The inspection took place on 08, 10 and 13 November 2017. It was unannounced on the first day and announced on the second and third days. This was the first inspection at the service.

Crossroads Care Northwest is a domiciliary care service offering support to 269 adults, young people and children within their own homes across the areas of St. Helens, Halton, Widnes, Leigh, Wigan, Runcorn and Warrington.

There was a registered manager at the service at the time of our 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.

Staff recruitment systems were robust and this helped to ensure only staff suitable to work with vulnerable people were employed. All staff had undertaken and thorough induction process which included completing shadow shifts at the start of their employment. Staff had all completed mandatory training required for their role. Staff attended team meetings and were supported through regular supervision. This meant staff had the right knowledge and skills to support people.

Systems were in place to protect people from abuse. Staff had completed safeguarding training and through discussion with them they demonstrated a good understanding of this. Staff were clear of the processes to be followed in the event of a person being at risk of harm.

Assessments were completed prior to a person receiving care from the registered provider. The information from this was used to create individual and person centred care plans and risk assessments. People and their chosen relatives participated in the development of their care plans. Regular reviews were undertaken to ensure information remained up to date.

People received support from regular staff that knew them well and whom they had developed positive relationships with. People received care from staff that promoted their independence and offered them choice.

People told us staff treated them with dignity and respect. People and their relatives described staff as kind, caring and patient. Staff rosters demonstrated there were sufficient staff available to meet the needs of people.

A complaints policy and procedure was readily available for people and their relatives. They told us they felt confident about raising a complaint and thought any concerns would be listened and responded to promptly.

The Care Quality Commission is required by law to monitor the operation of the Mental Capacity Act (MCA) 2005 and to report on what we find. We saw that the registered provider had policies and guidance in place for staff in relation to the MCA. Staff had received training in relation to the MCA and demonstrated a basic understanding of it.

The registered provider had quality monitoring systems in place that were followed by the management team for development and improvements. Audit systems were regularly undertaken as part of the registered provider’s governance process.

The registered provider had policies and procedures in place to support the running of the service and they were regularly reviewed.