Cross Keys

At the last inspection, in June 2015, the service was rated Good. At this inspection we found the service remained Good.

People told us they felt safe living at Cross Keys and with the staff who supported them. One person told us, “I feel safe here” and “happy.” Staff knew how to recognise and report the signs of abuse.

We observed people had good relationships with staff and staff interacted with people in a kind and respectful manner. People told us they felt staff were “brilliant” and “helpful.” The staff team had developed caring and supportive relationships with people using the service. People were supported to maintain contact with friends and family and had the opportunity to be involved in decisions about their care and the running of the service.

Care and support was provided by a consistent staff team, who knew people well and understood their needs. The registered manager said “We want to make a difference to people’s lives.” People had dedicated key workers who were responsible for updating care plans and leading on supporting people. These were chosen according to their experience and relationship with the person concerned.

People told us that staff were very supportive and were fully involved in every aspect of their life, both in Cross Keys and in the community. People told us they had set goals of things that they would like to achieve. Some examples were going on holidays and attending work placements. This showed that people were fully involved in setting their own goals, and were supported to, where possible, work towards achieving them.

People were supported to maintain good health, have access to healthcare services and receive on-going healthcare support. The staff had developed positive working relationships with health and social care professionals. Health and social care professionals told us “The team is well managed and they have regular team meetings which are client related.” They also told us that they had good communication and working relationships with the staff at Cross Keys. They felt the staff team worked with them positively, were open to ideas in how to best support a person’s care needs and then followed their recommendations and suggestions.

There were sufficient numbers of suitably qualified staff on duty and staffing levels were adjusted to meet people’s changing needs and wishes. Staff completed a thorough recruitment process to ensure they had the appropriate skills and knowledge. Staff were then supported through a system of induction and training. Staff told us the training was thorough and gave them confidence to carry out their role effectively.

People were supported to eat and drink enough and maintain a balanced diet and were involved in meal planning. Menu planning was done in a way which combined healthy eating with the choices people made about their food.

Care records were up to date, had been regularly reviewed, and accurately reflected people’s care and support needs. People who received care, or their advocates, were involved in decisions about their support and consented to the care provided. Risk assessment procedures were designed to enable people to take risks while providing appropriate protection.

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

People and their families were given information about how to complain. The registered manager was visible in the service, regularly working alongside staff to provide care and support for people. There was a positive culture within the staff team and staff said they were supported by the registered manager.

The registered manager had a clear vision for the service and encouraged people, relatives and staff to express their views and opinions. There was an open culture where staff were encouraged to make suggestions about how improvements could be made to the quality of care and support offered to people. The manager led by example and expected all the staff to carry out their role to the same standard.

The registered manager was passionate about promoting the importance and value of social care locally. For example to celebrate Cross Keys ‘birthday’ of five years, they invited neighbours and other members of the local community to a party. The registered manager had also attended a Care Ambassadors conference which school-leavers attended to promote the care industry. By highlighting the value of social care for people the provider was challenging negative perceptions and demonstrating its value for people in supporting them to live well independently.

There were effective quality assurance systems in place to make sure that any areas for improvement were identified and addressed. People and their families were involved in the running of the service and were regularly asked for their views through on-going conversations with staff and surveys.

Further information can be found in the detailed findings below

Care records showed people were given information to help them make decisions for themselves where possible, and we found people’s privacy, dignity and independence were respected and upheld. We saw people’s wishes were respected.

Care plans provided sufficient detail to direct and guide staff in order to meet people’s assessed care needs. People's records were personalised and provided information about the person’s wishes and abilities.

People were protected from abuse and staff were trained and supported to carry out their roles.

The premises were warm, well decorated and maintained and protected people from undue risk.

The service operated a consistently robust recruitment procedure in order to protect the people who lived at Cross Keys.

There was usually sufficient staff to meet people’s care needs, although their right to independence and choice was not always maximised. The registered manager anticipated four new staff would add to staff numbers in June 2013.

Staff were supported in their role with ongoing training provision and supervision.