Crossroads Braintree & Chelmsford

Updated 27 September 2018

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, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection took place on 7 and 26 February 2018 and was announced. Due to unavoidable circumstances unrelated to the service, the report was not finalised and published. We agreed with the service that is was not proportionate to carry out a new inspection. We therefore returned to office on 14 September 2018 and visited a person who used the service on 17 September 2018 to refresh the information we had gained during our original visits. We used the information from both sets of visits to write this report.

The provider was given 48 hours' notice of the first inspection visit because the service provided was domiciliary care in people's own homes and we needed to make sure the right people would be available to answer our queries.

We visited the office location and met with the registered manager, business manager and administrative staff member. We also visited the home of a person who used the service and met with them and the staff who supported them. We telephoned a member of staff and the family members of two people who used the service to ask them their views about the quality of the support they received.

The inspection team consisted of one inspector who carried out the original visits and a second inspector who carried out the follow-up visits.

As part of the inspection, we reviewed a range of information about the service. This included a Provider Information Return (PIR). A PIR is a form completed by the registered manager to evidence how they are providing care and any improvements they plan to make. We also looked at safeguarding alerts and statutory notifications, which related to the service. Statutory notifications include information about important events, which the provider is required to send us by law.

We looked at the care records for three people who used the service. We also looked at further records relating to the management of the service, including recruitment records and systems to monitor the quality of the care people received.

Updated 27 September 2018

The inspection was announced and took place on 7and 26 February 2018. We carried out follow up visits to the service on 14 and 17 September 2018. The reason for the later visits is outlined in the background section of this report. Crossroads Braintree & Chelmsford is a domiciliary care agency. They offer a respite break service for carers by providing care and support to family members in their homes. At the time of the inspection, 76 people were using the service, nine of whom were in receipt of the regulated activity of personal care. CQC only inspects the service being received by people provided with personal care; such as help with tasks related to personal hygiene and eating, and so did not look at the support being provided to the other people in the service.

The last inspection of the service took place on 22 November 2016. It was a focused inspection to follow up on concerns found during a comprehensive inspection on 12 September 2016. During both inspections, we had found the service was not maintaining a complete and contemporaneous record in respect of each service user and effective quality control and auditing systems were not in place. This was a breach of regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the quality of the service to at least good.

At this inspection, we looked to see whether the provider had implemented the action plan. We found the provider had made the required improvements to improve the standard of care and they were no longer in breach of any regulations.

A registered manager was 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 2008 and associated Regulations about how the service is run.

A business manager had been appointed since our last visit. They had supported the registered manager to address the concerns we had around the management and systems within the service. The registered manager and business manager are referred to as ‘the management team’ in this report. The management team was visible and supportive and their presence ensured effective leadership within the organisation.

Following the previous inspection, the service had made improvements to how staff recorded people’s care plans. Individual risk assessments were in place to mitigate the risk of harm. Staff were aware of the need to promote and maintain people's safety whilst taking a person-centred approach to risk. This enabled people to take calculated risks, which enhanced their well-being and enabled them to live as they chose within their home.

The management team had implemented effective quality assurance systems to monitor people’s care plans and ensure regular reviews were completed. This ensured they were up to date and reflected people’s current needs.

Staff knew how to recognise signs of abuse and were confident about what action to take if any concerns arose.

The service had a robust recruitment process in place to ensure that staff had the necessary skills and attributes to support people using the service. New members of staff completed an induction programme during which they completed training sessions and were introduced to, and spent time with, the people that they would be supporting.

Staff had completed a variety of training sessions. This meant people received care from skilled staff who were able to meet their needs. Staff received supervision and annual appraisals to support them in their role and identify any learning needs and opportunities for professional development.

People using the service, and their relatives, consistently spoke highly of the staff who visited them and the care that they received. People spoke positively about the quality of service describing staff as reliable, caring and professional in their approach to their work and explained how staff frequently went the extra mile to ensure their needs were met. We were told of occasions where the service had gone above and beyond what was expected of them.

Staff provided people with individualised care, which empowered them and was centred on their needs and preferences. Consequently, people received care from staff who knew and understood them and with whom they felt comfortable.

People knew how to raise concerns or complaints and were confident the registered manager would listen to and resolve any issues raised. The service actively sought and listened to the views of people supported by the service and acted promptly where areas of concern were identified.