Archived: Crossroads Care - Harrow

Updated 22 May 2015

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 provide a rating for the service under the Care Act 2014.

This inspection was carried out by one inspector and was supported by an expert by experience. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. The provider was given 48 hours’ notice because the location provides a domiciliary care service. We wanted to make sure they would be available for our inspection.

Before we visited the service we checked the information that we held about the service and the provider including notifications and incidents affecting the safety and well-being of people. No concerns had been raised.

Most of the people being cared for were elderly people who had dementia or a specific medical condition and could not always communicate with us and tell us what they thought about the service. Because of this we spoke to family carers and asked their views about the service and how they thought their relatives were being cared for.

We spoke with one person using the service, fifteen family carers, eight staff, two office staff and the registered manager. We reviewed seven people’s care plans, seven staff files, training records and records relating to the management of the service such as audits, policies and procedures.

Updated 22 May 2015

We undertook an announced inspection on 12 March 2015 of Crossroads Care – Harrow.

Crossroads Care Harrow is registered to provide the regulated activity personal care and provides support for family carers and the people they care for by supplying them with care workers. At the time of the inspection, the service was providing care for 140 people and 28 care workers working for them.

At our last inspection on 7 February 2014 the service met the regulations inspected.

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.

People using the service were protected from avoidable harm and abuse. There were safeguarding policies and procedures in place. Care workers had undertaken safeguarding training and were aware of what actions to take if they suspected abuse.

Risks to people were assessed and managed to enable people to be safe and be supported to take responsible risks with the minimum restrictions.

Care workers had not received training on the Mental Capacity Act 2005 however they were able to demonstrate a good understanding of how to obtain consent from people. Where a person was unable to give verbal consent records showed the person’s next of kin had been involved in decisions made in the person’s best interest.

We have made a recommendation about staff training on the subject of the Mental Capacity Act 2005.

Care workers generally spoke positively of the organisation and told us “It is a very good company”, “I enjoy my job and they are always there at the end of the phone if you need them”. However care workers were not being supported and did not receive regular supervision meetings and team meetings. One care worker told us “There is not much communication and no 121 meetings.”

This was in breach of regulation 23 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010, which corresponds to regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Positive caring relationships had developed between people using the service and staff and people were treated with kindness and compassion. Care workers understood the importance of building caring relationships with the people they support. One person using the service told us “So far [care worker] who helps me from Crossroads makes me cheerful and has a way to make me laugh. The care worker is a great character and cheers me up.” Family carers told us “They have been excellent”, “What I wanted was someone I could trust and they have earned this. They have been very kind and caring” and “It’s still a very personal service.”

Family carers told us care workers turned up on time and there were no missed calls. They also told us they received the same care workers on a regular basis and had consistency in the level of care they received.

Care plans were person-centred, detailed and specific to people and their needs and included details of things which were important to them. Family carers told us “They know about [person’s] likes and dislikes and these are in the plan. The service encouraged and prompted people’s independence. There were arrangements in place for peoples’ needs to be regularly assessed, reviewed and monitored.

There was a management structure in place with a team of care workers, three office staff and the registered manager. The registered manager told us the organisation had been going through a difficult period and it was a challenging time for the service. The registered manager had also come back from long term sickness.

We found little evidence of how the service was assessing and monitoring the quality of care being provided. Records showed that no quality monitoring spot checks had been conducted for staff performance. There was no evidence that staff team meetings were taking place or how issues about the service were being communicated to staff on a regular basis.

This was in breach of regulation 10 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010, which corresponds to regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Questionnaires had been sent out to people using the service and their family carers. We saw that positive feedback had been received and family carers felt that the service made a positive difference to their lives.