The inspection took place on the 25 July 2017 and was announced. The provider was given 48 hours’ notice because the location provides a support care service. We wanted to be sure that someone would be in to speak with us.

East Sussex, Brighton & Hove Crossroads Care is a charity providing home and respite care services for carers in East Sussex, Brighton & Hove. This included children and adults with various conditions including older people living with dementia, people with a learning disability or autism and people with a physical disability. The focus of the service is to, ‘Provide support to carers in their own home, and give carers ‘time’ to be themselves.’ At the time of our inspection around 160 people were receiving a care 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.

Staff spoke of a difficult last year with a number of changes in office staff. This had resulted in some slippage in systems in place such as reviews. However, new staff had been recruited and the registered manager demonstrated this had been addressed with a robust plan in place for staff to follow and the registered manager monitoring the completion of this.

People told us they felt safe, and the care they received was good. One person told us, “They do all I require. Absolutely safe.” Another person told us,” Have always felt safe. They are friendly and professional.” There were good systems and processes in place to keep people safe. Assessments of risk had been undertaken and there were clear instructions for staff on what action to take in order to mitigate them. Staff knew how to recognise the potential signs of abuse and what action to take to keep people safe. One member of staff told us,“ You have to use you practical skills. We went on an all-day course. If I thought someone was being physically or mentally abused I would report it. There’s also things in the home that could cause an accident, we have to make sure their home is safe.” Another member of staff told us, “Yes, we have our own clients. They fit the right person to the right client and this is also done with holiday and sickness cover. Crossroads are good at matching people to their clients.”

The provider had arrangements in place for the safe administration of medicines. People were supported to receive their medicine when they needed it. Care staff had received medicines training. One member of staff told us, “I’ve had medication training. I occasionally give meds. The carer will leave the tablets in a blister pack, we record it in the meds sheet in the daily record.”

Staff considered people’s capacity using the Mental Capacity Act 2005 (MCA) as guidance. People’s capacity to make decisions had been assessed. Staff observed the key principles in their day to day work checking with people that they were happy for them to undertake care tasks before they proceeded. One member of staff told us,“ A person is assumed to have mental capacity unless deemed otherwise by a health professional. Everyone should be given the opportunity to express themselves. Mental capacity can fluctuate from one day to the next.” Another member of staff told us, “People have consent form in their care plan. Other than that it would depend on the context of what you are asking but yes we ask for consent.” A third member of staff said,“ We know what’s right and wrong for them and we make the appropriate decisions. We explain what we’re doing and make the appropriate decisions. We make it light hearted.”

People told us they were involved in the planning and review of their care. People’s needs were assessed and regularly reviewed and they received support based upon t