The inspection took place on the 3rd and 4th January 2019 and was announced. The provider was given short notice of the visit to the office. This was because we needed to be sure key staff would be available at the office.

At our last inspection we rated the service outstanding. At this inspection we found the evidence continued to support the rating of outstanding 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.

There was a registered manager who managed the day to day operations of the service. 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.

Without exception people told us they received a fantastic service from Rotherham Crossroads. Staff we spoke with gave the provider compliments on how they cared for and supported people.

People continued to be protected from abuse because staff knew what action to take if they suspected someone was being abused, mistreated or neglected.

There were sufficient numbers of staff available to keep people safe and to meet their needs. The number of staff supporting people and times of the day people were supported had been planned as part of an individual package of care.

The provider and registered manager helped ensure people did not face discrimination or harassment. People's individual equality and diversity were respected because staff received training on the subject and got to know people well.

The registered manager and provider had worked hard to learn from incidents, near misses and mistakes. Investigations were carried out when required and systems were in place to help identify any trends or patterns, which could drive change, when needed.

Without exception everyone we spoke with told us the service was effectively delivering consistent high quality care and support.

Rotherham Crossroads is an employer that staff told us they want to work for and totally committed to investing in individual employees to ensure its workforce are successful and happy.

The service continued to provide high quality effective care and support. Staff were competent in their roles, undertook good quality training and had a very good knowledge of the people they supported. This meant they could effectively meet people's needs in a person-centred way.

Staff had received training and understood their responsibility in regard to the Mental Capacity Act 2005 (MCA). People's capacity to make decisions had been assessed when planning care. Staff confirmed they asked for people's consent before providing care and they respected and promoted each person’s choices.

Staff went that extra mile for people they supported. For example, we looked at how a person with a sensory impairment and health related problems was supported and we judged the person-centred care they received to be exceptional.

People were able to share their experiences, concerns and complaints and the provider acted upon information shared. The provider analysed complaint each year to learn and future improve the lives of the people they supported.

Support plans were comprehensive, well structured, and person centred. The care packages were reviewed at regular intervals or following a change of need.

Rotherham Crossroads had clear aims and objectives which were shared with people, their relatives and staff, which were embedded into our culture of the service.

Rotherham Crossroads had embraced and developed relationships with local ethnic groups to develop services for people living in the Rotherham area.

Quality audits were use

This inspection took place on the 16 and 17 June 2016 and was announced. The provider was given short notice of the visit to the office. This was because we needed to be sure key staff would be available at the office.

There is a registered manager who manage the day to day operations of the service. 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.

Crossroads Care Rotherham is an agency providing personal care to people in their own homes. It predominantly provides the service in the Rotherham and Sheffield areas. Crossroads is a registered charity and is a not for profit organisation. At the time of this inspection the service supported 298 people with various care needs, from social support to maintaining people’s independence with full personal care needs. Visits ranged from half an hour up to four hours for social sits and to give respite to family carers. The frequency of visits ranged from one visit

per week to four visits per day depending on people individual needs.

We received some outstanding feedback from people we spoke with. They told us that, “The service is marvellous, outstanding and staff are kind and considerate.” One person said, “They are like part of my family, they always turn up with a smile on their face and treat me with respect, they are like angels.” Another person said, “Nothing is too much trouble for the girls [staff].”

People told us they felt safe knowing that they [the staff] would do their best to enable them to maintain their independence. We saw there were robust systems in place to manage risks to people. For example, we saw staff had made referrals to the falls team and referrals for equipment to keep people safe. This demonstrated that they had acted on the information gained at the assessment which ensured people were safe.

The service actively involved people in their assessment which enabled them to make choices about the support they needed to help them to be as independent as possible. The service was flexible which meant times of visits could change if people had to attend hospital or any other health related appointments. One person we spoke with confirmed this they said, “Crossroads are excellent, they have changed my times to suit hospital appointments. I could not manage at home without them.”

The service had actively worked with the Rotherham Ethnic Minority Alliance [REMA] to promote Crossroads services within the diverse population of Rotherham. REMA had also translated leaflets so that they were accessible in different languages. They also provided training to Crossroads staff on ‘An introduction to Islam and Muslim Communities.’

They had also played an active role alongside the Alzheimer's Society in establishing the BME Memory Café at the Unity Centre in Rotherham. The café had raised awareness of dementia and the services available to people with dementia and their carers in Rotherham. The café had been very well attended by the BME community.

Peoples care and support was planned in partnership with them and their relatives and they told us they always received support from a regular team of care workers who understood their needs. One relative said, “We are highly delighted with the care, we could not wish for nicer caring people.” Care plans contained detailed step by step instructions for care staff to follow to meet the needs of people who used the service.

The registered manager told us that all staff were trained to undertake risk assessments which meant they could identify any issues both in the home environment or risks to people’s safety while in the community. The service also had clear lone worker policies which protected staff when working alone in the community.

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We spoke with six people who received a service and also some relatives. The feedback we got was very positive that the service provided was very good; staff turned up on time and delivered the care in a caring way maintaining dignity and privacy. People also said they were given choices and listened to.

As part of this inspection we visited people in their homes and also spoke with people on the phone. We visited two people who used the service and spoke with six on the telephone. We also spoke with 18 relatives of people who used the service. We spoke with relatives as many people who used the service were living with dementia.

People told us that the care staff were very good and they were well looked after. One person we spoke with said, “They never rush me at all and if I say sorry for being slow they tell me there is plenty of time, what are you worrying about and always ask if there is anything they can do before they go.”

People also told us that staff treated them with respect, listened to them, gave them choices, made them feel safe and supported them. One person we spoke with said, “The staff are very good, they arrive on time and look after me.” Another person told us, “I was given a choice and so I have a male carer for personal care which I prefer.”

A relative we spoke with told us, “The care staff will show initiative and are responsive to changing needs. If it needs doing they do it, for example safety issue with the cooker was highlighted to us, as well as continence issues and changes in mobility.”

We also found systems were in place to reduce the risk and spread of infection. People we spoke with who used the service told us, “Care staff wear gloves and aprons when washing me and they put a different coloured one on when they do my food and new gloves.”

There was an effective recruitment and selection processes in place. Staff received a good induction before they commenced work. One person we spoke with told us, “They come across as professional and new workers ask to look at my care plan and communication book before they start.”

We found people were protected from unsafe or inappropriate care by means of accurate records in relation to the care and treatment provided. People told us they were involved in the development of the care plans and their choices were taken into consideration.