The Crossings

Updated 10 November 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.

Inspection team

The inspection was carried out by one inspector onsite on day one and two. A second inspector reviewed documents offsite.

Service and service type

The Crossings is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. The Crossings is a care home without nursing care. CQC regulates both the premises and the care provided, 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.

At the time of our inspection there was a registered manager in post.

Notice of inspection

The inspection was unannounced.

What we did before the 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. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

During the inspection we interacted with 4 people. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We gained feedback from 5 relatives via telephone. We spoke with 6 staff members including the registered manager, scheme manager and support workers. We sent email questionnaires to the staff team and received 4 written responses. We reviewed 2 people’s care file records and a further 2 people’s medication records and stock. We looked at the provider’s clinical audits and policies and procedures. We sent feedback requests to healthcare professionals and received 6 responses.

Updated 10 November 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 assessment and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

The Crossings is a residential care home providing the regulated activity of personal care to up to 4 people. The service provides support to people with learning disabilities, some also have physical disabilities. At the time of our inspection there were 4 people living at the home. People live in a bungalow with adapted bathroom facilities. People had access to a well maintained garden.

People’s experience of the service and what we found

People used their own communication system to show us and we understood from the actions or gestures that we saw from people they enjoyed living at The Crossings. We observed lots of appropriate, professional interaction between staff and people. People were observed to be smiling, laughing and relaxed in the home. This was supported by what family members told us. Comments included, “I cannot fault them [staff]” and “(I have) never seen (anything) other than staff being kind to her, always looks clean and happy. No concerns.”

We found some improvements could be made with how staff recorded people’s daily activities, choices and decisions. We have made a recommendation about record keeping.

Right Support:

Staff communicated with people in ways that met their needs. Staff supported people with their medicines in a professional and safe way which achieved the best possible health outcomes.

People were encouraged to personalise their rooms with paint colours of their choice.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Right Care:

Staff promoted equality and diversity in their support for people. They understood people’s cultural needs and provided culturally appropriate care.

People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs. Staff understood how to protect people from poor care and abuse. The service worked well with other agencies to do so.

The service had enough appropriately skilled staff to meet people’s needs and keep them safe.

People who had individual ways of communicating, using body language, sounds, pictures and symbols could interact comfortably with staff and others involved in their care and treatment. Staff had the necessary skills to understand them.

People’s care, treatment and support plans reflected their range of needs and this promoted their wellbeing

Right Culture:

Without exception all the relatives we spoke with and healthcare professionals commented know well staff knew people. Relatives told us, “Perfectly happy”, “Staff are really nice” and “Very happy at the moment”.

Staff placed people’s wishes, needs and rights at the heart of everything they did. People and those important to them, including advocates, were involved in planning their care.

Staff evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate.

Staff ensured risks of a closed culture were minimised so that people received support based on transparency, respect and inclusivity.

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

Rating at last inspection

The last rating for this service was Good (Published 1 September 2017)

At our last inspection we recommended the provider had effective systems in place to ensure sufficient staff were provided to safeguard people's safety. At this inspection we found improvements had been made.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We undertook a focused inspection to review the key questions of safe and well-led only. For those key question not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

You can read the report from our last comprehensive inspection by selecting the ‘all reports’ link for The Crossings on our website at www.cqc.org.uk.

Follow Up

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