This was an announced inspection that took place on 13 January 2017.

Richmond Upon Thames Crossroads Caring for Carers is a domiciliary care service that provides personal care for vulnerable adults and young adults aged 13 to 18 in their own homes. This is primarily respite care for carers. It is located in the Teddington area.

There was 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 and associated Regulations about how the service is run.

This is the first inspection under the new methodology. Using previous methodology in July 2014, our inspection found that the service was overall good and rated good for the five key questions of safe, effective, caring, responsive and well-led.

People were satisfied with the agency and service it provided. They were given notice of any changes to staff and the timing of their care, unless it was unavoidable short notice. The agreed tasks were carried out to their satisfaction and the staff team were thoughtful and really cared. People thought the service provided was safe, effective, caring, responsive and well led.

People’s records, those of staff and other records were kept up to date and covered all aspects of the care and support people received, their choices and identified that their needs were met. Information was clearly recorded, fully completed, and regularly reviewed enabling staff to perform their duties to a high standard.

Staff spoken with were knowledgeable about the people they gave support to and the way people liked to receive support. When required they also worked well as a team, in instances such as calls that may require two staff members. The care and support staff provided was delivered in a professional and friendly way that was focussed on the individual. Their attitude made them approachable and accessible to people using the service and their relatives and they had appropriate skills to achieve this.

People who use the service and parents of younger adults said the manager, management team and organisation were very accessible, supportive, responsive, encouraged feedback and selected and provided a high calibre of staff that were well trained and gave an excellent quality of service. Staff said that they received excellent support and training from the manager and organisation, the organisation was a great place to work and they got a lot of satisfaction from the job they did. They said the management team was approachable, receptive to their ideas and there were opportunities for career advancement. The organisation also provided a number of support services in the community for people with dementia, carers and children.

People using the service and parents were encouraged to discuss health and other needs with staff and had agreed information passed on to GP’s and other community based health professionals, as appropriate. People were protected by staff from nutrition and hydration associated risks by them giving advice about healthy food options and balanced diets whilst still making sure people’s meal likes, dislikes and preferences were met.

The agency staff were familiar with the Mental Capacity Act and their responsibilities regarding it.

The manager, management team, office staff and organisation frequently monitored and assessed the quality of the service provided.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by the CQC which looks at the overall quality of the service.

This was an announced inspection and two days notice was given to the provider.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

In December 2013, our inspection found that the service was compliant.

Richmond Upon Thames Crossroads Caring for Carers is a domiciliary care service that provided personal care for 77 people in their own homes. Referrals to the agency were mainly made privately.

People told us they were very happy with the service they received, way it was delivered and the staff who delivered it. Our inspection visit to the office showed that the sample of records we looked at were well kept, fully completed and regularly reviewed. The management team and office staff were knowledgeable, professional and accessible to people using the service, their relatives and staff in the field. People said and we saw that the service they and their relatives received was safe, effective, caring, responsive and well led.

During our visit we spoke with the manager, the care manager and the children's services manager. Following our visit we carried out telephone interviews with 15 people who received care from Crossroads or were the carer for a person that received support. We also spoke with three support workers. We also received positive feedback from the commissioning teams at the local authority.

The people we spoke with all felt the service they received was "Excellent" and "Could not be any better".

We saw that the support plans for people were detailed and supported by assessments produced by other healthcare professionals. The people we spoke with confirmed they had current support plans and had been involved in their development and review.

The staff we spoke with all felt that they had received a high standard of training. They confirmed they had regular supervision and team meetings and that they felt supported by the manager.

We saw that there were clear monitoring and audit systems in place to ensure the quality of the service being provided.

There was a complaints policy in place and people we spoke with confirmed that they knew how to make a complaint but felt they would not need to. "I have always been happy with the support I receive and I have never had to complain about anything".

Richmond Upon Thames Crossroads Caring for Carers provides support to carers by looking after the people they support, so that they can have time do things they need to do. The frequency and amount of care provided is based on individual needs. The people we spoke with were the carers. They told us that the service provided invaluable support which allowed them to do things that they needed to do, such as work, attend medical appointments and shopping. Some people said that without the support of Crossroads they, ‘’did not know what they would do, and would not be able to cope’’. One person told us, ‘’they are a life line’’.

People told us that the service was ‘’excellent’’ and one person said, ‘’we have nothing but praise for the organisation, they are wonderful; the care staff are kind and the office staff are always helpful’’.

The people who we spoke with told us that the staff were always kind, caring and provided the individual support they needed. They told us that staff were always punctual and did everything required and more. One person said, ‘’nothing is too much trouble for our care worker’’ and another person told us, ‘’the care worker gets on with the whole family and helps out in any way we need’’.

We spoke to some of the staff who work for the organisation. They told us that they were very happy working there. They said that they felt Crossroads provided a high quality service and they were happy to be part of that. They told us that they were well supported and had the information they needed to do their job.

Everyone we spoke with was positive about the service and felt that the organisation worked with them to help make improvements.

Crossroads Care Richmond provides support to people and their families as part of the Carers Hub. They offer respite care and home support to both children and adults. They provide a caring cafe, and a Saturday club for children and young people with physical and learning disabilities.

We looked at an organisation tree of staff roles throughout the service and this included the Chairman, who we met, and the Chief Executive Officer. Crossroads Care Richmond had recruited several distinct posts, including a Children's Services Manager, a School Liaison Worker, Administration Office Support roles and Support Workers.

We spoke with eleven people, including their family carers. They told us how important the service was to them and how it had helped 'change their lives'. One person told us "staff are very supportive, they listen and are kind, caring and compassionate". Someone else said "I cannot speak too highly of them; they are professional, efficient and well informed about their work". Another family carer said "they have never let me down; they are completely reliable, dependable and respond very quickly".

We spoke with twelve staff members who all explained various aspects of how the service worked. Staff felt well supported and spoke highly of the organisation and its objectives. One staff worker said "everyone works as a team" while another said "I'm very happy here".

Records were accurate, complete, clear and concise, and stored securely.