Background to this inspection
Updated
6 August 2021
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection was carried out by two inspectors and an Expert by Experiences (EXE). An EXE is a person who has personal experience of using or caring for someone who uses this type of care service
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because due to COVID-19 restrictions we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 24 June 2021 and finished on 7 July 2021. We visited the office location on 24 June 2021.
What we did before the inspection
We reviewed information we had received about the service since registration. We sought feedback from the local authority and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.
We used all this information to plan our inspection.
During the inspection-
We spoke with four people who used the service and 15 relatives about their experience of the care provided. Some of those relatives lived with the person receiving care. We spoke with 10 members of the care staff, three office-based staff, the registered manager, the area manager and regional manager.
We reviewed a range of records. This included eight people’s care records, medication administration records and the daily notes recorded by care staff. We looked at three staff files in relation to recruitment and staff supervision and a variety of records relating to the management of the service, including policies and procedures and training records.
After the inspection
We asked the registered manager to provide us with a variety of policies and procedures and additional information. All information was sent within the required timeframe. We used all this information to help form our judgements detailed within this report.
Updated
6 August 2021
About the service
Crossroads Care North Nottinghamshire is a service providing personal care to people living in their own homes. It provides long term, short-term rehabilitation and respite care to people within the local community. At the time of our inspection, the service supported a total number of 48 people.
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 risk of people experiencing avoidable harm was reduced because the provider had processes in place to act on concerns raised and informed other agencies where required. Risks to people’s health and safety were appropriately assessed, reviewed and changes to care made when risks increased. The provider had experienced staff shortages due to the impact of COVID-19. These shortages were covered by staff from other branches within the provider group. No calls were missed. Contingency plans meant the most vulnerable were protected from harm during this period.
People’s medicines were, overall, managed safely. However, we noted a medicine administration record had gaps and the change to a person’s prescription had not been recorded. Action was taken to address this. Robust infection control and COVID-19 policies meant the risk of the spread of infection was reduced. The provider ensured staff learned from mistakes with increased training and supervision where needed.
People received care that was in accordance with their assessed needs. People were protected from discrimination. Staff received training that was mandatory to their role as well as additional training where required. We noted two areas of training that staff had not completed that were required to ensure care was provided safely. Immediate action was taken to address this. We did not find any evidence people had been harmed as a result.
Staff received supervision of their role. Records showed some staff ‘observations’ were overdue. The registered manager stated the impact of COVID-19 had restricted their ability to carry out the required observations but will be increasing the number of observations completed.
People were supported to maintain a healthy lifestyle and balanced diet. Staff worked in partnership with other health and social care professionals to provide timely and effective care.
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; the policies and systems in the service supported this practice.
People felt staff were kind and caring and they were treated with respect and dignity. Most people felt their choices about their care were respected and acted on. People’s privacy was respected, and most people and relatives felt their or their family member’s impendence was encouraged.
People received care that was personalised to their needs, choices and preferences. The provider had systems in place that enabled them to provide documentation in alternative formats; making information accessible for all. Specially adapted facemasks had been purchased to ensure people who communicated through lip reading due to being hard of hearing could still communicate with staff. The provider responded to formal complaints in accordance with their complaints policy.
People and relatives had raised concerns about the way office staff communicated with them earlier in the year; however, most felt this had recently improved. Action had already been taken by the provider to address this.
Quality assurance processes were in place. Although they had not identified the issues we raised in this report, immediate action was taken to improve systems and to address the concerns. The registered manager was knowledgeable about the regulatory requirements of their role and they were supported by the provider to carry out their role effectively. Staff were provided with a variety of resources to assist their learning and to improve the quality of care provided. The registered manager and provider worked well with other agencies and local authority commissioners.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was registered with us on 16 September 2019 and this is the first inspection.
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.