10 January 2023
During a routine inspection
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.