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Inspection carried out on 15 March 2017

During a routine inspection

This inspection took place on 15 March 2017 and was announced. At our previous inspection in August 2015 we had concerns that the service was not consistently safe or well led. At this inspection we found that improvements had been made and there were no concerns identified.

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.

Inspection carried out on 12 and 17 August 2015

During a routine inspection

The inspection took place between the 12 and 17 August 2015. The inspection was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be available.

At the last inspection of August 2013, we found improvements were needed to ensure the provider was compliant with Regulations. At this inspection we found some improvements were evident.

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 300 people using the service. 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 2008 and associated Regulations about how the service is run.

Improvements were needed to ensure medicines were safely managed, applied and recorded and staffing levels were not always sufficient to ensure people received their care call.

Risks were assessed and action plans developed to ensure risks were minimised in accordance with the person’s needs and to afford them the independence they wanted. Staff knew how to report and recognise suspected abuse, and policies were in place to ensure they had the information they needed.

Staff were properly recruited, with pre-employment checks undertaken to ensure they were suitable to work with people who used the service.

Staff received induction to the service and felt equipped to deliver the care and support people needed. They were subject to regular unannounced checks of their care practice and received one to one supervision to discuss their progress.

Staff were able to demonstrate how they sought consent to deliver care, regardless of people’s mental capacity.

People received the support they needed to maintain their health and welfare including assistance with eating and drinking if required.

People told us they felt they were treated with care and respect and did not have any concerns about how their privacy and dignity was upheld.

Care was personalised to each person’s individual care needs. People told us how the service was flexible in how it delivered care and responded to any requests they may have had.

Complaints procedures were in place and people had access to the contacts they needed to make a complaint.

Improvements had been made since the last inspection of the service and people’s views of the quality of the service were being sought.

Families of people who used the service are referred to as carers throughout the report and staff as care staff.

Inspection carried out on 2, 3 December 2013

During a routine inspection

At the time of our inspections the service provided support to 397 people of which 106 people received personal care in their own homes. We spoke with one person who used the service and a carer. An expert by experience spoke with 17 people or their carer over the telephone after the inspection.

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.

Inspection carried out on 24 January 2013

During a routine inspection

We spoke with the manager of the service and three members of staff. We also telephoned three carers whose elderly relatives received care in the home and four parent/carers whose son/daughter were in receipt of either support in the community or personal care and support in the home.

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.