Routes Healthcare Wirral

Updated 5 July 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

This inspection was undertaken by an inspector and an Expert by Experience. 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.

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 not a registered manager in post, however a new manager had been employed and was in the process of applying to register with CQC.

Notice of inspection

We gave a short period of notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 23 May 2023 and ended on 26 May 2023. We visited the location’s office on 24 May 2023.

What we did before the inspection

We reviewed information we had received about the service since it registered with the Commission. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with the manager, nominated individual and office staff during the site visit. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We spoke with a further 4 staff members, 2 people who used the service and 3 relatives, about their experience of the care provided.

We reviewed a range of records. This included 5 people's care records and medication records. We looked at 5 staff files in relation to safe recruitment. A variety of records relating to the management of the service, including audits were also reviewed.

Updated 5 July 2023

About the service

Routes Healthcare Wirral is a domiciliary care agency, providing personal care to people in their own homes. 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. At the time of the inspection there were 69 people receiving support.

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

Systems were in place to manage risks and medicines but required further improvement to ensure records to evidence support provided, including repositioning support and the application of topical creams, were completed robustly. Risk assessments had been completed and staff knew how to meet people’s needs. Medicines were administered by staff who had completed training and had their competency assessed.

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, but required further improvements to ensure best interest decisions were clearly recorded when people were assessed as lacking capacity to make specific decisions.

People and their relatives told us they felt safe with the support provided by Routes Healthcare Wirral. It was clear that lessons were learnt from incidents and any learning was shared with the staff team. Staff had been recruited safely, had undertaken relevant training and knew how to raise any safeguarding concerns. People mostly received support from a small consistent team of staff, who knew them well. Staff had enough time to travel between their allocated visits and had enough time to provide all the support people required.

The provider had implemented safe infection prevention and control (IPC) procedures, including regular training for staff, and ensuring required personal protective equipment (PPE) was available for staff.

People’s needs, choices and support preferences were assessed and person-centred care plans were created based on these assessments with the input from people and their relatives, to help guide staff how best to support people. People's health and well-being was regularly reviewed, and referrals made to other professionals when needed. When required, people were supported to maintain a healthy and balanced diet. Care plans reflected people’s dietary needs and preferences and people told us they were happy with the support they received.

People told us they were treated well, and their dignity and privacy were respected by staff that were kind, approachable and professional. They were involved in their care decisions and had the opportunity to provide feedback about the support they received. There was a complaints procedure in place and people knew how to raise concerns.

People told us the service was managed well and they could always contact the office if needed. Staff were well supported in their role and enjoyed working for the provider. They completed regular training and had supervisions and observations in the community to support their practice.

There were effective systems in place to monitor the quality and safety of the service. Most issues highlighted during the inspection had already been identified by the manager and an action plan created to ensure required improvements would be made.

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

Rating at last inspection

This service was registered with us on 10 September 2021, and this is the first inspection.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Recommendations

We made recommendations in relation to the management of medicines and risk and the recording of people's consent.

Follow up

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