Background to this inspection
Updated
5 December 2019
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.
Inspection team
The inspection was undertaken by one inspector, one assistant inspector and one 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.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because we needed some information about the people the service supported before the inspection started and we wanted to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 18 October 2019 and ended on 22 October 2019. We visited the office location on 21 and 22 October 2019.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority who work with the service. 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 one person who used the service and 15 relatives about their experience of the care provided. This was because people who used the service were being supported by a relative. We spoke with nine members of staff including the registered managers, senior care workers and care workers.
We reviewed a range of records. This included ten people’s care records and multiple medication records. We looked at seven staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We spoke with two professionals who had worked with the service.
Updated
5 December 2019
About the service
Crossroads Care Staffordshire is a domiciliary care agency providing personal to 65 people at the time of the inspection. They support both adults and children with a range of needs which may include physical disabilities and dementia and provide respite services for carers.
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 providers systems with regards to staff recruitment were not always robust. Risks to people were assessed but not consistently managed. People received their medication, however medicine management systems required strengthening. We have made a recommendation about this. Despite this, people told us they felt safe and there were enough staff to meet people’s needs. People were safeguarded from potential abuse and lessons were learned when things had gone wrong.
The providers governance systems were not robust and had not identified areas for improvement. For example, audits had not identified issues with medication and mental capacity assessments (MCA). However, the provider worked in partnership with others and there was a positive culture within the service.
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; however, the policies and systems in the service did not support this practice.
People’s needs were assessed, and staff received enough training to enable them to do their job effectively. People were happy with the way they were supported with eating and drinking, and staff worked with other agencies when necessary.
The provider worked in partnership with another agency around end of life care and support. However, not everyone had their wishes and preferences recorded. We have made a recommendation about this. The service was meeting people’s communication needs and complaints had been investigated and responded to.
People were supported by caring staff who knew them well. People were supported to express their views and be involved in making decisions about their care. Staff respected and promoted people’s privacy and independence.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 12 April 2017).
Why we inspected
This was a planned inspection based on the previous rating.
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