Archived: Crossroads Together Shropshire

Crossroads Care Cheshire West Wirral and Shropshire is a domiciliary care agency that is registered to provide personal care to people living in their own homes. At the time of the inspection, 40 people were receiving a service from the agency. 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.

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement. As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people. The service used positive behaviour support principles to support people in the least restrictive way. No restrictive intervention practices were used.

People’s experience of using this service and what we found

People told us they felt safe receiving a service and staff were kind and caring. Staff understood how to protect people from harm or discrimination and had access to safeguarding adult’s procedures. There were sufficient numbers of staff deployed to meet people's needs and ensure their safety. The provider operated an effective recruitment procedure to ensure prospective staff were suitable to work for the service. The staff carried out risk assessments to enable people to retain their independence and receive care with minimum risk to themselves or others. People were protected from the risks associated with the spread of infection. People received their medicines safely.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People’s needs were assessed prior to them using the service. The provider had appropriate arrangements to ensure staff received training relevant to their role. New staff completed an induction training programme.

People and their relatives consistently told us staff were caring and always showed kindness and compassion. People and where appropriate their relatives had been consulted about their care needs and had been involved in the care planning process. Staff worked in respectful ways to maintain people's privacy and dignity. Staff were motivated and demonstrated a clear commitment to providing dignified and compassionate support. People were supported in a range of activities in line with their interests and preferences. People and their relatives had access to clear complaints procedure.

There was no registered manager at the service. The area manager intended to apply for registration in due course. Whilst the care co-ordinator had carried out checks on people’s files and care documentation, there was limited evidence to demonstrate management checks and audits had been carried out during 2019 to assess the quality of the service. The nominated individual assured us the management systems and processes would be strengthened at the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection:

At the last inspection the service was rated as good (published 16 February 2017)

Why we inspected

This was a planned inspection based on the previous rating.

Crossroads Care Cheshire West Wirral and Shropshire is a domiciliary care agency that provides personal care and support to people in their own homes. They provide support to ‘Carers’ who care for people with illnesses or disabilities. At the time of our visit the agency was providing a service to 69 people who were receiving the regulated activity of personal care. The frequency of visits and duration across the service varied dependent on people’s needs.

There was a manager in post who was present during the inspection. The manager was in the process of applying to become registered manager for the service. 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 and their relatives felt safe with the care and support provided by staff both within their homes and when they went out with them. Staff were aware of the risks associated with people’s needs and how to minimise these without restricting people’s choice and independence.

Staff were knowledgeable about the different forms of abuse and knew how to recognise and respond to concerns. Where concerns had been raised these had been appropriately reported to the local authority safeguarding team.

There were enough staff to safely meet people’s needs and staff were allocated sufficient time to travel between calls. People received consistent support from regular care staff. Before any new staff started work, the provider carried out checks to ensure they were suitable to work with people.

Staff had the skills and knowledge to meet people’s individual needs. Staff received training relevant to their roles and the needs of individuals they supported. Staff felt well supported in their roles and could contact management for guidance at any time.

Staff sought people’s permission before supporting them. People were provided with information in a way they could understand to enable them to make decisions for themselves.

People were very complimentary about the care and support they received. People felt that staff were caring, kind and patient. They felt staff listened to and involved them in their care.

People were treated with dignity and respect. Staff spoke about people with warmth and respect for their individuality.

People received a flexible service that was tailored to their individual needs and preferences. Staff had formed positive working relationships with people and their relatives. People were supported by staff who knew them well.

People and their relatives were encouraged to voice their opinions on the quality of care and support they received. People had not had cause to complain but were confident that should the need arise these would be dealt with promptly.

The manager had a clear vision for the service which was shared and worked towards by the staff team. There was a positive working culture where staff felt valued and listened to.

The provider had a range of checks in place to monitor the quality and safety of the service and drive improvements.