We carried out an inspection of Crossroads Care North West: Hyndburn, Chorley and South Ribble on 20 and 22 November 2017. We gave the service 48 hours’ notice to ensure that the registered manager would be available when we visited.

Crossroads Care North West: Hyndburn, Chorley and South Ribble is a domiciliary care service. It provides personal care and support to adults and children with a variety of needs including people with a learning disability or autistic spectrum disorder, poor mental health, physical disability, sensory impairment, people who misuse drugs or alcohol, older people, people living with dementia and their carers. Crossroads Care North West is a Network Partner of the Carers Trust, a national organisation which provides support and guidance for unpaid carers. The agency’s office is located in Accrington in East Lancashire. At the time of our inspection the service was providing support to 126 adults and two children. This was our first inspection of this service.

At the time of our inspection there was a registered manager at the service who had been registered with the Commission since February 2015. 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.

During our inspection people told us they received safe care. Staff had a good understanding of how to safeguard vulnerable adults and children from abuse and were aware of the appropriate action to take if abusive practice was taking place.

Records showed that staff had been recruited safely and had received an appropriate induction. Staff received regular supervision and their practice was observed regularly to ensure that they were providing safe care. Staff told us they felt well supported by the registered manager and the office staff.

We found that people’s medicines were being managed safely and people told us they received their medicines when they should. Staff members’ competence to administer medicines safely was assessed regularly.

We found that people were supported with their healthcare needs and were referred to healthcare professionals when appropriate. The community health and social care professionals that we contacted provided positive feedback about the service.

People were happy with the care and support they received from the service. They told us that their care needs were discussed with them and they were involved in decisions about their care.

People told us staff arrived on time and stayed for the full duration of the visit. They told us that when two staff were required to meet people’s needs, two staff always visited.

People liked the staff who supported them and told us they were caring. They told us staff respected their privacy and dignity when providing care and encouraged them to be independent.

We found that people were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. Staff understood the main principles of the Mental Capacity Act 2005 (MCA). They sought people’s consent and supported people to make everyday decisions about their care. Where people lacked the capacity to make decisions about their care, their relatives had been consulted.

People were asked to give feedback about the service they received during regular reviews and in satisfaction questionnaires. We reviewed the questionnaires from September 2016 and found that people had reported a high level of satisfaction with all aspects of the service.

People we spoke with told us they were happy with the management of the service. They found the staff and management team approachable and helpful and knew who to contact if they had any concerns.

We saw evidence that regular audits were