Background to this inspection
Updated
17 August 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
Our inspection was completed by one inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats and specialist housing.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service a short period of notice of the inspection because some people using the service could not consent to being contacted as part of our inspection process and/or were unable to use the telephone. This meant we had to make alternative arrangements, for example, checking the person’s representative agreed to be contacted by us, on their behalf. The service was providing personal care for up to 150 people at the time of the inspection and we needed to be sure the provider or registered manager would be available to support the inspection process.
Inspection activity started on 13 June 2019 and ended on 17 June 2019. We visited the office location on 13 and 14 June 2019.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. This included previous inspection reports and details about incidents the provider must notify us about, such as abuse. We used information the provider sent us in their Provider Information Return. Providers are required to send us key information about their service, what they do well, and improvements plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with eight members of staff including the registered manager, nominated individual, deputy manager, quality lead, one team leader and three support workers. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We spoke with three people who used the service and another three people’s relatives about their experience of the care provided. We sought feedback from the local authority and professionals who work with the service. We reviewed a range of records. This included three people’s care records, including support plans and a selection of medication records. We looked at five staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We looked at training data, a selection of quality assurance related records and public documents produced by the service.
Updated
17 August 2019
About the service
Crossroads Care is a domiciliary care service which provides personal care and support to people with a variety of needs including dementia, physical disability, sensory impairment and/or learning disability. Care and support is provided to people in their own homes. The level and amount of support people receive is determined by their personal needs. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.
People’s experience of using this service and what we found
People benefitted from a service which was exceptionally well-led and where the needs of people, their relatives and staff were prioritised in the way the service was run and had developed. The management team had formed strong and stable working relationships with other key organisations within their local community and were trusted by commissioners to assess and meet people’s needs, including at short notice. The service had an open, caring, person-centred culture where innovation and exceptional work by staff was encouraged and rewarded.
People felt safe and were assured their needs would be met with respect and dignity. They were confident in the staff who supported them, some of whom they told us went, “above and beyond” and who they described as “friends”. Risks to people were managed through the timely involvement of health professionals when needed and through reviews of people’s needs when these changed.
People were cared for by staff who felt supported and valued in their role, were trained to meet their needs and had been recruited according to the values they held. Staff knew people well and understood their needs, they were able to use their knowledge to assist in developing the service as their ideas were welcomed and encouraged.
People’s rights were upheld and the service was proactive in developing services that reduced barriers to people with disabilities. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
The service was proactive in catering to the holistic care and support needs of people (and their relatives) living in the rural community it served. Services had been developed, in partnership with other agencies and providers, to support people to remain living at home while improving their quality of life, to avoid hospital admissions and to enable people with support needs to be discharged quickly from hospital. Through the services provided, people and their relatives had developed their knowledge, friendships and support networks and could access activities they enjoyed, were meaningful and had positive health benefits for them.
People described a service they could rely upon and speak openly with, when their expectations were not met. People were able to contact the office easily and knew they would be listened to without fear of judgement or reprisal. Action was taken to improve the service in response to people’s feedback. This gave people and their relatives peace of mind and allowed them to focus on the more enjoyable aspects of their lives and relationships.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (published 18 October 2016).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.