Crossroads in East Lancashire is registered to provide personal care to children and adults living in their own homes. It specialises in providing support to carers who care for a relative / friend and gives carers the opportunity to have some time away from their caring responsibilities. It provides a flexible 24-hour service around the needs of people supported and their main carers. At the time of the inspection, 20 children and 154 adults were using the service.

The last inspection was carried out on 30, 31 July and 3 August 2015. Whilst we rated the service as overall “Good”, we found there were shortfalls in the recruitment of new staff and noted not all notifications had been submitted to the commission without delay. During this inspection, we found the necessary improvements had been made and the service was meeting all the current regulations.

People using the service consistently told us they felt safe and staff treated them well. Safeguarding adults’ and children’s procedures were in place and staff understood their responsibilities to safeguard people from abuse. Potential risks to people's safety and welfare had been assessed and preventive measures had been put in place where required. People received their medicines safely and were supported to eat and drink in accordance with their care plan.

Staff arrived on time and stayed for the full time allocated. The registered manager ensured there were sufficient staff available to cover for staff leave in order to ensure there were no missed visits.

Staff had the knowledge and skills required to meet people's individual needs effectively. They completed an induction programme when they started work and they were up to date with the provider's mandatory training. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People’s healthcare needs were monitored as appropriate.

Staff were respectful of people’s privacy and maintained their dignity. All people spoken with told us the staff were kind and caring. People were actively involved in the development and review of their care plans. This meant people were able to influence the delivery of their care and staff had up to date information about people’s needs and wishes. People told us they usually received care from a consistent group of staff. People were aware of the complaints procedure and processes and were confident they would be listened to.

People were provided with a safe, effective, caring and responsive service that was well led. Systems were in place to monitor the quality of the service, which included seeking and responding to feedback from people and their relatives in relation to the standard of care.

People using the service told us they were very satisfied with the way the agency delivered their care and support. People said they shared a good relationship with their regular care staff who they described as “excellent” and “absolutely wonderful” and “the best”.

People’s care was planned and delivered in accordance with their needs. People had individual care plans which were supported by a series of risk assessments. People confirmed they had discussed their care needs and care plan with staff from the agency.

We found appropriate checks were made during the recruitment of new staff and all staff were provided with appropriate training opportunities and received regular supervision.

There were effective systems in place to monitor and assess the quality of the service. People were asked their opinion of the service and were given the opportunity to complete a customer satisfaction questionnaire. We saw the results of the survey and noted people had a high level of satisfaction with the service.

People were satisfied with the service provided, one person told us, “I think it is an invaluable service, I couldn’t do without them” and another person said, “Everyone is very friendly and caring”. People told us their rights to privacy, dignity and independence were upheld and respected.

People’s care was planned and delivered in accordance with their needs. People had individual care plans which were supported by a series of risk assessments. People confirmed they had discussed their care needs and care plan with staff from the agency.

We found staff had received training on safeguarding vulnerable adults and had access to appropriate policies and procedures. Staff had an understanding of the safeguarding processes and knew how to raise an alert.

We noted suitable arrangements were in place to handle and manage medication. At the time of the inspection, the agency was implementing a new recording system for medication. We saw examples of the new style of record.

There were sufficient numbers of staff to meet people’s needs and according to the records seen, staff were provided with a wide range of training opportunities.

People made positive comments about the staff team and felt they could talk to any of the staff or the manager if they had a problem or query. People were asked their opinion of the quality of the service and were given the opportunity to complete an annual customer satisfaction questionnaire. We saw the results of the survey and noted people had a high level of satisfaction with the service.

We carried out an inspection of Crossroads in East Lancashire on 30, 31 July and 3 August 2015. We gave the service 48 hours of our intention to carry out the inspection.

Crossroads in East Lancashire is registered to provide personal care to children and adults living in their own homes. It specialises in providing support to carers who care for a relative / friend and gives carers the opportunity to have some time for themselves and facilitates a break from their caring responsibilities. It provides a flexible 24 hour service around the needs of people supported and their main carers. At the time of the inspection 14 children and 155 adults were using the service.

The service was managed by a registered manager. 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.

We lasted inspected this service on 9 May 2013 and found it was meeting the regulations in force at the time.

During this inspection we found two breaches of the regulations related to recruitment of staff and the notification of incidents. You can see what action we told the provider to take at the back of the full version of the report.

People using the service and their carers told us they were well cared for and felt safe with the staff who provided their support. Staff knew about safeguarding procedures and we saw that concerns had been reported appropriately to the local authority, which helped to keep people safe. We received notifications from the registered manager of previous safeguarding concerns following the inspection. Risks to people’s well-being were assessed and managed.

We found the arrangements for managing people’s medicines were safe. Records and appropriate policies and procedures were in place for the administration of medicines.

All staff spoken with had an awareness of the Mental Capacity Act 2005 and had completed appropriate training.

Arrangements were in place to maintain appropriate staffing levels to make sure people received their contracted support. This included a computerised staff rota, which could be accessed remotely. There were systems in place to ensure all staff received regular training and supervision. New staff completed a comprehensive induction and undertook a probationary period of 26 weeks.

Staff knew the people they were supporting and provided them with a personalised service. People and their carers were actively involved in the development and review of their care plans. This meant people were able to influence the delivery of their care and staff had up to date information about people’s needs and wishes.

People told us they received care from a consistent group of staff. All people and carers spoken with made very complimentary comments about the staff and the service they provided. The agency had processes in place to match staff with people to ensure there was a compatible relationship.

The service was flexible and responded positively to people’s requests. Children and adults were supported by staff to access community facilities and pursue a wide variety of leisure activities. The staff had used creative ways to meet people’s aspirations. People said they greatly enjoyed their activities and told us being able to go out regularly made a positive difference to their lives. The agency also facilitated three weekly singing groups for people and their carers.

All people, their carers and staff spoken with had confidence in the registered manager and felt the agency had clear leadership. We found there were effective systems to assess and monitor the quality of the service, which included feedback from people using the service.