The Crossings

About the service

The Crossings is a residential care home providing the regulated activity of personal care to up to 4 people. The service provides support to people with learning disabilities, some also have physical disabilities. At the time of our inspection there were 4 people living at the home. People live in a bungalow with adapted bathroom facilities. People had access to a well maintained garden.

People’s experience of the service and what we found

People used their own communication system to show us and we understood from the actions or gestures that we saw from people they enjoyed living at The Crossings. We observed lots of appropriate, professional interaction between staff and people. People were observed to be smiling, laughing and relaxed in the home. This was supported by what family members told us. Comments included, “I cannot fault them [staff]” and “(I have) never seen (anything) other than staff being kind to her, always looks clean and happy. No concerns.”

We found some improvements could be made with how staff recorded people’s daily activities, choices and decisions. We have made a recommendation about record keeping.

Right Support:

Staff communicated with people in ways that met their needs. Staff supported people with their medicines in a professional and safe way which achieved the best possible health outcomes.

People were encouraged to personalise their rooms with paint colours of their choice.

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.

Right Care:

Staff promoted equality and diversity in their support for people. They understood people’s cultural needs and provided culturally appropriate care.

People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs. Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so.

The service had enough appropriately skilled staff to meet people’s needs and keep them safe.

People who had individual ways of communicating, using body language, sounds, pictures and symbols could interact comfortably with staff and others involved in their care and treatment. Staff had the necessary skills to understand them.

People’s care, treatment and support plans reflected their range of needs and this promoted their wellbeing

Right Culture:

Without exception all the relatives we spoke with and healthcare professionals commented know well staff knew people. Relatives told us, “Perfectly happy”, “Staff are really nice” and “Very happy at the moment”.

Staff placed people’s wishes, needs and rights at the heart of everything they did. People and those important to them, including advocates, were involved in planning their care.

Staff evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate.

Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity.

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

Rating at last inspection

The last rating for this service was Good (Published 1 September 2017)

At our last inspection we recommended the provider had effective systems in place to ensure sufficient staff were provided to safeguard people's safety. At this inspection we found improvements had been made.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We undertook a focused inspection to review the key questions of safe and well-led only. For those key question not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for The Crossings on our website at www.cqc.org.uk.

Follow Up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

At the time of the inspection The Crossings was providing accommodation and care for three adults with learning disabilities including one person who had additional physical disabilities. The service had a registered manager in place. 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.

Prior to the inspection we responded to concerns about low staffing levels by visiting the service unannounced. We found there to be sufficient staff on duty to support people safely.

We were told by the registered manager they had experienced difficulties in guaranteeing sufficient staff were available to work, following the resignation of a high number of staff. Given there was a small team working in the service, this had a large impact. Work had been undertaken and was on-going to recruit suitable staff to work in the service. The registered manager took appropriate steps to ensure suitable people were employed to support people using the service. We observed suitable numbers of staff were present in the service during the inspection.

Staff were trained to administer medicines safely, we found records and practice were up to date and accurate. Risks to people’s safety had been assessed and care plans gave detailed guidance to staff on how to provide appropriate care to people.

Staff were supported to carry out their role to the required standard. Staff attended training, and received supervision and appraisals. Staff meetings were available for them to discuss the service, and issue or any improvements that were necessary.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The service was operating within the principles of the Mental Capacity Act 2005(MCA).

People were supported to be involved in making day to day decisions about their care. Where people needed support with food and drinks this was provided. People’s health was monitored and where people needed extra support from medical professionals this was arranged.

We observed staff to be kind and caring towards people living in the home. They knew people’s needs well and were responsive and supportive. People were respected by staff and their privacy and dignity was maintained.

People were encouraged to participate in activities they enjoyed. These were reviewed to ensure they were still appropriate and enjoyable for the person.

Feedback was sought from people and their relatives. This assisted the registered manager to ensure where improvements could be made, they were. Quality assurance checks were carried out, and where improvements to the service were identified, these were completed.

There was an open and transparent culture in the service, they were clear that the challenges faced by staff shortages would be rectified as soon as possible. The registered manager made themselves accessible to people, staff and relatives to ensure contact with people was always available.