CQC report explained · a residential care home
What the CQC found at Crossley House
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Requires improvement
- Some falls had not been recorded or included in the falls analysis. One weekly medicine was missed in error, although immediate action was taken.
- Effective?
- Good
- Staff training was mostly up to date, people's consent was sought, and the home worked with health and social care professionals. Staff supervision and appraisal had not been happening as regularly as planned.
- Caring?
- Good
- People and relatives described staff as kind and caring. Inspectors saw people being treated with dignity, privacy and respect, and supported to remain independent.
- Responsive?
- Good
- Care plans were detailed, person-centred and reviewed regularly. Activities were tailored to people's interests, including one-to-one activities, and complaints were investigated.
- Well-led?
- Good
- The management team used audits, meetings and surveys to monitor the home and act on feedback. Most people, relatives and staff gave positive feedback about the leadership.
What inspectors found, June 2018
Rated Good overall; inspectors found kind, responsive care, but safety records and one medicine error needed improvement.
Inspectors visited the home without warning on 4 June 2018. They spoke with people, relatives, staff and health professionals, observed care, and checked care, medicine, staffing and management records.
People were described as safe, well cared for and treated with dignity. Inspectors found good support with food, health needs, activities, care planning and complaints. Staff were generally trained and enough staff were usually deployed.
Safety was rated Requires Improvement. Some falls had not been recorded or included in the home's analysis, and one weekly medicine was missed. The overall rating was Good, with the other four areas rated Good.
Kind and respectful staff
People and relatives praised the staff. Inspectors saw staff protecting privacy, treating people with dignity and supporting independence.
“People and their relatives said staff were kind and caring and we observed this during our inspection.” from the report
Personalised care
Care plans reflected people's needs and preferences. Staff generally knew people well and followed their plans.
“Care plans reflected people's care and support needs.” from the report
Management checks
The home had several audits, meetings, surveys and improvement plans. Feedback from people was recorded and acted on.
“A range of checks were in place to ensure the quality and smooth running of the service.” from the report
Falls were not always recorded
seriousTwo falls experienced by one person were not recorded as incidents or included in the monthly falls analysis. The manager said new checks and reporting arrangements would be introduced.
“Neither of these was recorded as an incident or included on the falls analysis.” from the report
One medicine was missed
seriousInspectors found that a weekly medicine important to a person's health had been omitted. The home contacted the GP, recorded the incident and put actions in place.
“However, we found an instance where a weekly medicine important to a person's health had been omitted in error.” from the report
Supervision was not regular enough
needs fixingStaff supervision and appraisal had not been taking place as regularly as they should. Only eight staff had received supervision since 1 February 2018.
“The registered manager told us that staff supervision and appraisal had not been taking place as regularly as it should have been.” from the report
Staff vacancies
needs fixingThe home had several vacancies and used agency staff, particularly at night. Day staffing was below the intended level on five of 20 days reviewed.
“The registered manager told us they had several vacancies and were using agency staff, particularly at night, to provide cover.” from the report
Communication policy still being developed
minorThe home did not yet have an accessible information standard policy, although staff were adapting communication to people's needs and the provider was developing one.
“The service did not yet have an accessible information standard policy although we saw this was being developed by the provider.” from the report
- 01How were the missing falls records corrected, and how are all falls now checked and included in the home's analysis?
- 02What changes were made after the missed weekly medicine, and how are medicines given at the correct times now checked?
- 03Are staff supervision and annual appraisals now up to date for every member of staff?
- 04How many permanent and agency staff are usually on duty during the day and at night?
- 05Has the accessible information standard policy been completed, and how are communication needs recorded for each person?
This was an unannounced inspection covering all five CQC questions, including care, premises, medicines, staffing, records and management. This explanation was written from the published report of 27 June 2018 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, May 2017
Rated Requires Improvement; inspectors found kind care and enough staff, but medicines, records and management systems needed stronger checking.
