Routes Healthcare (North East Limited)

Routes Healthcare (North East Limited) is a domiciliary care agency providing personal care to people in their own homes. At the time of our inspection there were 39 people using the service. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

The management of the service was not always effective. There had been a period of a number of management changes and some staff had felt uncertain during this period. People and their relatives also said that there had been issues with missed or late calls. However, people commented that this had improved recently. The provider was working to put support in place for staff and create a stable management structure.

Quality assurance checks were carried out to ensure people were receiving safe and good quality care. Feedback from staff and people had been listened to. Lessons had been learnt from incidents however they were not always well documented so we couldn’t be certain of the impact.

People were safe from the risk of abuse. Risks were assessed and regularly reviewed when people's needs changed. People were supported in positive risk taking.

Medicines were managed safely. The provider employed sufficient staff, who were trained appropriately and recruited safely. Staff worked effectively with visiting professionals and wore PPE to keep people safe.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection and update

The last rating for this service was good (published 14 July 2017).

Why we inspected

We received concerns in relation to management oversight and missed calls. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has not changed and remains good based on the findings of this inspection.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Routes Healthcare (North East Limited) on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Routes Healthcare is a domiciliary care agency providing care and support to people in their own home.

A registered manager was in place. 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 told us they felt safe when receiving care. They told us that they trusted the care workers who supported them. People were protected as staff had received training about safeguarding and knew how to respond to any allegation of abuse. When new staff were appointed thorough vetting checks were carried out to make sure they were suitable to work with people who needed care and support. Systems were in place to manage people’s monies safely.

There were sufficient staff employed in small teams to provide consistent and safe care to people. People told us that staff attended calls on time and although there were some late calls and missed appointments, these were kept to a minimum. An on call out of hours system was in place to deal with emergency situations.

Staff had received training and had a good understanding of the Mental Capacity Act 2005 and Best Interest Decision Making, when people were unable to make decisions themselves. There were other opportunities for staff to receive training to meet people’s care needs.

Staff were aware of people’s nutritional needs and made sure they were supported with eating and drinking where necessary. People received their medicines in a safe way. People’s health needs were identified and staff worked with other professionals to ensure these were addressed.

People praised the kind and caring approach of staff. We observed staff interacting well with people. Staff were respectful and explained clearly how people’s privacy and dignity were maintained. Staff understood the needs of people and care plans were person centred. People and their relatives spoke positively about the care provided.

A complaints procedure was available and people said they knew how to complain, although most people commented they had not needed to. Where complaints had been received they had been satisfactorily resolved.

People had the opportunity to give their views about the service. There was regular consultation with staff, people and/or family members and their views were used to improve the service. Regular audits were completed to monitor service provision and to ensure the safety of people who used the service.

All people told us the management team was approachable and communication was effective to ensure staff were kept up to date about any changes in people’s care and support needs and the running of the organisation.