Background to this inspection
Updated
12 November 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
This inspection was carried out by one inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats and respite support for their carers.
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 over 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity began on 10 September 2019 and ended on 10 October 2019. We visited the office location on 10 and 11 September 2019.
What we did before the inspection
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 also checked notifications made to us by the provider, safeguarding alerts raised regarding people receiving the service and information we held on our database about the service and provider. We used all this information to plan our inspection.
During the inspection
We spoke in person with the registered manager, deputy, field supervisors and other office-based staff. We contacted four people, twelve carers, six health care professionals, and seven care workers to gather their experience and views about the care provided. We looked at the personal care and support plans for seven people and six staff files. Carers support people such as relatives. Care workers were employed by the agency to provide care.
After the inspection
We continue to seek clarification from the provider to validate evidence found. This included training matrix, and audits. We received the information which was used as part of our inspection.
Updated
12 November 2019
About the service
Richmond upon Thames Crossroads Care is a domiciliary care agency providing personal care and support to 67 people living in their own homes at the time of the inspection.
31 out of 67 people using the service were receiving personal care. 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
Staff were very well-trained, supervised, and appraised. Everyone we contacted praised the excellent care that staff provided, which more than met their needs. People and their carers said staff spoke to them clearly, in a way and at a pace they could understand and took time to explain things to them. Carers said that in the case of people with dementia, staff patiently repeated information as many times as was required. Staff encouraged people to discuss their health needs and made sure these were passed on to other appropriate community-based health care professionals. The agency had a highly developed professionals’ network that enabled seamless joined up working between services based on people’s needs, wishes and best interests. This included transitioning to different services as people’s needs changed. Staff protected people from nutrition and hydration risks, and people were encouraged to choose healthy and balanced diets that also met their likes, dislikes and preferences. People and their carers said their equality and diversity needs were met and they did not feel they discriminated against.
The agency had a culture that was open, positive and honest with transparent, excellent management and leadership. The organisational vision and values were clearly defined, understood by staff and followed. Areas of responsibility and accountability were identified, staff were more than happy to take responsibility on the ground and report any concerns they may have in a timely way. Service quality was under constant review and the agency strove to make changes to improve the care and support people received. This was in a way that best suited them. Audits were carried out and records kept up to date. The agency played a huge role in the community running and participating in many projects, through well-established working partnerships that promoted people’s participation and reduced social isolation. Registration requirements were met.
The service provided was safe for people to use and staff to work for. People received support that enabled them to live safely and enjoy their lives. This was because risks to them were assessed and monitored. The agency reported, investigated and recorded accidents and incidents and safeguarding concerns. There were suitable numbers of appropriately recruited staff available to meet people’s needs. Medicine was safely administered.
People and their relatives said they really enjoyed the first-class way staff provided them with exceptional care and support. Their attention to small details made all the difference. Staff acknowledged and respected people’s privacy, dignity and confidentiality. People were encouraged and supported to be independent and do the things for themselves, where they could, to promote their self-worth and improve their quality of life. The staff were very friendly, caring and compassionate and passionate about what they did and the way they did it.
People had their needs assessed, reviewed and received person centred care. They were given choices, supported to follow their routines, interests and hobbies and did not suffer from social isolation. People were given enough information to make decisions and end of life wishes were identified, if appropriate. Complaints were recorded and investigated.
People were supported to have maximum choice and control of their lives staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service support this practice.
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 22 March 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.