Inspectors visited on 24 April 2017. The report says the visit was unannounced, but later says the provider was given short notice. They spoke with 19 people, four relatives, staff and health professionals. They observed care, looked at six people's records and checked medicines, recruitment, training and other records.
People generally felt safe and said staff were kind, respectful and knew them well. There were enough staff and recruitment checks were robust. The home was clean and welcoming, and people received choices about food and daily routines.
Inspectors found important gaps. Some medicines records were incomplete, creams were not always applied as prescribed, and accident records were not properly analysed. Care records did not always show people's involvement or best-interest decisions. There was no registered manager, staff meetings had not taken place for several months, and some complaints had not been fully investigated.
The overall rating was Requires Improvement. Safe, Effective, Responsive and Well-led were also rated Requires Improvement. Caring was rated Good. The management team had an improvement plan, and some changes had already been made, but inspectors said improvements needed to be completed and sustained.
Kind and respectful staff
People and relatives said staff were caring. Inspectors saw staff treating people with kindness, compassion and respect, and protecting their privacy and dignity.
“Staff treated people with kindness and compassion and knew people well.” from the report
Enough staff and safe recruitment
Inspectors found staffing levels were enough to keep people safe. Recruitment records showed the required checks had been completed before staff started work.
“We reviewed staff levels and found these sufficient to keep people safe.” from the report
Clean and welcoming home
The home was clean, bright and well maintained. Bedrooms could be personalised, and dementia-friendly signs and memory boards were in use.
“We found the home was clean, bright, well decorated and had a welcoming feel.” from the report
Food and choices
People were offered food choices and drinks throughout the day. Inspectors saw a relaxed mealtime, with staff encouraging people to eat and catering for different dietary needs.
“We observed the mealtime experience and saw this was relaxed, unhurried and inclusive” from the report
Improvement work underway
The management team had identified many of the problems through audits and had an improvement plan. Inspectors also saw some changes already in place.
“A service improvement action plan had been developed and it was clear some improvements had already been put in place.” from the report
Medicines records and creams
seriousSome medicine administration records had gaps. Creams and ointments were not always available or applied as prescribed.
“We found a number of gaps in the MAR where staff had not signed to show they had administered the medication” from the report
Missing risk and best-interest records
seriousSome equipment, including bed rails and bed wedges, did not have recorded risk assessments. The records did not show that best-interest meetings had taken place when people could not make certain decisions.
“We saw no evidence to show where people lacked capacity to make a decision that best interest meetings had been held” from the report
Incomplete care records
seriousSome records were not personalised enough, and one repositioning chart showed a gap of about 16 hours even though staff said the person had been repositioned.
“Records showed the next time they had been repositioned was on the 20 April 2017 at 10:10 which meant they had not been repositioned for about 16 hours.” from the report
No registered manager
needs fixingThere was no registered manager at the time of the inspection. The home was being supported by an interim manager while the provider hoped to appoint a new manager.
“At the time of our inspection there was no registered manager since the previous manager had commenced the registration process but recently left the service.” from the report
Complaints and staff meetings
needs fixingTwo complaints did not have evidence of investigation or an outcome being shared. Staff meetings had not been held for several months.
“We found no evidence to show an investigation had been carried out to look at the concerns raised or if the complainants had been informed of the outcome of their complaint.” from the report
- 01What has changed in the way medicines administration records, creams and ointments are checked?
- 02How do you now record risk assessments and best-interest decisions for people who use bed rails, bed wedges or other restrictions?
- 03How do you make sure repositioning records are completed at the required times?
- 04Has a registered manager now been appointed, and who is responsible for the home until then?
- 05How are complaints investigated, answered and checked to make sure the agreed action has been completed?
This was a comprehensive inspection covering all five CQC questions; inspectors spoke with 19 people and examined six people's care records, medicines records and management records. This explanation was written from the published report of 19 May 2017 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Crossley House
3 rated inspections over 2 years: the service has held its Good rating throughout.
- June 2018Goodcurrent ratingup from Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2017Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- January 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- November 2014
Report published without a new overall rating.
- January 2014
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 9 December 2010.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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