About the service:

Crossroads (Barnsley) Limited is a domiciliary care service which provides personal care to adults with a range of support needs, including dementia and physical disability, in their own homes.

The Care Quality commission (CQC) only inspects the service being received by people provided with ‘personal care’. Where they do we also take into account any wider social care provided. Crossroads (Barnsley) was providing personal care to 55 people at the time of the inspection.

People’s experience of using this service:

People supported told us they felt safe with the staff that supported them. Staff had undertaken safeguarding training which was regularly refreshed. Staff understood their role and responsibility to keep people safe from harm.

Recruitment procedures were thorough and robust, with clear evidence of the pre-employment checks which had been carried out.

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 supported spoke with the highest praise and regard of the staff that provided support and the office team including the registered manager. People told us staff treated them with dignity and respect and were kind, caring and sympathetic to them.

People received personalised support from staff who knew them well. Staff had built positive relationships with the people they cared for and supported. Staff supported people to retain their independence and to remain involved in planning and reviewing their care. This helped to ensure care was provided in accordance with people’s preferences.

Staff worked closely with a range of community healthcare professionals to promote good outcomes for people. Feedback from healthcare professionals involved with the service was extremely positive.

People, their relatives and staff could approach the management team if they had any concerns. The provider had a complaints procedure in place which explained how people could raise concerns. The service had not received any concerns.

The registered manager operated a governance system which included the completion of several audits. These were to ensure the service was operating within the policies and procedures set by the provider. Any concerns were acted on appropriately.

More information is in the full report

Rating at last inspection:

At our last inspection, the service was rated "good". Our last report was published on 8 September 2016.

Why we inspected:

This was a planned inspection based on the rating awarded at the last inspection.

Follow up:

We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned for future dates.

The inspection was carried out 12 and 13 July 2016 and was announced. The service was last inspected February 2014 and was found to be fully compliant at this time.

Crossroads (Barnsley) Ltd is a charitable not for profit organisation that offers support and personal care and respite services to people who are cared for by a family member. People who use the service have a wide range of needs including physical and learning disabilities and older people who are living with a diagnosis of dementia or who have suffered a stroke. At the time of our inspection there were 61 people receiving support.

There was a registered manager who had been with the service since it was opened in 1993. 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 supported told us they felt safe with the staff that supported them. Staff had undertaken safeguarding training which was regularly refreshed. Staff understood their role and responsibility to keep people safe from harm.

There were robust risk assessments in place which covered the environment in which people were supported and any assistance they required with moving and handling. There were risk specific assessments which identified risks and the measures which were put in place to minimise the risks to people.

There were sufficient staff to meet people’s needs and there was a high level of consistency in the staff who attended each person. People told us they found this reassuring as they knew the staff who were supporting them.

Recruitment procedures were thorough and robust, with clear evidence of the pre-employment checks which had been carried out. This included disclosure and barring service checks (DBS) which help employers make safer recruitment decisions.

Staff were trained in the handling and administration of medicines, and there was a process in place to ensure staff were competent in their daily practice. Records of medicines given were detailed and we found no omissions in the records we reviewed.

Staff received a comprehensive induction and regular refresher training in all mandatory subjects. New staff who were new to the care sector also undertook the care certificate to ensure they had all the relevant knowledge to carry out their roles. Staff had access to a good range of additional training and nationally recognised qualifications to enhance their skills and knowledge. This meant that staff were knowledgeable and skilled.

People supported, their relatives and staff told us communication within the service was very good. People told us they were always contacted if staff were running late or there was a different carer attending for any reason.

We saw the registered manager had ensured consent to care had been sought and gained in all cases we reviewed. Staff told us how they would always ask for verbal consent before assisting people.

Staff had undertaken training on the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards. Staff were all able to explain how this legislation related to the people they supported, which meant people’s rights were being protected.

People supported spoke with the highest praise and regard of the staff that provided support and the office team including the registered manager. People told us staff treated them with dignity and respect and were kind, caring and sympathetic to them.

The care plans we reviewed were very detailed and person centred. They included personal details and preferences throughout, along with good practice reminders for staff. Care plans were regularly reviewed and we could see they were evolving as people’s needs changed.

There was a robust process in place to deal with any complaints, however there had been ver

We visited Crossroads Care on 4 February 2014. We found that people who used the service hand been involved with and consented to their care and treatment.

We looked at the care records for people who used the service. They contained relevant information and were individual and personalised. People's choices and preferences were noted. The documentation was up to date and reviewed on a regular basis.

We looked at the management of medication and saw that the service had appropriate policies and procedures in place. Staff received annual training in medication and people who used the service confirmed that staff supported them with administration of medication when necessary.

We looked at staff training and supervision. We saw training records which showed that this was relevant to their work and saw that regular supervision sessions were undertaken which gave staff the opportunity to discuss their work with their line manager.

There was a complaints procedure in place and complaints were followed up appropriately. We saw that there were various systems in place, for example spot checks, audits and service user visits to allow the continual monitoring and improvement of the service delivery.

We saw that all relevant policies and procedures were in place and that they were regularly reviewed and updated. We saw that all records were appropriately and safely stored.

People’s views and experiences were taken into account in the way the service was provided and delivered in relation to their care. People using the service and their families had contributed their opinions and preferences in relation to how care was delivered.

People’s needs were assessed and care and treatment was planned and delivered in line with their individual care plan. People had thorough, detailed care plans relating to all aspects of each person's care needs. They contained a good level of information setting out exactly how each person should be supported to ensure that their needs were met.

All staff had received training in abuse awareness and protecting vulnerable adults in the previous year. There were resources available to all staff in relation to safeguarding, including an information guide that was given to all staff to keep with them when at work.

Appropriate checks had been undertaken before staff began work. This included carrying out a Criminal Records Bureau (CRB) check, taking up references from previous employers and checking evidence of the identification of new recruits.

There was an annual quality evaluation programme where people were asked to give their views about the service. The results of this were collated and incorporated into the provider's annual general meeting. The board used the findings of the quality evaluation programme to identify ways to improve the service.