Rotherham Crossroads - Caring for Carers t/a Crossroads Care Rotherham

At our last inspection we rated the service outstanding. At this inspection we found the evidence continued to support the rating of outstanding 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.

There was a registered manager who managed the day to day operations of 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.

Without exception people told us they received a fantastic service from Rotherham Crossroads. Staff we spoke with gave the provider compliments on how they cared for and supported people.

People continued to be protected from abuse because staff knew what action to take if they suspected someone was being abused, mistreated or neglected.

There were sufficient numbers of staff available to keep people safe and to meet their needs. The number of staff supporting people and times of the day people were supported had been planned as part of an individual package of care.

The provider and registered manager helped ensure people did not face discrimination or harassment. People's individual equality and diversity were respected because staff received training on the subject and got to know people well.

The registered manager and provider had worked hard to learn from incidents, near misses and mistakes. Investigations were carried out when required and systems were in place to help identify any trends or patterns, which could drive change, when needed.

Without exception everyone we spoke with told us the service was effectively delivering consistent high quality care and support.

Rotherham Crossroads is an employer that staff told us they want to work for and totally committed to investing in individual employees to ensure its workforce are successful and happy.

The service continued to provide high quality effective care and support. Staff were competent in their roles, undertook good quality training and had a very good knowledge of the people they supported. This meant they could effectively meet people's needs in a person-centred way.

Staff had received training and understood their responsibility in regard to the Mental Capacity Act 2005 (MCA). People's capacity to make decisions had been assessed when planning care. Staff confirmed they asked for people's consent before providing care and they respected and promoted each person’s choices.

Staff went that extra mile for people they supported. For example, we looked at how a person with a sensory impairment and health related problems was supported and we judged the person-centred care they received to be exceptional.

People were able to share their experiences, concerns and complaints and the provider acted upon information shared. The provider analysed complaint each year to learn and future improve the lives of the people they supported.

Support plans were comprehensive, well structured, and person centred. The care packages were reviewed at regular intervals or following a change of need.

Rotherham Crossroads had clear aims and objectives which were shared with people, their relatives and staff, which were embedded into our culture of the service.

Rotherham Crossroads had embraced and developed relationships with local ethnic groups to develop services for people living in the Rotherham area.

Quality audits were used to identify issues and development plans were in place to drive improvements.

There is a registered manager who manage the day to day operations of 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.

Crossroads Care Rotherham is an agency providing personal care to people in their own homes. It predominantly provides the service in the Rotherham and Sheffield areas. Crossroads is a registered charity and is a not for profit organisation. At the time of this inspection the service supported 298 people with various care needs, from social support to maintaining people’s independence with full personal care needs. Visits ranged from half an hour up to four hours for social sits and to give respite to family carers. The frequency of visits ranged from one visit

per week to four visits per day depending on people individual needs.

We received some outstanding feedback from people we spoke with. They told us that, “The service is marvellous, outstanding and staff are kind and considerate.” One person said, “They are like part of my family, they always turn up with a smile on their face and treat me with respect, they are like angels.” Another person said, “Nothing is too much trouble for the girls [staff].”

People told us they felt safe knowing that they [the staff] would do their best to enable them to maintain their independence. We saw there were robust systems in place to manage risks to people. For example, we saw staff had made referrals to the falls team and referrals for equipment to keep people safe. This demonstrated that they had acted on the information gained at the assessment which ensured people were safe.

The service actively involved people in their assessment which enabled them to make choices about the support they needed to help them to be as independent as possible. The service was flexible which meant times of visits could change if people had to attend hospital or any other health related appointments. One person we spoke with confirmed this they said, “Crossroads are excellent, they have changed my times to suit hospital appointments. I could not manage at home without them.”

The service had actively worked with the Rotherham Ethnic Minority Alliance [REMA] to promote Crossroads services within the diverse population of Rotherham. REMA had also translated leaflets so that they were accessible in different languages. They also provided training to Crossroads staff on ‘An introduction to Islam and Muslim Communities.’

