At our last inspection in May 2016 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.

This inspection took place on 9, 11 and 14 January 2019. At the time of our inspection, 145 people were receiving a service which included personal care.

Carers Trust Mid Yorkshire is a provider of direct support for carers in Huddersfield, Dewsbury and Wakefield. They provide a range of support services for carers and the people they look after. The location is registered with the Care Quality Commission to provide personal care to people of all ages.

At the time of our inspection, Carers Trust Mid Yorkshire had a registered manager in post. 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 relatives consistently said they felt safe receiving this service. Care support workers knew how to identify and report abuse as they had received training for this.

The recruitment process required improvement in some areas to ensure this was robust. Accidents and incidents required further action to ensure the information gathered from these events was used to update care plans and risk assessments.

Risks to people had been identified and assessed and information on how to reduce the likelihood of harm was provided for care support workers.

People and relatives we spoke with were overwhelmingly positive about the quality of care they received.

People received their support on time and care support workers stayed for the full duration of their visit. Family carers received a handover at the end of a visit and care support workers recorded care they provided in daily notes. These records showed care plans were followed. Care plans were person-centred and provided care support workers with relevant information about people and their care needs. These were reviewed annually or sooner if needed.

People's equality, diversity and human rights were respected. People and relatives confirmed they were treated with dignity and respect by care support workers. People were supported to have maximum choice and control of their lives and care support workers supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People and relatives knew how to complain if they were dissatisfied with their service. The October 2018 satisfaction survey showed people were happy with the way complaints were managed.

Training was a strength of the service and care support workers told us they always had training relevant to the needs of people they were caring for. Regular supervision, appraisal and team meetings ensured staff were well supported. Care support workers felt confident about approaching the senior management team if needed.

People and staff had completed satisfaction surveys which the registered provider planned to give feedback on through newsletters and on their website. Spot checks were carried out regularly which helped to ensure a high quality of care. Evidence of lessons learned was seen which showed a commitment to continuous improvement.

People confirmed they received their medication as prescribed from care support workers. We saw they had received training for this and they all had an up-to-date check of their competency. People were supported to ensure they had enough to eat and drink and their dietary needs were being met. Care support workers assisted people where they neede

The inspection of Carers Trust Mid Yorkshire took place on 3 May 2016 in their office and on 9 May 2016 through telephone calls to people who used the service. The inspection was announced as we needed to ensure people were going to be in the office. The service was previously inspected in January 2014 and found to be complaint with all requirements.

Carers Trust Mid Yorkshire is a provider of direct support for carers in Kirklees, Wakefield, Leeds and Calderdale. They provide a range of support services for carers and the people they look after. The location is registered with the Care Quality Commission to provide personal care to people of all ages. At the time of our inspection they were providing personal care to 233 people, 76 of whom were under the age of 17 years, 49 aged between 18 and 65 years and 108 over the age of 65 years. Carer support workers provide regular visits to support the person’s informal carer to have a break.

There was a registered manager in post of the day of the inspection. 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.

The service was extremely well spoken of by all in receipt of its support. People told us they felt safe while being cared for by staff and informal carers were able to have a valuable rest as they were confident in the skills of the staff. Staff had a wide understanding of the remit of safeguarding and were aware of their unique monitoring role within the community as they were often present when other services were there, and all staff understood the impact of informal caring on an individual.

Risks were managed in a comprehensive manner, by thorough risk assessments of the environment and other specific tasks such as moving and handling. Staff had access to detailed step by step guidance on how to support someone safely and had received training on managing people’s more complex health conditions.

The service endeavoured to provide continuity of support for people with the same carer support worker visiting on a regular basis. If that worker was on annual leave a replacement was always arranged if this was the person’s wish. Medicines were administered and managed safely, and all staff had their competency checked at least annually.

