Richmond Upon Thames Crossroads Caring for Carers

Richmond upon Thames Crossroads Care is a domiciliary care agency providing personal care and support to 67 people living in their own homes at the time of the inspection.

31 out of 67 people using the service were receiving personal care. 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

Staff were very well-trained, supervised, and appraised. Everyone we contacted praised the excellent care that staff provided, which more than met their needs. People and their carers said staff spoke to them clearly, in a way and at a pace they could understand and took time to explain things to them. Carers said that in the case of people with dementia, staff patiently repeated information as many times as was required. Staff encouraged people to discuss their health needs and made sure these were passed on to other appropriate community-based health care professionals. The agency had a highly developed professionals’ network that enabled seamless joined up working between services based on people’s needs, wishes and best interests. This included transitioning to different services as people’s needs changed. Staff protected people from nutrition and hydration risks, and people were encouraged to choose healthy and balanced diets that also met their likes, dislikes and preferences. People and their carers said their equality and diversity needs were met and they did not feel they discriminated against.

The agency had a culture that was open, positive and honest with transparent, excellent management and leadership. The organisational vision and values were clearly defined, understood by staff and followed. Areas of responsibility and accountability were identified, staff were more than happy to take responsibility on the ground and report any concerns they may have in a timely way. Service quality was under constant review and the agency strove to make changes to improve the care and support people received. This was in a way that best suited them. Audits were carried out and records kept up to date. The agency played a huge role in the community running and participating in many projects, through well-established working partnerships that promoted people’s participation and reduced social isolation. Registration requirements were met.

The service provided was safe for people to use and staff to work for. People received support that enabled them to live safely and enjoy their lives. This was because risks to them were assessed and monitored. The agency reported, investigated and recorded accidents and incidents and safeguarding concerns. There were suitable numbers of appropriately recruited staff available to meet people’s needs. Medicine was safely administered.

People and their relatives said they really enjoyed the first-class way staff provided them with exceptional care and support. Their attention to small details made all the difference. Staff acknowledged and respected people’s privacy, dignity and confidentiality. People were encouraged and supported to be independent and do the things for themselves, where they could, to promote their self-worth and improve their quality of life. The staff were very friendly, caring and compassionate and passionate about what they did and the way they did it.

People had their needs assessed, reviewed and received person centred care. They were given choices, supported to follow their routines, interests and hobbies and did not suffer from social isolation. People were given enough information to make decisions and end of life wishes were identified, if appropriate. Complaints were recorded and investigated.

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

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 22 March 2017).

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.

Richmond Upon Thames Crossroads Caring for Carers is a domiciliary care service that provides personal care for vulnerable adults and young adults aged 13 to 18 in their own homes. This is primarily respite care for carers. It is located in the Teddington area.

There was 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 and associated Regulations about how the service is run.

This is the first inspection under the new methodology. Using previous methodology in July 2014, our inspection found that the service was overall good and rated good for the five key questions of safe, effective, caring, responsive and well-led.

People were satisfied with the agency and service it provided. They were given notice of any changes to staff and the timing of their care, unless it was unavoidable short notice. The agreed tasks were carried out to their satisfaction and the staff team were thoughtful and really cared. People thought the service provided was safe, effective, caring, responsive and well led.

People’s records, those of staff and other records were kept up to date and covered all aspects of the care and support people received, their choices and identified that their needs were met. Information was clearly recorded, fully completed, and regularly reviewed enabling staff to perform their duties to a high standard.

Staff spoken with were knowledgeable about the people they gave support to and the way people liked to receive support. When required they also worked well as a team, in instances such as calls that may require two staff members. The care and support staff provided was delivered in a professional and friendly way that was focussed on the individual. Their attitude made them approachable and accessible to people using the service and their relatives and they had appropriate skills to achieve this.

People who use the service and parents of younger adults said the manager, management team and organisation were very accessible, supportive, responsive, encouraged feedback and selected and provided a high calibre of staff that were well trained and gave an excellent quality of service. Staff said that they received excellent support and training from the manager and organisation, the organisation was a great place to work and they got a lot of satisfaction from the job they did. They said the management team was approachable, receptive to their ideas and there were opportunities for career advancement. The organisation also provided a number of support services in the community for people with dementia, carers and children.

People using the service and parents were encouraged to discuss health and other needs with staff and had agreed information passed on to GP’s and other community based health professionals, as appropriate. People were protected by staff from nutrition and hydration associated risks by them giving advice about healthy food options and balanced diets whilst still making sure people’s meal likes, dislikes and preferences were met.

The agency staff were familiar with the Mental Capacity Act and their responsibilities regarding it.

The manager, management team, office staff and organisation frequently monitored and assessed the quality of the service provided.

The people we spoke with all felt the service they received was "Excellent" and "Could not be any better".

We saw that the support plans for people were detailed and supported by assessments produced by other healthcare professionals. The people we spoke with confirmed they had current support plans and had been involved in their development and review.

The staff we spoke with all felt that they had received a high standard of training. They confirmed they had regular supervision and team meetings and that they felt supported by the manager.

We saw that there were clear monitoring and audit systems in place to ensure the quality of the service being provided.

There was a complaints policy in place and people we spoke with confirmed that they knew how to make a complaint but felt they would not need to. "I have always been happy with the support I receive and I have never had to complain about anything".

We looked at an organisation tree of staff roles throughout the service and this included the Chairman, who we met, and the Chief Executive Officer. Crossroads Care Richmond had recruited several distinct posts, including a Children's Services Manager, a School Liaison Worker, Administration Office Support roles and Support Workers.

We spoke with eleven people, including their family carers. They told us how important the service was to them and how it had helped 'change their lives'. One person told us "staff are very supportive, they listen and are kind, caring and compassionate". Someone else said "I cannot speak too highly of them; they are professional, efficient and well informed about their work". Another family carer said "they have never let me down; they are completely reliable, dependable and respond very quickly".

We spoke with twelve staff members who all explained various aspects of how the service worked. Staff felt well supported and spoke highly of the organisation and its objectives. One staff worker said "everyone works as a team" while another said "I'm very happy here".

Records were accurate, complete, clear and concise, and stored securely.