CQC report explained · a nursing home
What the CQC found at Crossways Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, December 2019
Crossways Nursing Home was rated Good; inspectors found safe, kind and personalised care, with only minor concerns about staff language and community links.
The inspection was unannounced and took place over two days. Inspectors spoke with people living in the home, relatives and staff. They observed care, reviewed records and checked the premises, medicines and management systems.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found that people were protected from avoidable harm, received appropriate healthcare and nutrition, and were treated with patience, privacy and respect.
The rating had improved from Requires Improvement at the previous inspection. The provider had acted on earlier problems, including security and mental capacity procedures. Inspectors found these improvements had been sustained and that there were no current breaches of regulations.
Safe care and medicines
Risks were assessed and staff had plans to manage them. Medicines records showed people received medicines as prescribed.
“Medicines administration records showed people received them as prescribed.” from the report
Kind and respectful staff
People appeared comfortable with staff, who were patient and attentive. Relatives gave positive feedback about the care.
“Staff were caring and kind in their approach.” from the report
Personalised activities
Activities were matched to people's abilities and interests. People who were cared for in bed were still offered time with staff and meaningful interaction.
“Activities were adapted based on people's individual needs and interests so people with different abilities could participate.” from the report
Improved oversight
The provider had strengthened its quality checks. Inspectors found that actions identified through audits had been completed.
“Quality assurance processes had been greatly improved and were now robust and well embedded.” from the report
Respectful language
minorInspectors saw isolated examples of staff using a more directive tone and a patronising expression. This was raised with the manager, who agreed to address it.
“There were instances of staff having used a more directive tone and patronising expression for someone, however, these were isolated events” from the report
Community links
minorThe home had opportunities to develop relationships with the local community and voluntary organisations further, to help reduce social isolation.
“There were opportunities to further build relationships with the community and utilise voluntary services” from the report
- 01How do you check that staff always speak to people in a respectful and non-patronising way?
- 02What activities are available for someone who is cared for in bed or has limited mobility?
- 03How will you develop links with voluntary organisations and the local community?
- 04How are changes in a person's health, risks or support needs recorded and shared with relatives?
- 05How are mental capacity decisions and best-interest decisions recorded for each person?
This was a planned inspection covering all five key questions; the report says a previous focused inspection had already checked whether Warning Notice issues had been resolved. This explanation was written from the published report of 18 December 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, June 2019
Rated Requires Improvement overall; inspectors found safe care and good leadership, but identified a cream-related fire risk and said quality audits needed strengthening.
This was an unannounced, focused inspection on 30 April 2019. One inspector reviewed earlier information, the previous warning notice, care records, incident and complaint records, audits, and quality reports. They also spoke with people using the service, a family member, a health professional, managers, a nurse and care staff.
The home was rated Good for Safe and Well-led. Inspectors found enough staff, safe recruitment, safe medicines systems, suitable safeguarding arrangements, and appropriate management of most risks. The home was clean and staff were described as caring and supportive.
There were two areas to improve. Risks linked to prescribed paraffin-based creams had not been identified or reduced, although the manager acted after inspectors raised this. Quality monitoring systems had been introduced but needed further development and embedding.
The overall rating stayed Requires Improvement because this was a focused inspection and did not reassess all five areas. The previous full inspection, published on 18 November 2018, had rated the service Requires Improvement and had found a breach of Regulation 17.
Enough staff
Staffing levels allowed people to receive support when they needed it. Inspectors saw staff spending time with people and supporting them safely.
“Staffing levels ensured that people received the support they needed safely and at the times they needed.” from the report
Safe medicines
Medicines were managed safely and records were completed correctly. Nurses administering medicines had training and competency checks.
“Medicines continued to be managed safely and records were completed correctly.” from the report
Clean environment
The home was clean and maintained, with infection control training and protective equipment available to staff.
“The home was clean and well maintained. People were protected from the risk of infection.” from the report
Improved governance
The provider acted on the previous governance warning notice and was no longer in breach of Regulation 17 at this inspection.
“At this inspection we found the provider had taken the required action and the home was no longer in breach of this regulation.” from the report
Paraffin cream risks
seriousRisks linked to the use and storage of prescribed paraffin-based creams had not been identified or reduced. The manager reviewed these risks after inspectors raised the issue.
“Known additional risks, in respect to their use and storage away from sources of ignition had not been identified and action had not been taken to mitigate those risks.” from the report
Audits still developing
needs fixingThe home had introduced audits, but inspectors said they needed to be developed and embedded so they gave a stronger check on quality and legal compliance.
“These systems need to be further developed and embedded to create a more robust focus and ensure they supported the registered manager to monitor quality and compliance with the regulations.” from the report
- 01What specific steps have been taken to record and reduce the risks from paraffin-based creams, including keeping them away from sources of ignition?
- 02How have the medicines, care plan, accident, fire safety and environmental audits been developed since this inspection?
- 03What evidence can you show that the new quality checks are now fully embedded and identify problems quickly?
- 04What are the current ratings for Effective, Caring and Responsive, which were not assessed during this focused inspection?
- 05What changes have been made since the previous full inspection and warning notice?
This was a focused inspection of Safe and Well-led only; Effective, Caring and Responsive were not assessed during this visit, so the overall rating remained Requires Improvement. This explanation was written from the published report of 12 June 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.
Every inspection of Crossways Nursing Home
5 rated inspections over 3 years: the service has improved, from Requires improvement to Good.
- December 2019Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2019Requires improvementstayed Requires improvementSafe: GoodWell-led: Good
- November 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- August 2017Requires improvementstayed Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- August 2016Requires improvementSafe: GoodEffective: Requires improvementCaring: GoodResponsive: Requires improvementWell-led: Good
- October 2013
Report published without a new overall rating.
- October 2012
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- October 2011
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 20 January 2011.
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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