We carried out an announced inspection of the service on 25 October 2016. Crossroads Care Kent is a domiciliary care service which provides personal care and support for carers who support people in their own home.

There was a manager registered with the Care Quality Commission (CQC). 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.

People felt safe and were supported by staff who were trained in how to keep people safe. Risks to people’s health and safety were managed. Plans were in place to identify and reduce the risk to people’s safety. Care plans contained sufficient information to support staff to minimise the risks. There were sufficient numbers of staff to meet people’s care needs and staff were recruited safely. People received the level of support they required to safely manage their medicines.

People were supported by staff who received appropriate induction, training, supervision and a yearly appraisal. Staff were fully supported by management. People’s rights were protected under the Mental Capacity Act 2005. People received the assistance they required to have enough to eat and drink. External professionals were involved in people’s care as appropriate.

People were treated with kindness and compassion by the staff. Relatives reported positive and caring relationships were made with them and the people they cared for. Staff were respectful and spoke in a calm way. People and their families felt able to contribute to decisions about the care and relatives were involved in the planning and reviewing of their family members care and how they wanted their care delivered. People were treated with dignity and respect by staff who understood the importance of this. Relatives that we spoke with gave many examples of how staff maintained their relations dignity when providing assistance and respected their privacy.

People received the care they needed. The provider was responsive towards people’s health needs. Care records were written in a person-centred way that focused on people’s wishes and respected their views. Care plans provided information for staff so people could receive personalised care. A complaints process was in place, and people felt able to make a complaint and felt staff would respond in a timely manner. Relatives told us that they felt the service was well-led; they had not had any concerns, but knew how to complain and were confident to raise concerns with the service if needed.

The service promoted a positive culture that was person-centred, inclusive and open. People and their relatives described communication with the service as good. Staff felt supported by the management. All staff felt the registered manager was approachable and listened to their views or concerns. People were encouraged to share their experience about the service and feedback on those experiences. There were a number of quality assurance processes in place that regularly assessed the quality and effectiveness of the support provided.

For the purpose of this inspection we spoke with three family members of people supported and six staff members.

We found the agency had all the required policies and procedures in place to ensure people's safety and welfare was maintained. All staff were seen to have been through a thorough recruitment process, had references and had either a report from the CRB or Disclosure and Barring Service (DBS) in place. All staff had undertaken mandatory training required to carry out their role. The provider was also supporting several staff through apprenticeships in health and social care and leadership and management, and diploma's level three and four. This meant that the needs of the people using the service were met by experienced and well trained staff.

People who use the service and their main carers told us that Crossroads were very approachable and took their input into account when preparing the care plans. One said, 'their service is invaluable to me, it gives me the time I really need'.

All the staff spoken with confirmed they felt very supported. They were confident that care plans in place gave them the information required to carry out their roles well.

All people supported by the agency underwent a thorough assessment of needs. The full time carer or person themselves created their own care plan, covering a detailed approach required. All care plans were monitored monthly by a team leader and adapted to any care changes as soon as required.

We spoke with some people who use the service and everyone we spoke with said that they were very happy with the service. People told us that they felt safe when care staff were in their homes. People told us that they trusted the staff and that they thought the staff were kind and caring. They said “We have brilliant help from them (the agency). They are really helpful and very supportive. They have never let us down.” Another person said “They are fantastic, I could not ask for a better service. The four hours when the carer is here allows me to go and play bowls or see my family. (My relative) really looks forward to the care staff coming.”

The assessment process was robust so that the agency knew about a person’s range of needs before they offered a service. Care plans were detailed giving staff the guidance they needed to ensure that they met people’s needs. People told us that they had been involved in writing and updating their care plans.

The agency worked closely with health, voluntary sector and social care professionals to ensure that people remained safe and well. Staffing was planned around individual needs and activities. This ensured that people had the support they needed when they needed it. One person said “They are very good. They come once a week for three hours and that really helps me. I can go out, go shopping, it gives me some ‘me time’. They are so helpful, (my relative) really looks forward to the care worker coming.”