Background to this inspection
Updated
6 December 2023
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
Inspection team
The inspection was carried out by 1 inspector and 2 Experts by Experiences. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats and specialist housing.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was a registered manager in post.
Notice of inspection
We gave a short period notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 27 October 2023 and ended on 10 November 2023. We visited the location’s office on 31 October 2023 and 1 November 2023.
What we did before inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used all this information to plan our inspection.
The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.
During the inspection
We spoke with 6 people who used the service and 13 relatives about their experience of the care provided. We spoke with 17 members of staff including the registered manager, quality and compliance manager, care co-ordinators, healthcare assessor, care workers and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of records. This included eight people’s care records and multiple medication records. We looked at records in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were also reviewed.
Updated
6 December 2023
About the service
Routes Healthcare Rochdale is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older people and younger adults with various needs, including people living with physical disabilities and dementia. At the time of this inspection 151 people were 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
Care plans were delayed and not in place when people started receiving support from the service. Risks relating to people’s health and safety were not assessed when people started receiving support from the service. There was no evidence reviews of people’s care were taking place.
Medicines were not always managed safely. Medicine records and auditing processes required improvement.
Governance systems did not always address immediate risks when identified through auditing processes.
Some of the audits completed by the service did not contain clear information about the action taken when concerns were identified.
We received mixed feedback from people and their relatives about staff cleaning up after themselves and about staff wearing PPE during care visits.
We received mixed feedback from people and their relatives in relation to staff arriving on time for visits, being notified if staff were delayed and people receiving regular staff members for their visits.
Recruitment checks were robust to ensure staff were suitable to work with vulnerable people. Appropriate staff were recruited and staff had the necessary safety checks in place before starting work.
Staff had received training in safeguarding people. Staff we spoke with were confident on how to report concerns. People were protected from the risks of abuse and staff were trusted to keep them 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.
Staff had received an induction when they first started working at the service, and training relevant to their roles had been provided. We received mixed feedback from people and their relatives about how trained staff were to deliver care.
Staff knew people well and supported them in the way they wanted. People’s views and decisions about care were incorporated in their care plans. People were involved in making decisions about their day to day care. People were treated with dignity, privacy and respect. People’s independence was encouraged where possible and elements of the care plan reflected this.
The provider was committed to continuous learning and improving care. The registered manager and staff had a clear understanding of their roles and contributions to service delivery. Staff praised the registered manager and wider management team, they felt supported in their roles.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk.
Rating at last inspection
The last rating for this service was good (published 30 August 2018).
Why we inspected
This inspection was prompted by a review of the information we held about this service.
Enforcement
We have identified a breach in relation to safe care and treatment.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.