Crossroads Care Staffordshire

Crossroads Care Staffordshire is a domiciliary care agency providing personal to 65 people at the time of the inspection. They support both adults and children with a range of needs which may include physical disabilities and dementia and provide respite services for carers.

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

The providers systems with regards to staff recruitment were not always robust. Risks to people were assessed but not consistently managed. People received their medication, however medicine management systems required strengthening. We have made a recommendation about this. Despite this, people told us they felt safe and there were enough staff to meet people’s needs. People were safeguarded from potential abuse and lessons were learned when things had gone wrong.

The providers governance systems were not robust and had not identified areas for improvement. For example, audits had not identified issues with medication and mental capacity assessments (MCA). However, the provider worked in partnership with others and there was a positive culture within the service.

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; however, the policies and systems in the service did not support this practice.

People’s needs were assessed, and staff received enough training to enable them to do their job effectively. People were happy with the way they were supported with eating and drinking, and staff worked with other agencies when necessary.

The provider worked in partnership with another agency around end of life care and support. However, not everyone had their wishes and preferences recorded. We have made a recommendation about this. The service was meeting people’s communication needs and complaints had been investigated and responded to.

People were supported by caring staff who knew them well. People were supported to express their views and be involved in making decisions about their care. Staff respected and promoted people’s privacy and independence.

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 12 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

Crossroads Care Staffordshire provides a range of services to people in their own home. The services include respite services for carers, palliative care services, domestic homecare services, an emergency service, one to one and group activities. There were approximately 250 people using the service at the time of the inspection.

There was a manager in post who was in the process of registering with us. 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.

People felt safe and risks of harm had been assessed and minimised through the effective use of risk assessments.

People were receiving their medicines from trained staff when required.

There were sufficient numbers of suitably trained staff to meet people's needs safely. New staff were recruited through safe procedures to ensure that they were fit and of good character to work with people who used the service.

People were safeguarded from abuse as staff and the management knew what to do when they suspected potential abuse. The local safeguarding procedures were being followed.

People were receiving care from staff who felt supported and had received training to be effective in their roles.

People were consenting to their care or when they lacked mental capacity were being supported by their representatives to consent to their care.

When required people were supported to eat and drink sufficient amounts. Staff knew what to do if people became unwell or their health needs changed.

People were treated with dignity and respect. People's right to privacy was upheld and they were encouraged to be as independent as they were able to be.

People were receiving care that met their individual assessed needs and preferences and their care was regularly reviewed with them.

There was a complaints procedure and people were confident that if they raised any issues they would be dealt with.

People, their relatives and staff had confidence in the provider and thought that the service was well led. Their views were regularly sought on the quality of care being provided and action was taken when shortfalls were identified.

The systems the provider had in place to monitor and improve the quality of the service were effective.

A person who used the service told us, 'Crossroads go the extra mile to make sure the staff are tip top. I can't find any fault with them'. A carer told us, 'X needs people who understand their condition around them and Crossroads absolutely do understand. All the staff treat X with patience, kindness and respect ' I can't ask for anymore'. People told us before they received care they were asked for their consent and staff acted in accordance with their wishes.

We saw people had individualised plans of care but the care described in some of the care plans did not always reflect the care staff gave. People were not always protected from the risk of abuse because the provider had not taken reasonable steps to prevent it from happening.

We saw there were effective recruitment procedures in place. The provider had systems in place for monitoring and improving the quality of service provided. We saw complaints people made were responded to appropriately.

All the carers we spoke with said they were satisfied with the service. They all told us that they had a regular care worker who was familiar with the person's needs and treated them with dignity and respect. One person said that, 'I can confidently go out and leave the care worker to get on with it and that is worth a great deal to me'.

People told us that their care worker turned up on time and stayed long enough to do everything they needed to. We were told that if things needed to be done in a different way then they only had to mention it and it would happen.

We were told that communication from the agency was very good and gave positive feedback about the way the agency was managed. One person said 'If I have any worries or want to discuss something I only have to pick up the phone to the office'.

Two people said that where they have had to make a complaint or raise concerns then they were dealt with quickly and effectively.