Routes Healthcare Tameside

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture. At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high quality ,person-centred care.

This service scored 61 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not have a clear shared vision, strategy and culture which was based on transparency, equity, equality and human rights, diversity and inclusion, and engagement. They did not always understand the challenges and the needs of people and their communities.

Staff and leaders shared a common goal of ensuring people received good care. The provider had organisational strategy, policies and procedures in place to support organisational culture. However, there was very little input and feedback from people and staff gathered to enable their participation and meaningful engagement in the development of the organisational culture.

Some people and staff raised concerns about not being listened to or their concerns not being followed up. One person told us, “There have been so many management and staff changes-nobody is taking responsibility.” One staff member told us, “I feel like the office doesn’t listen to us.” The provider recognised challenges regarding communication with people and staff and this formed a part of an ongoing action plan.

Not all leaders understood the context in which the provider delivered care, treatment and support. They did not always embody the culture and values of their workforce and organisation. Leaders did not always have the skills, knowledge, experience and credibility to lead effectively, or they did not always do so with integrity, openness and honesty.

Leaders had some knowledge and understanding of issues and priorities within the service. For example, there was an internal action plan developed which identified some of the issues we found during the assessment. There was evidence some issues and poor practice had been addressed. For example, ensuring better engagement with staff and people and aiding better communication. However, we received mixed feedback from people and staff regarding leaders of the service. We were told leaders were not always visible within the organisation and frequent changes within the management structure were identified by both people and staff as one of the main challenges within the organisation. One relative told us, “There is no stable management, nobody tells us what is going on with the management. Managers come and go continuously. It is very stressful to work with this agency.” One staff member told us, “We have gone through a lot of managers in the time I have been here.” The provider was aware of the challenges including frequent changes within the leadership and had undertaken work to ensure continuity was implemented and sustained. The provider employed a new manager for the service who was currently going through their registration process with us.

People did not always feel they could speak up and that their voice would be heard.

There were policies and procedures in place to support speaking up. Some people and staff raised told us they didn’t always feel their concerns would be followed up or acted upon. People and staff felt comfortable to raise concerns and staff knew who to speak to. However, people told us that due to the frequent changes within the management structure they were speaking and raising concerns with care staff rather than management. One person told us, “We really speak with the carers.” One staff member told us,” Yes, I can speak up.” Another staff member told us, “Yes, I can speak up and I would ring the office.” The provider had a complaints and comments policy in place. We saw some evidence people’s complaints were addressed. The provider had started to review and deal with some of the historical issues and concerns. There was a clear record of actions taken and outcomes agreed when responses were provided to people.

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

The provider adhered to Equality and Diversity Act. The provider supported a diverse workforce within the organisation. None of the staff we spoke with shared any concerns regarding experiencing discrimination within the organisation.

The provider had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

There was no registered manager at the time of the assessment. However, the registration process for one of the appointed managers was ongoing. There were clear responsibilities, roles and governance systems within the organisation. There was a good level of oversight at provider level. This included performance tracking tools and action plans identifying areas of improvement within the service, actions required and timescales. Lessons learnt were overall identified. The provider’s action plan recorded areas of improvement identified in this assessment.

“The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement.

Provider worked with a range of different stakeholders and professionals such as GP, District Nurses or Commissioners to support people with their health and well-being outcomes. We received no feedback from the stakeholders and professionals of their work with the provider.

The provider did not always focus on continuous learning, innovation and improvement across the organisation and local system. They did not always encourage creative ways of delivering equality of experience, outcome and quality of life for people. They did not always actively contribute to safe, effective practice and research.

The provider and the managers of the service felt strongly about ensuring any failings or improvements were addressed in a timely manner to improve outcomes for people receiving care and support. However, this had not always been communicated to people and staff. We received feedback from both people and staff despite feeling able to speak and raise their concerns they did not always feel these would be followed up and acted up. People told us they were listened to more by the care staff than leaders of the service.

The provider had identified some learning opportunities and areas of improvement within the organisation. For example, the provider had developed internal improvement and action plans to address issues such as updating people’s care plans, documentation and recording as well as communication and training. Some of these areas for improvement were identified during this assessment.