant events which the service is required to send us by law. In addition, we reviewed the Provider Information Return (PIR). This is a form that asked the provider to give some key information about the service, what the service did well and improvements they planned to make.

This inspection took place on 21 and 24 November 2017. The inspection was undertaken by one inspector and one expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.

During the inspection we spoke with 10 people, four relatives and one person’s friend. We also spoke with the registered manager, clinical lead, business manager and four staff. We reviewed the care records of 12 people and the medicines administration records of nine people. We read seven staff files which included their recruitment, training and supervision records. We reviewed the provider’s quality assurance checks as well as their health and safety, fire safety, food safety and infection control practices. We also carried out general observations. Following the inspection we contacted four health and social care professionals for their feedback.

Updated 14 February 2018

This inspection took place on 21 and 24 November 2017. The first date of the inspection was unannounced.

Crossways Nursing Home provides residential and nursing care for up to 40 older people, some of whom were living with dementia or other mental health difficulties. At the time of the inspection there were 39 people living in the home.

At our last inspection in March 2015, we gave the provider an overall rating of Good. At this inspection we found the provider to be Good overall and Outstanding in caring.

The service had 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.

People were protected from avoidable harm. Staff assessed people’s risks and implemented plans to reduce the possibility of their occurrence. Management and staff were trained to safeguard people from abuse and neglect. Medicines were administered safely and the environment of the home was safe and hygienic. There were enough staff to deliver care and support and there was collective learning following incidents when things had gone wrong to ensure the service improved and people were safe.

Trained and skilled staff met people’s assessed needs. Staff were supervised by their managers although not always at the frequency identified in the provider’s policy. Staff received appraisals each year to evaluate their skills and performances. People were treated in accordance with the Mental Capacity Act 2005. People’s nutritional needs were met and people enjoyed the meals they chose. Staff supported people to access the health services they required to remain healthy and the service participated in a pioneering programme supporting people in the event of their admission to hospital.

The service was exceptionally caring. Staff went to great lengths to support people’s wishes. Creative methods were used to gather and present personalised information about people and their lives that was meaningful to them. The service liaised extensively with a wide range of faith organisations to ensure people’s spiritual needs were met. The expertise of healthcare professionals was sought to enable staff to protect people’s dignity where their behaviours may have otherwise compromised it.

The care people received was responsive to their individual needs. A range of activities were available for people to engage in as groups and individuals. The service provided an intermediate care service through which people were supported for short periods of time before returning home. People benefited from this service as an alternative to being in hospital. People were actively supported to plan their end of life care which was delivered compassionately.

The service had an open culture. The registered manager was visible and accessible to people and their relatives, and staff said she led by example. The service engaged in an exemplary level of partnership working and public engagement within the local community and nationally. The quality of the service was checked and the provider was reviewing its auditing procedures to ensure that shortfalls identified were acted on promptly.