This inspection took place on 30 and 31 March 2016 and was unannounced.Crossways provides residential care and support for up to 24 older people. Some people also stay at Crossways for periods of respite or convalescence, before returning to their own homes. At the time of our inspection, 22 people were living in the home.
The service is required to have 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 safe in the home. Staff had a good understanding of safeguarding and knew what constituted abuse. Staff knew how to keep people safe and reported any issues of concern appropriately. Risk assessments were clear and detailed and reviewed regularly. Staff acted in accordance with the guidance and protocols that were in place to help reduce the risks for people. People received their medication on time and in the manner the prescriber intended.
Staffing levels were sufficient to meet people’s needs appropriately and all the staff on duty had the skills and knowledge to support people effectively and meet their needs in a timely manner. Appropriate and safe recruitment practices were followed, to ensure staff were suitable to work with people in a care environment.
Staff received good support from each other as well as from senior staff and management. Staff received good levels of supervision and the management team were approachable.
The CQC is required to monitor the Mental Capacity Act (MCA) 2005 Deprivation of Liberty Safeguards (DoLS) and report on what we find. The management team ensured the service operated in accordance with the MCA and DoLS procedures and staff demonstrated a clear understanding of the MCA, DoLS, capacity and consent. People were supported to make their own decisions and choices as much as possible.
People received enough food and drink to meet their individual needs and staff had a good understanding and knowledge of people’s dietary needs.
Prompt referrals were made to healthcare professionals as needed and any advice or guidance given was followed appropriately by staff. There was also consistent monitoring and appropriate communication by staff, regarding people’s healthcare needs and any changes.
People were fully involved in planning and reviewing their own care and staff appropriately supported people, when necessary, to make informed choices for themselves.
The staff were kind, caring and compassionate. People were treated with dignity and respect and their privacy was always upheld. People were also supported to do as much for themselves as possible, in order to enhance and maintain their independence.
People had access to activities that complemented their interests and enhanced their wellbeing. Visitors were welcome, without restrictions. People were listened to and their complaints were welcome. Any complaints were fully investigated and actions taken to improve the quality of care provided.
There were effective systems in place to monitor the quality of the service and these were used to develop the service further. Staff and people living in the home were involved in making decisions on how the home was run.
Record keeping and management systems were in good order, with effective auditing and follow up procedures in place. An open and inclusive culture was demonstrated in Crossways, with clear and positive leadership evident.