We carried out a review of the data available to us about Crossroads Caring for Carers on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Crossroads Caring for Carers, you can give feedback on this service.
Crossroads Caring for Carers is a domiciliary care service which is registered to provide people with personal care in their own homes. On the day of our inspection there were 90 people using the service.
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
There was a positive and empowering culture established within the service. This meant people were supported by exceptionally caring and attentive staff that knew them well and helped them to achieve their potential. People were encouraged to live as full a life as possible and supported to achieve the best possible outcomes. Staff had formed positive relationships with people they supported and looked for ways to make them feel valued. Care was person centred and delivered by committed and dedicated staff.
The leadership of the service was outstanding. Robust quality assurance systems had sustained continual development and improvement throughout the service resulting in positive outcomes for people. The registered manager, supported by their senior management team, had established a person-centred culture amongst the staff team, that consistently delivered high quality care. Staff and the management team were passionate and motivated about their roles and understood their responsibilities. They actively engaged and included people, their relatives and professionals in the ongoing design and delivery of their care and support.
Without exception feedback was complimentary about the caring, attentive nature and approach of the staff and management team. It was evident feedback was valued and used to further enhance people's experience of using the service.
People were safe using the service. There were established relationships of trust and support between staff which enabled people to stay safe. Staff were very sensitive to the challenges of people living in the community. They acted proactively when concerns were identified and supported people to protect themselves.
Since our last inspection, the service has grown from strength to strength. Clear leadership and effective management had led to a visibly person-centred culture that was embedded throughout the service. This consistently delivered high quality care and support achieving positive outcomes for people. This was underpinned by the provider's principles, values and expectations of staff which demonstrate the characteristics of an outstanding service.
The provider clearly demonstrated how they consistently met the characteristics of providing outstanding care. The registered manager and the staff team ensured people were at the heart of the service and received high quality person-centred care. Staff were clearly committed and compassionate, striving to provide outstanding care, with excellent outcomes at all times. People were treated with exceptional kindness, dignity and respect and received their care and support from a highly motivated and dedicated staff team.
People received highly effective care and support from a consistent staff team who knew them well and were well trained. People's rights to make their own decisions were protected. Staff worked well together for the benefit of people and were completely focused on meeting people’s individual personal, health and social care needs.
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. When people were unable to make decisions about their care and support, the principles of the Mental Capacity Act (2005) were followed. There was evidence the service went the extra mile to ensure people were supported to make decisions.
Staff were skilled in communicating and understanding the needs of the people they supported. There continued to be enough staff safely recruited, trained and supported appropriately in their roles to care and meet people’s needs.
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 25 April 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.
At the time of our inspection 121 people received personal care in their own homes.
At the last inspection on the 6 August 2014 the service was rated as good. There was a registered manager in place at the time of 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.
Staff we spoke with knew how to protect people from harm. We found staff recognised the signs of abuse and knew how to report this. Staff made sure risk assessments were in place and took actions to minimise risks without taking away people’s right to make decisions.
People told us there were enough staff to help them when needed. Staff told us there were enough staff to provide safe care and support to people. Advanced planning meant that staffing levels were reviewed and reflected the needs of people who used the service. People’s medicines were checked and managed in a safe way.
People received care and support which met their needs and preferences and in line with their consent and agreement. Staff understood and recognised the importance of this. We found people were supported to eat a healthy balanced diet and were supported with enough fluids to keep them healthy. We found staff supported people with access to healthcare professionals, such as their doctor or hospital appointments.
People told us they were involved in planning their care. People’s views and decisions they had made about their care were listened and acted upon. People told us that staff treated them kindly, with dignity and their privacy was respected.
We found people knew how to make a complaint and felt comfortable to do this should they feel they needed to. Where the provider had received complaints, these had been responded to. Learning had been taken from complaints received and actions were put into place to address these.
Staff felt supported by the registered manager to carry out their roles and responsibilities effectively, through training and staff meetings. We found checks the registered manager completed on the service provided focused upon the experiences of people. Where areas for improvement were identified, systems were in place to ensure lessons were learnt and used to improve staff practice.
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 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.
The inspection was announced. We called the provider 48 hours before our inspection to ensure that we could speak with staff and look at the relevant records. We undertook the inspection over a two day period, on the 29 July and 6 August 2014. We carried out an inspection on 17 September 2013 and found the provider to be in breach of two regulations, safeguarding people who use the service and supporting workers. We asked the provider to send us a report of the changes they would make to comply with the standards they were not meeting. In March 2014 we followed up to make sure that the necessary changes had been made and found the provider was now meeting the regulations.
Crossroads Caring for Carers is a service that provides care to people in their own home. At the time of our inspection there was a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.
Our findings from our inspection meant that the provider was not in breach of any regulations. We found that people were kept safe by trained staff who knew how to protect people. There were sufficient staff to meet people’s needs.
People confirmed that staff knew them well, knew what their preferences were and how they wanted their care to be delivered. People we spoke told us they mainly had the same staff visit them regularly and knew their needs well.
People told us that all the staff were caring and that staff were respectful and talked to them calmly and respectfully. People that we spoke with gave many examples of how staff maintained their dignity when providing assistance and respected their privacy. People told us they were supported to remain independent and received assistance when they needed it.
We found that the provider was responsive towards people’s health needs. People told us that if they had a hospital appointment and requested a staff member to come earlier then the provider accommodated this.
All of the people we spoke with told us that they often met the team leaders and discussed concerns they may have with them. People told us that they felt the service was well-led, they had not had any concerns however if they did they had the information available to them to know who to contact. We found that when staff had raised concerns to the registered manager, they had acted promptly and appropriately.
We found the registered manager had systems in place to ensure that the quality of the care was monitored. Annual questionnaires were sent out, which people confirmed they received. Audits such as incidents and accidents, record keeping and staff training were monitored. Where there were any actions following these audits they were followed up and improvements had been made. This meant there were systems in place to continually monitor the quality of the service provided to better achieve safe and effective care.
We also found that the provider had improved how they supervised and supported to staff. This meant that staff received adequate support to enable them to deliver care safely and effectively.
All the people we spoke with who used the service spoke positively about the care they received. One person told us that the staff were: 'Very good, I have never had a cause for concern'. All the people we spoke with told us that the care workers who supported them understood their care needs. People told us that their wishes were always listened to and we found that the provider made sure people consented to any care.
We found that the provider had not taken the necessary actions to ensure that people who used the service were safeguarded against abuse.
Staff employed at the service had access to further training. One staff member told us: 'I always feel that there are opportunities for further training'. However we found that staff did not receive regular supervision even if they had indicated that they had experienced difficulties with the work they had done.
We saw that the provider had systems in place to monitor and assess the quality of services provided. Feedback was regularly sought from the people who used the service, families and staff. The provider and managers held regular quality report meetings that identified actions for improvement.
People were complimentary about the care and support that they received. One person told us, 'They're very good. They always try and accommodate me. I've always been very pleased with them.' Another person said, 'I find them very helpful. They do the best they can. They always do their best for me.' Another person said, 'I can't think of anything they could do better. I'm very fortunate.' This meant that people felt the agency was meeting their individual needs.
We found that people who used the agency were protected from the risk of abuse.
People were cared for, or supported by, suitably qualified, skilled and experienced staff.
The provider had systems in place to regularly assess and monitor the quality of service that people received