The inspection took place on 6 and 13 February 2018. It was unannounced on the first day and announced on the second day.

There was a registered manager at the service. 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.

Crosshill House Residential Care Home is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.

Crosshill House Residential Care Home may accommodate up to 26 people, some of whom may be living with dementia. At the time of our inspection 25 people were living there. This service also operates a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults.

Not everyone using Crosshill House Residential Care Home receives regulated activity; The care Quality Commission (CQC) only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

At our last inspection we rated the service as good. We found some shortfalls regarding making the environment and daily menus more accessible for people living with dementia. At this inspection we found those issues had been addressed.

At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People we spoke with confirmed they felt safe being supported by the staff. People were safeguarded from harm and abuse. There were sufficient knowledgeable and skilled staff provided to meet people’s needs. Risks to people’s wellbeing were monitored and advice was sought from relevant health care professionals to help to maintain people’s wellbeing. Medicine management was monitored effectively and safe recruitment practices were in place.

People’s needs were assessed before they were offered a service. People were involved in planning their care and support. People’s care records were person-centred and informed the staff about their current needs and any changes to people’s health were acted upon.

Staff undertook a programme of induction and training to help develop and maintain their skills. They were provided with regular supervision and a yearly appraisal. Staff we spoke with told us this helped them feel valued and supported.

Staff treated people with care, compassion, dignity and respect. Staff listened to and acted on what people said. People’s preferences for their care and support were known by staff. People’s diversity was promoted and they were encouraged to live the life they chose.

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

There were systems in place to deal with complaints that were received. People we spoke with had no complaints to make about the service they received.

The management team undertook audits and checks to help monitor or improve the service. People views were asked for and were acted upon. Regular staff meetings were held. The management team worked well with the local authority and commissioners of the service and looked at how they could improve the service on a

Crosshill House residential care home is centrally located in the market town of Barrow Upon Humber close to local shops and amenities. The service is registered with the Care Quality Commission (CQC) to provide residential care and accommodation for up to 17 people. The service is also registered to provide personal care in the community. At the time of our inspection the service was supporting 16 people to live at Crosshill House and was providing personal care in the community for 13 people living in their own homes.

The service provides support for older people or people living with dementia related conditions. It offers 15 single rooms and two shared bedrooms. Six of the bedrooms have en-suite facilities. The service also provides two communal lounges, kitchen, bathroom and toilet facilities, conservatory, dining area, passenger lift access to the first floor and outside garden space with a pond.

The inspection took place on 4 November 2015 and was unannounced. The service was last inspected on 3 May 2013. At that inspection we found the registered provider was compliant with all the regulations we assessed.

At the time of our inspection the service had a registered manager in post. 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.

We found there were policies and procedures in place to guide staff in how to safeguard people who used the service from harm and abuse. Staff received safeguarding training and knew how to recognise and report potential abuse. Risk assessments were in place to guide staff in how to support people appropriately and minimise risks. People lived in a safe, clean environment where the equipment used was regularly checked and serviced.

The registered manager was following the principles of the Mental Capacity Act 2005 (MCA) and we saw that applications, where required, had been submitted in respect of people being deprived of their liberty.

During our inspection we found that staff had been recruited safely and appropriate checks had been completed prior to them working with vulnerable people. Staff had a good knowledge and understanding of the needs of the people they were supporting. Staffing levels were adequate and there was a training programme in place to ensure staff were equipped with the knowledge and skills required to carry out their role effectively. Medicines were managed, stored and administered in a safe way.

We found people’s health and nutritional needs were met and they accessed professional advice and treatment from community services when required. Positive interactions were observed between staff and the people they cared for. People’s privacy and dignity was respected and staff supported people to be independent and to make their own choices.

People who used the service were supported to engage in activities and local community groups were welcomed into the service. People were supported to maintain relationships with their families and friends.

The service was well managed and the registered provider undertook regular audits to ensure the service was safe. The registered manager promoted an open door culture and staff told us they felt well supported working at the service. People who used the service and their relatives were encouraged to give feedback on the service to help make improvements or changes to practice.

We recommended that the registered provider referred to current good practice guidance with regards to making the environment and daily food menus more accessible for people who may be living with dementia.

During the inspection we spoke with four people who used the service. They told us the standard of care they received was very good. One person said: "I like living here, its very good. I’ve been here 12 years, the girls are very good. You couldn’t be better looked after." We also spoke with one relative. They were complimentary about the care and support their relative received. They told us staff always kept them up to date and knew how to meet people's needs.

People's privacy, dignity and independence was respected. We found people’s views and experiences were taken into account in the way the service was provided and delivered in relation to their care.

We found the provider had taken steps to provide care in an environment that was suitably designed and adequately maintained.

There were enough qualified, skilled and experienced staff to meet people’s needs. People who used the service told us "The staff are very kind and do what they have to." Another person said "They couldn't do any better. You can give them a big tick from me."

There was an effective complaints system available. Comments and complaints people made were responded to appropriately. People we spoke with told us they could raise any concerns with staff or the manager and these would be acted upon.

People we spoke with were very positive about the care and support they received. They told us they liked living at the home and confirmed they were supported to make choices and decisions about the care they received. Comments included “I am very happy living here”, “It’s a lovely home”, “I am very well looked after,” and “The staff are very good, they do anything for you.”

People told us they liked the staff. Comments included “The staff are very good,” “the staff are very nice,” “There are always plenty of staff on duty” and “The staff are brilliant.”

During this inspection we spent time observing the care provided and speaking to people who lived in the home.

People we spoke with were very positive about the care and support they received. They told us they liked living at the home and confirmed they were supported to make choices and decisions about the care they received. They told us they were assisted to be as independent as possible. Comments included “I wouldn’t have believed I could be so comfortable,” “It couldn’t be better” and “I am very, very happy.”

They told us they were happy living in the home and confirmed they felt safe. They told us they liked the staff. Comments included “The staff are wonderful” and “The staff are all lovely.”