Archived: Help for Carers

Updated 15 April 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked 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.

This inspection took place on 22 March 2016 and was announced. We gave the provider 48 hours’ notice of the inspection because senior staff are sometimes out of the office supporting staff or visiting people who use the service. We needed to be sure that senior staff would be available to speak with us on the day of our inspection. The inspection team consisted of an inspector and an Expert by Experience. This is a person who has personal experience of using or caring for someone who uses this type of service.

Before the inspection we asked the provider to complete a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed other information about the service such as statutory notifications about events or incidents that have occurred, which they are required to submit to CQC. We also sent out questionnaires to people and their carers, staff and other community professionals involved in people’s care and asked them for their feedback about the service. People’s responses were analysed to provide us with a view about what people thought about the service.

During the inspection we spoke to the registered manager, the Chief Executive Officer, a service manager and a Trustee. We reviewed the care records of seven people using service, the records of five members of staff and other records relating to the management of the service.

After the inspection we undertook telephone calls to people using the service and spoke to nine people and 15 relatives who were people’s primary carers. We asked them for their views and experiences of the service.

Updated 15 April 2016

This inspection took place on 22 March 2016 and was announced. The last Care Quality Commission (CQC) inspection was carried out in January 2015. At that time we gave the service an overall rating of ‘requires improvement’. This was because some aspects of the way medicines were managed were not as safe as they should be and the quality of records maintained by the service was inconsistent.

South Thames Crossroads, which is a registered charity, provides support to approximately 500 carers living in the London Boroughs of Merton, Wandsworth, Sutton, Lambeth and Croydon. Staff employed by the organisation provide short respite breaks for carers by taking over the care and support tasks for people or children they care for. The breaks can be anywhere between a few hours a week or over a number of days. Approximately 80 adults and 60 children, with a wide range of health care needs and conditions, receive help with personal care and support from this service. The majority of people receiving this support were funded by their local authority but some people also pay privately for support from the service.

The service had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act and associated regulations about how the service is run.

At this inspection we found significant improvements had been made in the way medicines were managed and in the way important information about people, and other records relating to the service, were maintained. People received their medicines as prescribed. Improvements had been made in the way staff maintained records each time they supported people with their medicines. There was appropriate guidance for staff to follow to ensure people received their ‘as required’ (PRN) medicines when they needed this. We also found other records maintained by the service were accurate and contained up to date information. Measures were in place to ensure these were consistently maintained to a good standard.

People and their carers told us they felt safe with the support provided by the service. Staff had been provided with the information and support they needed to take appropriate action to ensure people were protected if they suspected they were at risk of abuse and not harmed by discriminatory behaviour or practices. Risks to people’s health, safety and wellbeing had been assessed by senior staff. Plans were put in place which instructed staff on how to minimise any identified risks to keep people safe from harm or injury.

The provider ensured people were supported by staff that were suitable and fit to work for the service. They carried out employment and criminal records checks on all staff. The majority of people told us they had no concerns about staff turning up late or missing a scheduled visit. This indicated there were sufficient numbers of staff available to support people. Staffing levels were monitored by senior staff to ensure people’s needs could be met at all times.

Staff received relevant training to meet people’s needs. Senior staff monitored training to ensure staff skills and knowledge were kept up to date. Staff received supervision so that they were appropriately supported in their roles to care for people. Staff were provided opportunities to share their views about the quality of support people experienced and for their suggestions about how the service could be improved.

People and their carers told us their views were taken into account when staff assessed their care and support needs. Each person had a care plan which was reflective of their specific needs and preferences for how they wished to be cared for and supported. People and their carers said staff were able to meet their needs. Senior staff reviewed people’s care plans regularly to ensure staff had up to date information about people’s current care and support needs.

Where the service was responsible for this, people were encouraged to eat and drink sufficient amounts to support them to stay healthy and well. Staff monitored people’s general health and wellbeing. Where they had any issues or concerns about this they took appropriate action so that medical care and attention could be sought promptly from the relevant healthcare professionals.

The provider had clear goals and objectives about what people and their carers should expect from staff and the service in terms of service standards and conduct. The majority of people and carers we spoke with were satisfied with the care and support they received. People and their carers knew how to make a complaint if needed. People and their carers told us staff looked after them in a way which was kind, caring and respectful. People’s right to privacy and dignity was respected and maintained by staff, particularly when receiving personal care. People were encouraged to do as much as they could and wanted to do for themselves to retain control and independence.

They provider had arrangements in place to ensure all people, including hard to reach communities, could access information, advice and support for carers and their family members. The views of people and staff were regularly sought about the service. Senior staff used this information along with other checks to assess and review the quality of service people experienced. There was regular communication from the senior staff team to people and their carers keeping them updated and informed about the service.

People, staff and others such as local authority commissioning teams had been consulted and engaged with, in deciding the changes the service needed to make in order to continuously improve. The provider was proactive in making improvements where these were needed. This included investment in new technology and resources which will provide staff with improved tools to support them in their roles.

Senior staff carried out checks of the service to assess the quality of care and support people experienced. Where there were any shortfalls or gaps identified the registered manager took responsibility for ensuring these were addressed promptly. Progress against these actions was discussed and reviewed weekly by the senior staff team. Information about current service standards and progress against action and improvement plans was shared with Trustees so that there was oversight and scrutiny at board level.

We checked whether the service was working within the principles of the Mental Capacity Act (MCA) 2005. Staff received training in the MCA so they were aware of their roles and responsibilities in relation to the Act. Records showed people’s capacity to make decisions about aspects of their care was considered when planning their support. Where people lacked capacity to make specific decisions there was involvement of their relatives or representatives and relevant care professionals to make these decisions in people’s best interests.