The inspection took place on the 11 April 2016 and was announced. We gave the provider 48 hours’ notice that we would be visiting the service. This was because the service provides domiciliary care and we wanted to be sure that the manager and staff would be available. The last inspection was carried out on the 23 January 2014 and the provider met all the regulations inspected.

Dudley Crossroads is registered to provide personal care services to people in their own homes. People who use the services may have a physical disability or sensory impairment. On the day of the inspection there were 17 people receiving a sitting respite support service from in their home, this also involved providing personal care support where needed. 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.

People using the service told us they felt safe. Care staff we spoke with knew how to keep people safe and the actions they would take where people were at risk of harm. Care staff were only required to remind people to take their medicines and their relatives managed all their medicine requirements.

We found that while people all had capacity and did not fall within the Mental Capacity Act 2005 (MCA) requirements, the provider was aware to the act and it requirements and staff received training. People’s consent was being sought by care staff. People’s dignity, privacy and independence was being respected.

Care staff received the appropriate support to ensure they had the skills and knowledge to meet people’s needs. There was sufficient care staff so people’s needs could be met how they wanted.

The appropriate assessment of people’s needs were being carried out and a care plan was in place which people were involved in devising. Where decisions needed to be made people were involved in the process and reviews were carried out in line with people’s wishes.

People were able to share any concerns they had by way of the provider’s complaints procedure.

The provider carried out quality assurance checks and audits to ensure the appropriate service standards were being met.

People were able to share their views on the service they received.

The service is currently supporting 145 people in their own homes. The aim of the service is to support the carer of the cared for person. The service is flexible and ‘needs led’ meaning carers receive varying amounts of support dependent upon their needs. The service offers respite care to carers to enable them to take a break from caring for their relative. We carried out telephone interviews with seven carers who use the service and five care workers. We also spoke with the manager and looked at five people's care records and other records relating to the running of the service.

We found that people's consent was sought and that people were in full agreement to care workers going into their home to provide support to their relative whilst enabling them to have a break. One person told us, “Care workers deliver proper care for the carer and the benefits to my relative are enormous. She enjoys social time out with the care worker and I have a break”.

We saw that people's needs were assessed and support plans were developed with them. People told us that care workers understood their needs and supported their relative in the way they wanted. One person told us, “Without this service I would not have a break and we would both be isolated, it’s a god send”.

People told us that care workers were reliable and consistent and they were confident their needs were met. Staff told us they were confident people had the support they needed when they needed it. One care worker said, “This is the best agency I have worked for we have proper time to do the things people want us to do”.

We found that systems had been used to monitor how the service was run and people had been encouraged to provide their comments.

We spoke with three people, three relatives and five members of staff. People told us that they were very happy with the service and it made a big difference to people's lives. They told us that care workers treated them with respect and dignity. One person said, “The service is invaluable to me”.

All of the people we spoke with said that they felt very involved in the planning of their care. They told us that they had been consulted about their preferences. One said, “They don’t tell her what to do, she tells them and they help her to do it”.

Systems were in place to protect vulnerable people. Staff had training in safeguarding issues and records confirmed this. Staff we spoke with had a very good understanding of what may constitute adult abuse and knew what the reporting procedures were.

Staff had regular supervision meetings with their managers. Staff had a good understanding of people's needs and what they needed to do to meet them. A staff member said, “The training is extensive and management are very supportive”.There were effective recruitment and selection processes in place and appropriate checks had been undertaken before staff began work.

People we spoke with were confident that they could raise concerns if they were not happy with the care being received. We saw that complaints had been dealt with effectively and in a timely manner.

We carried out this review to check on the care and welfare of people using this service.

We spoke with five people who use the service and three staff employed by the service. People told us that they were involved in agreeing the care and support they received. They said they were treated with respect and dignity by the staff. They told us that the service was free at the point of delivery and that it enables them to carry on caring for their relative. People made some of the following comments:

"The service is brilliant and I can't manage without it."

"They are very good and they make things clear. They talk to her and make her feel

comfortable. Its' a brilliant service and I would recommend it."

We saw that people's needs were assessed, planned for and regularly reviewed. We found that staff had good understanding of the needs of the people they supported. Staff received the training and support they needed to provide the service that was currently on offer. We found that systems were in place to consult with people about the quality of the

service they received.