Routes Healthcare Burnley

Routes Healthcare Burnley is a domiciliary care agency registered to provide personal care to people in their own homes. At the time of the inspection, there were 74 people using the service. All people using the service were receiving personal care.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. 'Right support, right care, right culture' is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

At the time of the inspection, the location did not care or support anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

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

The service was able to demonstrate how they were meeting the underpinning principles of right support, right care, right culture.

Right support

People told us they felt safe and staff were kind and caring. Staff understood how to protect people from harm or discrimination and had access to safeguarding adults’ procedures. There were sufficient numbers of staff deployed to safely meet people's needs. The provider followed safe recruitment procedures. Risks were assessed and monitored, which reduced the potential of avoidable harm. People were also protected from risks associated with the spread of infection. People received their medicines safely and were supported to eat and drink in accordance with their care plan.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People’s needs were assessed prior to them using the service. The provider had arrangements for the induction of new staff and provided regular training updates for existing staff. Staff were supported by the registered manager and the management team. People were helped to access healthcare services, as appropriate.

Right Care

People and their relatives told us staff were caring and treated them with kindness and respect. People and where appropriate their relatives had been consulted about their care needs and were closely involved in their ongoing care and support. Staff respected people's privacy and dignity. People and their relatives had access to the complaints procedure, if they wished to raise a concern. The registered manager had maintained detailed records of complaints.

Right Culture

The provider promoted a person-centred culture which was focused on meeting people's individual needs. The registered manager and the management team carried out a series of audits to check the quality and safety of the service. Spot checks were carried out to monitor staff performance. People, relatives and staff were asked for their views and their suggestions were used to improve the service and make any necessary changes. All people, staff and relatives praised the care provided and the management of the service. They confirmed the registered manager was approachable and supportive.

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

Rating at the last inspection

The last rating for the service was good (published 12 December 2018).

Why we inspected

The inspection was prompted in part due to concerns received about infection prevention and control practices, the lack of action taken to complaints, staff consistency and the management of medicines. A decision was made for us to inspect and examine those risks.

We found no evidence during this inspection that people were at risk of harm from these concerns.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Routes Healthcare Burnley 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.

No risks or concerns were identified in the remaining key questions through our ongoing monitoring or during our inspection activity so we did not inspect them. The ratings from the previous comprehensive inspection for these key questions were included in calculating the overall rating in this inspection.

This service is a domiciliary care agency. It provided personal care to people living in their own houses and flats in the community. It provided a service to people who were considered to be at the end of their life.

The service had a registered manager 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.

All the staff we spoke with confirmed they had received safeguarding training and that safeguarding policies and procedures were in place to guide them in their roles. Training records we looked at showed that safeguarding adults was an annual, mandatory course [a course the provider had deemed necessary as part of people’s roles]. Other safeguarding records we looked at showed the registered manager had notified the appropriate authorities when a safeguarding concern had been raised.

The service had a recruitment policy in place to guide the manager on safe recruitment processes. We looked at four staff personnel files. There was excellent evidence of records to demonstrate adequate checks had been undertaken prior to making a decision to employ people.

Records we looked at also showed that continuous checks of staff competence and suitability was monitored through spot checks, direct observations, supervisions and appraisals. This meant the registered manager and provider were able to ensure any concerns or gaps in knowledge were addressed to ensure staff remained suitable and competent.

We saw where concerns or complaints had been highlighted about the conduct of any staff member, the registered manager and provider had acted accordingly through robust disciplinary procedures.

We looked at how risks to people’s individual safety and well-being were assessed and managed. Care records contained risk assessments in relation to areas such as pressure ulcers, skin integrity, medicines and moving and handling.

Some people who used the service required equipment such as hoists to assist them to move. All the staff we spoke with told us they had received moving and handling training and this was in a classroom so they could practice using the equipment. Whilst the service was not responsible for the maintenance of any equipment, staff knew to report any faults or safety issues to external agencies.

We noted records were kept in relation to any accidents or incidents that had occurred at the service, including falls. All accident and incident records were checked and investigated where necessary by the registered manager.

All the staff we spoke with, told us they had received training and were aware of their responsibilities in relation to infection control. The service had an infection control policy to guide staff in their roles and to reduce the risk of cross infection.

We asked the quality manager how they shared any lessons learnt. The service was open and transparent about lessons learnt. The quality manager told us all lessons learnt were discussed at board level so there was appropriate oversight.

All the staff we spoke with told us the registered manager was approachable and the service was well run. Throughout our inspection we found the registered manager was knowledgeable about the service and people who used the service.

The service promoted a clear vison and approach to deliver high-quality care and support which achieved positive outcomes for people.

We looked at how people who used the service, staff and others were consulted on their experiences and shaping future developments. All the staff we spoke with told us they felt supported in their roles and were confident if they raised any concerns or issues they would be addressed.

Records we looked at showed staff also had regular supervisions to support them in their roles. However, we found some staff were unaware or were concerned what they needed to do when a service user passed away. We have made a recommendation that the service considers current best practice guidance on end of life care plans.

People who used the service and their relatives were also consulted about the service and if any improvements could be made. We saw surveys were given out to people and their relatives on a regular basis.

The service also had ‘carers feedback forms’ in place. These were given out to people who used the service to gain their feedback about their experience with staff and if there was anyone they would like to nominate for an award.

We noticed throughout our inspection there was a ‘no blame’ culture, which supported and promoted everyone to be transparent and open to ensure improvements were made. There was an emphasis on improving the service for the benefit of people using it.

All the staff we spoke with told us they would definitely be happy for one of their family members to be cared for by the service.

Routes Healthcare - Burnley is registered to provide personal care to people living in their own homes. The agency specialises in providing rapid care for people nearing the end of their life. At the time of the inspection there were 37 people using the service.

The service had a manager in post, who was in the final stages of the registration process. Following this process, the manager will be registered with the Care Quality Commission. 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.

This was the first inspection of the service since the location was registered on 16 November 2016.

People using the service consistently told us they felt safe and staff treated them well. Safeguarding adults’ procedures were in place and staff understood their responsibilities to safeguard people from abuse. Potential risks to people's safety and welfare had been assessed and preventive measures had been put in place where required. People received their medicines safely and were supported to eat and drink in accordance with their care plan.

Staff support was planned flexibly in line with people’s needs. Staff had the knowledge and skills required to meet people's individual needs effectively. They completed an induction programme when they started work and were up to date with the provider's mandatory training. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People’s healthcare needs were monitored as appropriate and staff worked closely with social and healthcare professionals.

Staff were respectful of people’s privacy and maintained their dignity. All people spoken with told us the staff were kind and caring. People were involved in the development and review of their care plans. This meant people were able to influence the delivery of their care and staff had up to date information about people’s needs and wishes. People were aware of the complaints procedure and processes and were confident they would be listened to.

People were provided with a safe, effective, caring and responsive service that was well led. Systems were in place to monitor the quality of the service, which included seeking and responding to feedback from people and their relatives in relation to the standard of care.