Background to this inspection
Updated
20 September 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 carried out by one inspector.
Service and service type
Crossroads Care Cheshire West Wirral Shropshire is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
There was no registered manager at the time of the inspection. This means the provider is 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 two working days’ notice of the inspection. This was because it is a small service and we needed to be sure someone would be in the office to support the inspection.
Inspection activity started on 2 September 2019 and ended on 4 September 2019. We visited the office location on 3 and 4 September 2019.
What we did before the inspection
We reviewed information we had received about the service since the last inspection such as notifications. These are events that happen in the service the provider is required to tell us about by law. We sought feedback from the local authority. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
During the inspection, we visited the office and spoke with the area manager, service improvement lead, the care co-ordinator, the administrator and four members of staff. We also spoke with six people using the service, five relatives and one member of staff over the telephone.
We reviewed a range of records. This included three people’s care records and medication records. We looked at two 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 discussed the findings of the inspection with the nominated individual and continued to seek clarification from the provider to validate evidence found. The nominated individual is responsible for supervising the management of the service on behalf of the provider. The nominated individual sent us a range of documents and information about the service. The information was considered as part of the evidence for the inspection.
Updated
20 September 2019
About the service
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.