Ribble Valley Crossroads Care

Updated 30 January 2024

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

This inspection was carried out by 1 inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats and specialist housing.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. A new manager had been identified and was planning to submit an application to register shortly.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the provider or manager would be in the office to support the inspection.

Inspection activity started on the 1 December 2023 and ended on the 12 December 2023. We attended the office on the 1 December 2023 and the 3 December 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used this information to plan our inspection.

The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection

During the inspection we visited 3 people in their own homes to discuss their experience of the care provided by Ribble Valley Crossroads Care. We reviewed documentation kept in people’s homes in relation to their support.

We spent time at the office and looked at a range of records including 6 people’s care records and risk assessments and recruitment files for 3 staff. We reviewed information about staff training and support, meetings and responses from questionnaires; and documentation relating to the management of the service such as incidents and accidents, audits and policies.

We spoke with the chairperson, the manager and a senior care worker. We spoke with 3 care staff and received email feedback from a further 3 staff. The Expert by Experience contacted 1 person who used the service and 7 relatives by telephone, asking about their views of the service.

We continued to seek clarification from the manager to validate evidence, by email.

Updated 30 January 2024

About the service

Ribble Valley Crossroads Care is a domiciliary care service providing personal care to adults with a range of support needs, in their own homes. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks relating to personal hygiene and earing. Where they do, we also consider any wider social care provided. The service was providing personal care to 20 people at the time of inspection.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

Right Support:

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Where people lacked capacity to make specific decision, the service was following the best interest principles.

Needs were assessed, and care records developed with input from people and their relatives. Care records focused on desired outcomes and promoted choice and control, though some lacked detailed information relating to people’s medication, conditions and potential risk. We saw evidence support was tailored to meet people’s individual requirements and adjusted accordingly when care needs changed.

Staff offered positive encouragement to promote independence; and they knew how to protect people from abuse. People were actively supported to maintain links with family, friends and local community groups.

Right Care:

Staff were employed following robust recruitment processes. There was a good level of ongoing training and support, however staff competencies and supervisions had not always been carried out in line with the provider’s own policies. There were enough staff to meet people’s needs and keep them safe. Continuity of care enabled staff to build trusting working relationships with people. Staff treated people with dignity, respected people’s unique characteristics and communicated with people in a way they could understand.

The service worked closely with a range of health and social care professionals to improve people’s outcomes, and processes were in place to support people with their medication or eating and drinking if required.

We advised the provider to review incident, accident and safeguarding procedures to ensure appropriate action was taken and lessons could be learned to prevent re-occurrence.

Right Culture:

There was an in-depth staff induction which enabled the provider to share its ethos with new recruits, and good levels of communication and support helped instil positive values and behaviours. Staff told us they felt welcome to express concerns or seek help from office staff and managers at any time and spoke fondly about their experience working for Ribble Valley Crossroads Care.

People and their relatives had regular opportunities to give feedback about care received and commented positively about the service and staff. One relative said, “I feel confident. They know what they are doing. They are caring and very respectful.” A person using the service added, “I think staff are excellent. A smiley face is always lovely. They are all so pleasant and always happy to chat. I am happy about everything.”

Though audits and checks were in place, these were not fully embedded due to recent changes in management. The provider acknowledged areas of development within their monitoring systems and spoke about ongoing improvements and plans for the future.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection

The last rating for the service under the previous provider was good, published on 4 July 2018.

Why we inspected

We undertook this inspection as part of a random selection of services rated Good and Outstanding.

Recommendations

We have made a recommendation about documentation relating to risk and people’s care, and improving auditing processes to ensure better oversight.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.