Crossbrook Court

Updated 26 May 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

Three Inspectors carried out the inspection.

Service and service type

Crossbrook Court is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

The service had an interim manager in post who was not registered with the Care Quality Commission for this location..

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all of this information to plan our inspection.

During the inspection

We communicated with 4 people who used the service and observed interactions between another 3 people and staff. We received feedback from 2 relatives about their experience of the care provided. Not all people who used the service were able to talk with us and they used different ways of communicating including using Makaton, gestures and their body language. We adapted our communication styles as well as making observations of people’s responses to communicate with them.

We spoke with 4 support staff, the interim manager, a support manager, the quality manager, regional operation manager, the clinical manager, and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We received feedback from 4 health and social care professionals about the care and support people received in the service.

We reviewed a range of records. This included 5 people’s care records. We looked a variety of records relating to the management of the service and medicine records.

Updated 26 May 2023

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Crossbrook Court is a care home without nursing providing accommodation and personal care to 10 people at the time of the inspection. The service can support up to 14 people.

There were 2 separate buildings sharing the same grounds. One building had 1 self-contained apartment and 7 en-suite bedrooms. The second building had 3 self-contained apartments and 3 en-suite bedrooms.

People’s experience of using this service and what we found

Right Support

Staff supported people to have the maximum possible choice and control over their lives and be independent. Since the last inspection all restrictions imposed to people’s freedom were reviewed and lowered as much as possible. Where restrictions had to be in place these were regularly reviewed, and staff involved health and social care professionals in these reviews. The provider’s behaviour specialists were working with people to manage their anxieties better so that restrictions were minimised. People had specialist psychological support as well as on-going support from staff.

People were supported by staff to identify and pursue their interests or aspirations. People were supported where possible to participate in setting goals for themselves as well as participate in ‘Quality of Life’ reviews. The provider started using the quality-of-life tool in care reviews. This tool helped them focus on people’s experience, allowed feedback from relatives and other professionals involved in people’s care and highlighted areas where further improvements were needed to achieve good outcomes for people.

People had a choice about their living environment and were able to personalise their rooms. People told us they were supported to choose their décor and furnishings. The environment was undergoing refurbishment at the time of the inspection to ensure it better suited people living there. People’s medicines were managed safely.

Right Care

Staff understood how to protect people from poor care and abuse. Staff had training on how to recognise and report abuse and they knew how to apply it. Incidents were recorded electronically for senior managers to access and review remotely to identify trends and patterns if needed and take further action to support staff in how to keep people safe.

The provider employed enough staff to meet people’s needs and keep them safe. The use of temporary agency staff had dropped significantly since the last inspection, and this had a positive impact on people.

The provider started a training programme for staff to learn how to communicate with people who had individual ways of communicating, such as using body language, sounds, Makaton (a form of sign language), pictures and symbols. Daily support from a supporting manager was available for staff working in the home to help ensure effective communication with people.

People started to receive care and supported to fulfil their needs and aspirations and focus on their quality of life following best practice. Staff were working with people to create new opportunities for them to try and enhance their lives. However, more work needed to be done to ensure people’s care was centred around their likes, dislikes and their wishes respected.

Risk assessments were in place to ensure staff knew how to support people safely. Work was still being done to encourage and enable people to take positive risks.

Right culture

The provider’s management team recognised the need to promote a positive culture in the home. Their ethos and values to ensure people were enabled to lead inclusive and empowered lives were promoted within the new staff team. Staff were valued and supported to develop their strengths and skills and to understand best practice in relation to supporting people with a learning disability and/or autistic people. However, further work was needed for personalised care and support to be embedded in staff culture.

The quality of support provided to people was reviewed regularly. This involved people, their families, and other professionals as appropriate. Health and social care professionals as well as relatives gave positive feedback about the way the service had improved since the last inspection. Family members felt more involved in people’s care, and they felt listened to.

At the previous inspection we found staff did not ensure the risks of a closed culture were minimised. Whilst there was still a reliance on internal resources, the service had involved and listened to external health and social care professionals in implementing current best practice and guidelines when supporting people. The service worked in an open and transparent way, sharing information, and regularly meeting with external professionals to discuss people’s support.

The provider had changed and further developed their governance systems. This was to ensure they effectively monitored and improved the quality and safety of the care people received. The improvements identified as needed by our previous inspection had commenced with a delay. This was because the provider had to employ and train a permanent staffing group as well as employ a new manager. Some positive outcomes could be already identified for people following the improvements made, however the improved practices needed to be embedded and sustained.

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

Rating at last inspection and update

The last rating for this service was inadequate (published 06 September 2022).

The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

This service has been in Special Measures since 06 September 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

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