We carried out an unannounced inspection of Crossways on 30th August 2018.

Crossways is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Crossways is registered to accommodate 39 people. At the time of our visit, 32 people were living there.

This care service is owned by Croftwood Care (Cheshire) Limited. The registered provider was registered with us in December 2016. This was the first inspection of the service since the registered provider changed.

They are registered to provide personal and respite care for up to 39 adults. A passenger lift and staircases provide access to all levels. The home is purpose built and situated in the village of Lostock Gralam, about three miles from Northwich town centre. Parking is available to the side of the building.

The service had a registered manager who was registered with us in August 2018. 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. The manager was present during the days of our visit.

We have made a recommendation in relation to the decoration of the premises to assist people who are living with dementia. We have also made a further recommendation in relation to them providing information in a format that is accessible for all people who use the service.

Activities were not always structured. This was because the activities co-ordinator employed by the registered provider had started a period of temporary absence. The registered manager recognised this and took steps subsequent to our visit to remedy this. As a result people had received a regular activities programme.

Arrangements were in place for the reporting of safeguarding incidents.

The management of medication was robust. Medication was appropriately stored and subject to regular audits.

Staffing levels were appropriate to the needs of people. Staff were available to assist people at all times.

The premises were clean and hygienic. Equipment used by people were checked and serviced regularly to ensure that they were safe to use.

Risks faced by people in respect of health needs such as pressure ulcers, falls and malnutrition were in place and reviewed regularly. Where people had experienced weight loss, a clear plan of action was in place to protect people’s health.

Recruitment of staff was robust. This ensured that vulnerable people were supported by suitable staff.

Accidents and incidents were recorded to ensure that patterns and trends could be identified to prevent re-occurrence.

Staff received the training they needed to perform their role. This training covered mandatory health and safety topics as well as training inked to the specific needs of the people they supported.

Staff received supervision on a one to one basis as well as through staff meetings.

A structured induction process was in place. The care certificate was used for those who had no previous experience of care.

The registered provider was operating within the principles of the Mental Capacity Act 2005. Appropriate safeguards had been applied for and granted to ensure that people were safe.

People had their health needs promoted and had access to health professionals in order to ensure they kept healthy.

Staff adopted a caring and patient approach to people they supported. The privacy of people was promoted at all times.

People had the opportunity to personalise their rooms as they wished to which reflected their interests.

Care plans were person centred and included the personal preferences of people. Care plans were reviewed and audited on a regular basis