Staff had access to an excellent induction programme which built on their own skills and ensured they developed in their knowledge and confidence. Each competence was assessed through completion of workbooks, observations and discussions. Supervision was offered on a six weekly basis and staff also had annual appraisals. All checks were recorded and evidenced in detailed notes.

The service adhered to the principles of the Mental Capacity Act 2005 and all staff we spoke with understood the importance of gaining people’s consent. Staff had knowledge of how to support people with more complex behaviour and discussed with us the various techniques they would use.

People were encouraged to maintain nutrition and hydration, and the service obtained guidance from health and social care professionals where required.

Everyone we spoke with spoke highly of the care staff. They said staff were attentive and knowledgeable, and the service was a lifeline for many as this was the only break they had. People’s views were regularly obtained and care plans amended as necessary.

People told us the service met their needs as they wished them to be met and we saw in the records that people’s views were reflected. Compliments were plentiful and any minor issues were logged with the service and action taken promptly to resolve them.

We were told by all people we spoke with how invaluable the service was and staff were enthused by working for the Carers Trust. It was evident th

During the inspection we spoke with four people who use the service and they told us they were very satisfied with the quality of the service provided. They also told us they had been fully involved in the assessment and care planning process. One of the people we spoke with told us 'I cannot speak highly enough of the service the staff are kind, supportive and professional and without this service my mother would have to go into a care home'. Another person told us 'This is a worthwhile service that gives me respite and has been absolutely brilliant'. We were also told 'The carer is very respectful and polite he understands what care my husband and I need, this service has been a great help to me and has given me a break which I didn’t have before'.

As part of this planned review, we spoke with three people who are receiving a service. Each of these people are the main carer for a person who receives personal care or support from Crossroads. All the feedback was positive and each person expressed that they were extremely satisfied with the service they received. Some of the comments we received include:

“They are fantastic, very professional. The staff are encouraged to report anything they think is wrong which is really important when they are working with vulnerable people.”

“It is a wonderful service. I would always recommend them. They have immaculate time keeping and they always keep me informed.”

“The staff are very, very competent.”

“The staff seem to really enjoy working with my daughter.”

All the people we spoke with said the staff were kind, treated them and their family member who required care with respect, and ensured their privacy and dignity was respected.

People told us there was discussion about how the service would be delivered and staff listened to their views and opinions. People knew how to contact the office if they needed to speak with a manager or make any changes to their service, and they all felt comfortable approaching the management team.

People knew how to make a complaint, or comment about the service. Everybody we spoke with said they were comfortable about doing this and that any concerns or complaints were taken seriously and dealt with promptly. One person said “there are very strict procedures, and Margaret (the manager) won’t take any slack”.

People we spoke with said staff kept a record of what services had been delivered; they all confirmed the records were an accurate reflection of what had happened.

People said managers came to their home to check they were receiving a good quality service.

As part of our inspection we gained feedback from questionnaires of 21 people or their friend/ relative who used the service. We also spoke with three members of staff, the registered manager and the policy and development manager. These are some of the comments people told us:

"I am delighted to have been offered a 2 hour support visit from Crossroads. It helps greatly to know that my mother has some company for this time to enable me to have time out. This service in itself is very good."

"The carer always listens to what I need and helps me achieve my goals."

"The care worker always gives a good standard of care and support. They show a wide interest in dementia care and they pass on information about activities or events we would possibly like."

"Makes a huge difference to my well-being knowing Mum is cared for properly."

"This excellent service allows my wife valuable time to leave our home knowing that I am well cared for. We could not do without it."

We found before people received any care or treatment they were asked for their consent and the provider acted in accordance with their wishes.

People’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. We saw care plans were person centred and people's likes and dislikes were recorded in their care plan.

People’s health, safety and welfare was protected when more than one provider was involved in their care and treatment, or when they moved between different services. This was because the provider worked in co-operation with others.

Medicines were handled appropriately.

People who use the service, their representatives and staff were asked for their views about their care and treatment and they were acted on.