Crossroads Care Surrey is a charity run domiciliary care agency that provides support to family members who care for people in their own home. The aim of the service is to provide short periods of respite (normally 3 - 3 ½ hours per week) for the carer by giving care and support to the person they care for. At the time of our inspection the service was supporting 950 people. Approximately 200 of these people were children. Support for adults was mainly provided in people’s homes and for children in their homes after school and in Saturday clubs. Everyone receiving support had personal care planned, but for most people this was never or only occasionally provided.

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 2008 and associated Regulations about how the service is run.

There was a risk that people’s rights would not be protected because people had not consented to care in line with the Mental Capacity Act 2005 (MCA). The registered manager accepted this and planned to carry out mental capacity assessments at people’s next reviews.

Carers felt that the people they cared for were safe. People’s care records contained up to date risk assessments to guide staff in how to protect people from risks whilst enabling them to remain independent. People were protected against the risks of potential abuse because the provider followed safe recruitment practices and staff knew how to safeguard people. People were supported by sufficient staff to meet their individual needs, and medicines were administered safely.

People received individualised care from staff who had the skills, knowledge and understanding needed to carry out their roles. Staff were supported and received regular supervision.

People’s dietary needs and preferences were met. People’s health care needs were monitored and any changes in their health or well-being were reported to their carer. For those people receiving end of life care staff worked in partnership with hospices, palliative care teams and community nurses to support people.

People were treated with kindness and compassion and staff knew people well. People were matched with staff according to their interests and received care from regular staff. Staff promoted people’s privacy and dignity and encouraged their independence.

Care plans were detailed and contained information on how people’s needs should be met as well as their lifestyles and preferences. Carers and the people they were cared for were involved in developing their care plans. People’s needs were assessed and their care was regularly reviewed.

People had access to activities and were able to choose what activities they took part in. Carers knew how to make a complaint and raise concerns. Carers had their concerns responded to.

The registered manager promoted a positive culture and supported their staff. Staff were involved in the running of the service. Carers had opportunities to feed back their views about the quality of the service they received. Audits and surveys were completed and were used to make improvements to the service carers and the people they cared for received.