Archived: Carers Trust Lea Valley Crossroads Care Service Limited

Carers Trust Lea Valley Crossroads Care Services Limited provides a respite and relief domiciliary care service to informal carers who have caring responsibilities for a child, young adult, their partners, their parents or other relatives in their own homes. The service aims to give a regular break to the carer and during this time provides care and support which includes the provision of the regulated activity of personal care where this is an identified need.

The service supports individuals of a varying age with wide ranging support needs which include learning disabilities, physical disabilities, mental health and people living with dementia. At the time of this inspection the service was supporting 22 people.

At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Relatives felt assured and confident with the service they received which allowed them to take regular breaks with the confidence that their relative would be cared for safely in their absence.

Risk assessments in place identified people’s individualised risks associated with their health and social care needs. Information and guidance available to care staff detailed how to minimise and reduce known risks to keep people safe.

The service followed appropriate medicine management and administration processes to ensure people received their medicines safely and as prescribed.

There were sufficient staff available to ensure people’s needs were appropriately met. The service only recruited care staff that had been appropriately assessed and relevant checks completed to confirm their suitability to work with vulnerable adults.

Processes in place enabled the service to record all accidents and incidents so that further analysis of these would promote further learning and prevent re-occurrences.

Care staff were regularly supported through training, supervision and annual appraisals.

People’s needs were assessed prior to a package of care being agreed so that the service could confirm that they were able to meet their needs effectively.

People were appropriately supported with their nutrition, hydration and health care needs where this was an assessed and identified need.

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.

Relatives confirmed that their relatives were supported by a regular team of care staff. Caring and positive relationships had been established between people, their relatives and care staff that supported them.

Care plans were person centred and reflective of people’s health and support needs. Staff knew people well and relatives told us that they were all treated with dignity and respect.

Relatives knew who to speak with if they had any concerns or complaints and were confident these would be dealt with appropriately.

Management oversight processes in place ensured that the service continuously monitored the quality of care provision so that issues could be identified and addressed. Quality assurance also promoted further learning and development of the service. However, checks and audits were not always recorded.

Further information is in the detailed findings below.

Crossroads Enfield is a domiciliary care service based in the London Borough of Enfield. The service is provided to children and adults with a range of care and support needs. At the time of the inspection 104 people were using the service.

The service had a registered manager. 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 were safe. Medicines were managed safely. Risk assessments identified the risks to people and how these could be prevented. Staff were available to meet people's needs.

People were involved in decisions about their care and how their needs would be met. Managers and staff had received training on the Deprivation of Liberty Safeguards and the Mental Capacity Act 2005. Services should only deprive someone of their liberty when it is in the best interests of the person and there is no other way to look after them, and it should be done in a safe and correct way.

Staff had access to ongoing training. They were knowledgeable about their roles and responsibilities. They had the skills and knowledge to meet people’s support needs.

People were supported to eat and drink. Staff supported people to attend healthcare appointments and liaised with their GP and other healthcare professionals as required to meet people’s needs.

People received individualised support that met their needs. Staff knew how to respond to people's needs in a way that promoted their individual preferences and choices regarding their care.

People were treated with dignity and respect. Staff understood people’s preferences, likes and dislikes regarding their care and support needs. Care was planned and delivered in ways that enhanced people’s safety and welfare according to their needs and preferences.

People, relatives and staff said the manager was approachable and supportive. Systems were in place to monitor the quality of the service. People felt confident to express any concerns, so these could be addressed.

People told us that they understood how to raise concerns with the service. They said that someone was always available at the office when they called, and that the staff would listen to them. A person's comments were typical when they said," I know I can talk to them if I am concerned about anything and they would take what I had to say seriously."

People who use the service told us they felt staff understood the needs of the people they supported. One person's said "the staff are good and they understand my needs.' They confirmed that staff had where necessary received particular training in the person's home.

People who use the service confirmed that regular checks were carried out by the agency to make sure that people received the quality of care they expected. They were happy with the service and they confirmed they felt consulted. One person's comments were typical when they said, "the service is wonderful, and they listen to what you have to say."