CQC report explained · a residential care home
What the CQC found at Crossways
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People's risks were identified and reviewed, staffing was considered sufficient, and medicines were managed safely. Staff knew how to recognise and report possible abuse.
- Effective?
- Good
- Staff had suitable skills, training and support. People's health, food, fluid intake and legal rights around consent were addressed.
- Caring?
- Good
- Staff treated people with kindness, dignity and respect. They understood people's routines and supported independence, although some people needed help to communicate their views.
- Responsive?
- Good
- Care plans contained detailed information about people's routines, preferences and needs. People were supported to take part in activities and go into the community.
- Well-led?
- Good
- Inspectors found effective quality checks, an open culture and staff who felt supported. Audits had identified some care plans that needed updating and old information that needed archiving.
What inspectors found, May 2019
Crossways was rated Good overall; inspectors found safe, kind and personalised care, with some maintenance and end-of-life planning points to follow up.
This was an unannounced, comprehensive inspection by one inspector on 7 and 15 May 2019. The inspector reviewed information about the home, observed care, spoke with staff and the manager, and received feedback from four relatives. Some residents could not give detailed verbal feedback because of their complex communication needs.
Inspectors found that people were kept safe, received their medicines as prescribed and were supported by staff who knew them well. People were helped to make choices, stay independent, access the community and take part in activities they enjoyed. Relatives described the staff as kind and caring.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors noted some tired décor, mould on bathroom ceilings and rotten wooden window frames. They also found that early discussions about end-of-life wishes had started, but this work needed to be developed.
Safe staffing
Inspectors found enough safely recruited staff to meet people's needs. Regular bank staff were used instead of agency staff, helping to maintain continuity.
“There were enough, safely recruited staff to meet people's needs.” from the report
Kind and respectful care
Staff knew residents well and supported them with kindness, dignity and respect. Relatives also gave positive feedback about the care.
“People's privacy and dignity were respected by staff. Staff spoke with people respectfully and ensured their privacy was maintained.” from the report
Personalised support
Support plans included people's histories, routines, likes and dislikes. Staff understood that changes to routines could cause anxiety or distress.
“Support plans were detailed and contained important information about people's personal histories, their likes and dislikes, routines and preferences.” from the report
Choice and community activities
People were supported to make choices, develop independence and take part in activities outside the home according to their preferences.
“People were supported to access the community and take part in activities and social events according to their preferences.” from the report
Medicines managed safely
Staff were trained and checked as competent before giving medicines. Records, storage and stock were checked by senior staff.
“Medicine records, storage and stock were checked by two senior staff at handover during the day” from the report
Property maintenance
minorSome décor looked tired. Inspectors saw mould on bathroom ceilings and rotten wooden window frames. The home had raised these issues, with repainting and replacement work being considered.
“Areas of the décor were tired in appearance with some evidence of mould growth to bathroom ceilings and several of the wooden window frames were rotten.” from the report
End-of-life wishes
minorNo one was receiving end-of-life care during the inspection. Early discussions had started, but the home recognised that it needed to do more to understand people's specific wishes.
“The team leader told us that they had commenced preliminary discussions about end of life care during people's annual review meetings” from the report
- 01Have the mould, tired bathroom décor and rotten window frames identified in the report now been fully repaired?
- 02How do you record and review each person's end-of-life wishes and preferred care?
- 03How do you involve people with complex communication needs in decisions about their care?
- 04How do you check that support plans are up to date and that old information has been archived?
- 05How are staffing levels maintained when people need one-to-one or two-to-one support in the community?
This was an unannounced comprehensive inspection covering all five CQC questions, with care and the premises both examined. This explanation was written from the published report of 31 May 2019 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, October 2016
Rated Good overall; inspectors found safe, kind care, but the service needed to improve choice, independence and involvement in daily life.
The inspection was unannounced and took place on 30 August 2016. Inspectors spoke with people living in the home, relatives, staff and the manager. They observed care, reviewed care plans and other records, and contacted relatives after the visit.
Inspectors found the home safe, effective, caring and well-led. Staff knew people well, managed risks and medicines safely, supported health needs, and treated people kindly. Relatives had confidence in the manager and staff.
The home was rated Requires Improvement for being responsive. Care plans were detailed, but staff did not always promote independence or give people enough choice and involvement in everyday activities. Overall, the home was rated Good.
Staff knew people well
The home had a stable team, with many staff having supported people for years. This helped staff understand people's anxieties, triggers and communication needs.
“People were supported by a stable staff team who knew them well as the majority of staff had supported them for many years.” from the report
Safe medicines practice
Inspectors found medicines securely stored, administration records fully completed and stocks checked at handover.
“We looked at the medication administration charts and saw that these had been completed fully by staff.” from the report
Kind and respectful care
Staff were observed communicating clearly, respecting privacy and providing compassionate support. People were helped to keep in touch with family and friends.
“We saw examples of kind and compassionate care.” from the report
Good health support
People were supported to attend health appointments and had health action plans setting out their needs and professional contacts.
“People were supported to attend health care appointments such as with the optician, dentist and chiropodist.” from the report
Independence and choice
needs fixingSome routines were followed because they had always been done that way. This meant people did not always have enough control over everyday choices, including meals.
“Our observations were that some routines were undertaken in a way that they had always been done which meant that peoples independence and choice was not always fully promoted.” from the report
Staff knowledge of care plans
needs fixingNot all staff understood the contents of people's care plans. The report also said the care planning was largely carried out by the manager.
“However not all the staff we spoke to were aware of the contents of the care plan and one told us that although they contributed, the care plan was largely undertaken by the manager.” from the report
Limited engagement and activities
needs fixingInspectors saw periods when people had little engagement after formal activities. Some families wanted a wider range of activities and more one-to-one time.
“However we noted that on the day of our visit there were two staff on duty but there was little engagement or activity with the people living in the service” from the report
Feedback was too limited
minorThe weekly meeting focused mainly on choosing food for one night and was very brief. Inspectors said the home needed more imaginative ways to involve people.
“The manager told us that some people do not like meetings but none the less we have agreed that more inventive and imaginative ways should be found to consult with people.” from the report
- 01How do you now help people choose what and how much they eat at each meal?
- 02How do you make sure every staff member knows and follows each person's care plan?
- 03What has changed to give people more daily activities, independence and one-to-one time?
- 04How do people who do not like meetings give feedback about their care and daily life?
- 05What progress has been made with staff recruitment, staff deployment and the improvement plan?
This was an unannounced inspection of the overall service covering all five CQC questions. This explanation was written from the published report of 25 October 2016 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 Crossways
2 rated inspections over 3 years: the service has held its Good rating throughout.
- May 2019Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- October 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- January 2014
Report published without a new overall rating.
- August 2012
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 23 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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