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Archived: Crossroads Care - Harrow Requires improvement


Inspection carried out on 12 March 2015

During a routine inspection

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.

Inspection carried out on 7 February 2014

During a routine inspection

Due to their current state of health it was not possible to speak with any of the people being cared for. We spoke with the principal carers who were either spouses or very close relatives of the person.

People being cared for received appropriate care and support that met their individual needs and were treated with dignity and respect. Carers spoke positively about the service and told us it was �very good� and �absolutely wonderful�.

There were processes in place to protect people using services from harm. The care support workers were trained to recognise the signs of abuse and to report concerns in accordance with the service's procedures.

People were cared for and supported by suitably skilled and experienced care support workers.

Records kept were fit for purpose and held securely.

Inspection carried out on 8, 13 February 2013

During a routine inspection

In this report we refer to people providing care to their relatives as �carers� and to paid care providers as �care workers�

Carers told us that they were very happy with the care workers provided by the service and would recommend them to anyone. People received appropriate care and support that met their individual needs.

There were processes in place to protect people using services from harm. Care workers were trained to recognise the signs of abuse and to report concerns accordingly.

People were cared for and supported by suitably qualified and skilled staff. Care workers were trained, supervised and appraised appropriately.

There were systems to monitor the quality and safety of the service .There was an effective complaints system available. Comments and complaints people made were responded to appropriately.

Inspection carried out on 10 January 2012

During a routine inspection

All the carers we spoke with said they had the same care worker on a regular basis and gave us positive feedback about them. People told us their regular care workers were very familiar with people�s needs and knew how they preferred things to be done. One person said of their regular care worker, �She�s a marvellous woman. She�s built a really good rapport with my Mum - she�s a really good support to her� and another said, �She�s excellent, she�s very experienced. My Mum looks forward to seeing her each week�.

People said that their care worker always turned up on time and stayed long enough to do everything they needed to. People told us that care workers provided support in a flexible way which enabled the person being cared for to make choices about what they wanted to do during each session.

People told us that communication from the agency was good and gave good feedback about the way the agency is managed. One person said, �We have no complaints at all. They always keep in touch. - I think they�re very well run�. People said that their concerns had been addressed if they had ever been unhappy about an aspect of the service. One person told us, �I�ve only ever needed to complain once and they dealt with it really well�.