Background to this inspection
Updated
29 January 2022
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
The inspection was carried out by one inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
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 48 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 14 December 2021 and ended on 23 December 2021. We visited the office location on 16 December 2021.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they 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 one person and nine relatives about their experience of the care provided. We spoke with ten members of staff including the registered manager, care coordinators and care workers.
We reviewed a range of records. This included five people’s care records and multiple medication records. We looked at three 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 continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records. We spoke with two professionals who regularly work with the service.
Updated
29 January 2022
About the service
Crossroads Together Merseyside is a domiciliary care agency providing personal care to 145 people at the time of the inspection.
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 received their medicines as prescribed. However, we found some gaps and the use of incorrect codes on some of the Medication Administration Records. Some recording errors had already been identified by the providers systems and action was taken to drive improvement. However, some of the recording issues were not identified. While we were assured this did not directly impact on the person receiving care, we raised our concerns with the registered manager who took immediate action to improve auditing processes in relation to medicines.
Staff were safely recruited. Rotas showed there were enough staff to safely care for people. Most people were supported by a small and consistent staff team. Relatives we spoke with told us staff were punctual.
Risk to people's health and safety had been assessed on an individual basis. Care plans and risk assessments gave staff detailed guidance to help mitigate risks related to areas such as medicines, mobility and eating and drinking.
There were effective safeguarding systems for adults and children. All people and relatives we spoke with told us they felt safe with staff. Comments included, “I trust them implicitly.”
Staff followed good infection control practices to help prevent the spread of healthcare related infections.
Care plans contained detailed information about people's eating and drinking needs and included people's preferences. Staff received training to complete their job roles effectively and gained practical experience by shadowing experienced staff. Relatives told us staff were competent in their roles.
People were treated with kindness and respect. Staff showed good understanding of people's likes, dislikes and preferences and explained how they supported people according to these. Staff spoke with compassion when describing their role and the people they cared for.
People were supported to have maximum choice and control of their lives and staff supported the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People's communication needs and any assistance they needed was recorded in their care plan. Care plans were written in a way which focused on promoting people’s independence. Where people required support with activities, records showed people’s interests were considered in helping to produce an activity programme which was tailored to them.
There was good partnership with external health professionals to provide people with compassionate end of life care.
There was an open culture in which all safety concerns raised were highly valued as integral to learning and improvement. The culture of the service focused on ensuring people received person-centred care that met their needs and preferences.
The views of people using the service were at the core of quality monitoring and assurance arrangements. The provider involved people, relatives and staff through regular reviews, team meetings and satisfaction surveys. The registered manager understood the importance of using this feedback to improve the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This is the first inspection for this newly registered service.
Why we inspected
This was a planned inspection.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.