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Routes Healthcare Tameside Good

Inspection Summary

Overall summary & rating


Updated 25 November 2017

We inspected Routes Healthcare Tameside on 11 and 12 October 2017. We gave the provider 48 hours' notice that we would be visiting the office to make sure that the appropriate people would be there to assist us with our inspection. This was the first inspection after the service registered with the Care Quality Commission in May 2016.

Routes Healthcare Tameside is a domiciliary care agency that works closely with healthcare commissioning teams in supporting people who have complex healthcare needs or are at the end of their life. The hours of support vary depending on the assessed needs of people. The service provides 24 hour support for some people with complex needs. At the time of our inspection 29 people were receiving a service.

The service had a registered manager. 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 received extremely personalised care which was delivered in accordance with their wishes and lifestyle. The service employed a nurse, who with the support of care coordinators, carried out assessments which looked at people's interests and lifestyle choices as well as their needs. This enabled them to match people to staff who shared their values and therefore helped them to build relationships. This had proved valuable when working with people who found it hard to accept help.

Staff developed exceptionally positive and caring relationships with people and their families. Staff were very motivated and demonstrated a commitment to providing the best quality care to people in a compassionate way. People told us their privacy and dignity was maintained at all times.

There was a clear management structure in place and oversight from the provider. There were systems in place to monitor the safety and drive the continuous improvement of the quality of the service provided. A comprehensive programme of audits and checks were in place to monitor all aspects of the service, including care delivery, accidents and incidents, health and safety and medicines. Audits resulted in clear action plans to address shortfalls or areas of improvement.

The manager displayed good leadership qualities, drive and enthusiasm. They empowered staff to provide care that was tailored to people's individual needs. Without exception, people, their relatives and professionals told us they experienced and we observed, compassionate care from staff who strove for excellence. This ensured the service was run in the best interest of people who used the service.

Risks that were associated with people's care were assessed and managed well. Where people received support from staff with taking prescribed medicines, this was done in a way that ensured people were supported with their medication safely.

Safe recruitment procedures were followed before new staff were appointed. Appropriate checks were undertaken to ensure staff were of good character and were suitable for their role. The staff induction programme was comprehensive. Staff views were very positive about the support, guidance, training and supervision they received.

People were safe because staff had received training and understood the different types of abuse and knew what actions they should take if they thought that someone was at risk of harm. Staff were knowledgeable about the actions to take in the event of emergencies and about how the risks to people in respect of their care should be managed.

Staff demonstrated an in-depth awareness of the principles of the Mental Capacity Act 2005 and associated Deprivation of Liberty Safeguards (DoLS) within a community setting. The service was in the process of incorporating a section in people’s care plans that assessed their mental capacity.

Some people received support with their food and nutrition. Where this was the case their nutritional needs and preferences were recorded in their care records. The service worked with external professionals to maintain and promote people's health and wellbeing.

There was a complaints procedure available which enabled people to raise any concerns or complaints about the care or support they received. People told us they felt able to raise any concerns with the registered manager and felt these would be listened to and responded to effectively and in a timely manner.

Inspection areas



Updated 25 November 2017

The service was safe.

People were safe and protected from abuse because staff knew how to identify, report and act on any concerns they may have.

Safe recruitment practices were in place and there were enough staff deployed to meet people's needs safely.

People were fully protected because risk management plans reduced or mitigated the risks associated with their care and with their environment.



Updated 25 November 2017

The service was effective.

Staff received induction and refresher training. Staff were supported with regular staff supervision, and their performance was regularly monitored.

People were protected by the principles of the Mental Capacity Act.

People were referred to relevant healthcare professionals if appropriate and their dietary needs were met.



Updated 25 November 2017

The service was extremely caring.

People who used the service and their relatives consistently praised the excellent care provided saying care staff went the extra mile. People were supported to maintain their independence and received support from a consistent team of care staff.

Care staff spoke passionately about being committed to delivering high quality care.

Staff demonstrating kindness, patience and respect and people were given time to express themselves fully. Staff knew people well and interactions were relaxed.



Updated 25 November 2017

The service was responsive.

People received personalised care and support which was appropriate to their needs, preferences and aspirations. The service was very flexible and staff adapted the support they provided to constantly meet people`s changing needs.

Care plans were personalised and detailed and people were always involved in reviews of their care.

People were aware of how to make a complaint. Complaints were investigated and outcomes were shared with staff for lessons to be learned and sustain the changes implemented to improve the service.



Updated 25 November 2017

The service was well-led.

The provider had designed and embedded a quality assurance monitoring system which continually monitored and identified any shortfalls in service provision.

There was a clear staffing structure and a good staff support network.

The people, relatives and staff we spoke with all felt the registered manager was caring, approachable and person centred in their approach.