Crossroads Braintree & Chelmsford

The last inspection of the service took place on 22 November 2016. It was a focused inspection to follow up on concerns found during a comprehensive inspection on 12 September 2016. During both inspections, we had found the service was not maintaining a complete and contemporaneous record in respect of each service user and effective quality control and auditing systems were not in place. This was a breach of regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the quality of the service to at least good.

At this inspection, we looked to see whether the provider had implemented the action plan. We found the provider had made the required improvements to improve the standard of care and they were no longer in breach of any regulations.

A registered manager was 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.

A business manager had been appointed since our last visit. They had supported the registered manager to address the concerns we had around the management and systems within the service. The registered manager and business manager are referred to as 'the management team' in this report. The management team was visible and supportive and their presence ensured effective leadership within the organisation.

Following the previous inspection, the service had made improvements to how staff recorded people's care plans. Individual risk assessments were in place to mitigate the risk of harm. Staff were aware of the need to promote and maintain people's safety whilst taking a person-centred approach to risk. This enabled people to take calculated risks, which enhanced their well-being and enabled them to live as they chose within their home.

The management team had implemented effective quality assurance systems to monitor people's care plans and ensure regular reviews were completed. This ensured they were up to date and reflected people's

current needs.

Staff knew how to recognise signs of abuse and were confident about what action to take if any concerns arose.

The service had a robust recruitment process in place to ensure that staff had the necessary skills and attributes to support people using the service. New members of staff completed an induction programme during which they completed training sessions and were introduced to, and spent time with, the people that they would be supporting.

Staff had completed a variety of training sessions. This meant people received care from skilled staff who were able to meet their needs. Staff received supervision and annual appraisals to support them in their role and identify any learning needs and opportunities for professional development.

People using the service, and their relatives, consistently spoke highly of the staff who visited them and the care that they received. People spoke positively about the quality of service describing staff as reliable, caring and professional in their approach to their work and explained how staff frequently went the extra mile to ensure their needs were met. We were told of occasions where the service had gone above and beyond what was expected of them.

Staff provided people with individualised care, which empowered them and was centred on their needs and preferences. Consequently, people received care from staff who knew and understood them and with whom they felt comfortable.

People knew how to raise concerns or complaints and were confident the registered manager would listen to and resolve any issues raised. The service actively sought and listened to the views of people supported by the service and acted promptly where areas of concern were identified.

The five questions we ask about services and what we found