They had also played an active role alongside the Alzheimer's Society in establishing the BME Memory Café at the Unity Centre in Rotherham. The café had raised awareness of dementia and the services available to people with dementia and their carers in Rotherham. The café had been very well attended by the BME community.

Peoples care and support was planned in partnership with them and their relatives and they told us they always received support from a regular team of care workers who understood their needs. One relative said, “We are highly delighted with the care, we could not wish for nicer caring people.” Care plans contained detailed step by step instructions for care staff to follow to meet the needs of people who used the service.

The registered manager told us that all staff were trained to undertake risk assessments which meant they could identify any issues both in the home environment or risks to people’s safety while in the community. The service also had clear lone worker policies which protected staff when working alone in the community.

People were supported to take their medication safely and the care records identified the level of support needed for each person. The service ensured that priority for visits were given to support medication calls to ensure that people’s medication needs was given at the time prescribed. For example, Parkinson specific medications which may be needed to kick start people’s mobility, and people who were required to take their insulin at a specific time.

People and their relatives knew how to make a complaint and were able to share their views and opinions about the service they received. The provider listened to all complaints and made sure people were confident their complaints would be taken seriously. There were also surveys in place to allow people and their relatives the opportunity to feedback about the care and treatment they received.

The service promoted an open and honest culture and the managers and care co-ordinators were transparent in their discussions with us. Staff spoke highly of their teams and felt well supported by their care co-ordinators. Staff were confident they could raise any concerns or issues, knowing they would be listened to and acted on. Staff said, “This is the best job I have had. I love my work and get a lot of satisfaction from helping people to live well in their own home.” Another said, “I have worked in care for many years but this is like working for a big family. The values and expectations of us all means we work as a team.”

People told us that staff were very professional and always respected their dignity when undertaking personal care tasks. Staff we spoke with were highly motivated to provide a good service to people they supported. One staff member said, “This is the best service, we work to the same values and ensure people are cared for as if they were our own relative.”

Staff working at the service were recruited safely and were able to complete training to meet the support people needed. The service also enabled staff to undertake nationally recognised training to help them progress in their work. The service prided themselves on supporting people living well with dementia and had a team of care support workers dedicated to the role. A care co-ordinator was a dementia champion and had developed links with the Alzheimer’s society.

The registered manager was very committed to continuous improvement and feedback from people, whether positive or negative, and it was used as an opportunity for improvement. The registered manager demonstrated a good understanding of the importance of effective quality assurance systems. There were processes in place to monitor quality and understand the experiences of people who used the service. The registered manager demonstrated strong values and a desire to learn about and implement best practice throughout the service.

People and their relatives spoke very positively about the registered manager. People felt the service was very well led and organised and this helped to ensure they received effective care and support.

People told us that the care staff were very good and they were well looked after. One person we spoke with said, 'They never rush me at all and if I say sorry for being slow they tell me there is plenty of time, what are you worrying about and always ask if there is anything they can do before they go.'

People also told us that staff treated them with respect, listened to them, gave them choices, made them feel safe and supported them. One person we spoke with said, 'The staff are very good, they arrive on time and look after me.' Another person told us, 'I was given a choice and so I have a male carer for personal care which I prefer.'

A relative we spoke with told us, 'The care staff will show initiative and are responsive to changing needs. If it needs doing they do it, for example safety issue with the cooker was highlighted to us, as well as continence issues and changes in mobility.'

We also found systems were in place to reduce the risk and spread of infection. People we spoke with who used the service told us, 'Care staff wear gloves and aprons when washing me and they put a different coloured one on when they do my food and new gloves.'

There was an effective recruitment and selection processes in place. Staff received a good induction before they commenced work. One person we spoke with told us, 'They come across as professional and new workers ask to look at my care plan and communication book before they start.'

We found people were protected from unsafe or inappropriate care by means of accurate records in relation to the care and treatment provided. People told us they were involved in the development of the care plans and their choices were taken into consideration.