Archived: Crossroads Care North West - West Lancashire

Updated 13 January 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on the 5, 10 & 11 November 2015 and was announced. 48 hours’ notice of the inspection was given because we wanted to ensure the registered manager was available.

The inspection was carried out by two adult social care inspector’s, including the lead inspector for the service, and an expert-by-experience, who made telephone calls to main carers and people who they cared for. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Before the inspection visit we reviewed the information we held about the service. The provider sent us a provider information return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

We spoke with a range of people about the service; this included 21 people who used the service either as the main carer receiving respite or the person they cared for. We also spoke with four care and support workers and the registered manager of the service.

We spent time looking at records, which included six people’s care records, four staff files, training records and records relating to the management of the home which included audits for the service. We also looked to see if the home had relevant, up to date policies and procedures in place.

Updated 13 January 2016

This inspection took place on the 5, 10 & 11 November 2015 and was announced. 48 hours’ notice of the inspection was given because we wanted to ensure the registered manager was available.

We last inspected this service under its previously registered name of ‘Crossroads Care West Lancashire’ in February 2013. The service was judged to be compliant in all the areas we looked at. The service registered under the name of ‘Crossroads Care North West – West Lancashire’ on 31 July 2015.

Crossroads Care North West – West Lancashire provide support and personal care for people of all ages to enable them to remain in their own homes. The service helps people’s main carers in West Lancashire and surrounding areas to have some respite from their caring duties so that their own health and wellbeing is maintained. The agency office is located near to the town centre of Ormskirk.

The registered manager of the service was present throughout our inspection. 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 looked at training records we found that all of the staff had received medication training and updates, as stipulated in the providers’ medicine policy and procedure. Staff files included staff competency assessments for the administration of medicines.

We saw that the service had appropriate policies in place to ensure that people who used the service were kept safe, including an up to date safeguarding policy.

We asked people if care support workers turned up on time and if they stayed the amount of time they were allocated to do so. All the people we spoke with, and their main carers, agreed that they did stay for the amount of time they should.

The care records we looked at evidenced service user agreements and consent to care. However, we found a lack of consideration for assessment of a person’s mental capacity prior to asking the service user for consent to care and treatment or prior to making a decision on a person’s behalf. Staff were not trained in Mental Capacity Act awareness. The manager told us they were aware this area needed development. During our feedback meeting the week following our inspection we saw that training had been sourced for staff with regards to MCA and DoLS.

Staff we spoke with told us that they received appropriate training, formal support through supervisions and appraisals as well as informal support. They told us they were able to visit or contact the office, including outside of office hours, for advice or support.

We looked at care records for four people and found that nutritional risk assessments, preferred foods and drinks and peoples abilities were recorded throughout the related care plans.

People we spoke with told us they were happy with the care they received from the service and told us that they had positive relationships with staff.

We contacted other professionals involved with the service and asked them about their experiences of dealing with managers and staff at Crossroads, including the local authority contracts team. The responses we received were positive regarding the care people received and how managers and office staff dealt with enquiries and issues.

Details of the services complaints process was contained within the ‘Service User Information and Guidelines for Carers and People with Care Needs Using our Service’ booklet that was given to people when they started to receive a service. This pack also contained contact details for the agency’s ‘out of hours’ or ‘on-call’ service which was available 24 hours a day seven days per week.

Care plans were completed and reviewed in accordance with the persons changing needs. There was a lack of consistency in the information between care files. However overall the care plans included personal preferences and individual information.

Assessments were completed prior to agreement of services and they showed a good standard of person centred detail.

A range of quality audits and risk assessments had been conducted by the registered manager. The organisation had their own internal quality audit tool entitled ‘CROQUET’ (Crossroads Care Quality Evaluation Tool) with the most recent audit having taken place in July 2014. The West Lancashire service had received the highest level within the organisations structure.

The service held regular staff meetings and we were shown a copy of the latest minutes. Staff we spoke with told us that they found these meetings useful and were able to contribute within the meetings.