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Archived: Rochdale DCA Good

This service is now registered at a different address - see new profile

Inspection Summary


Overall summary & rating

Good

Updated 2 April 2016

This was an announced inspection that took place on the 2 and 3 February 2016. The service was previously inspected in January 2014 and was found to be compliant with all regulations inspected.

Routes Healthcare – Rochdale works closely with healthcare commissioning teams in supporting children and adults 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.

The service currently supports 80 people. This number changes rapidly with people being referred to the service who choose to pass away in their own home. Services may be required the same day as the referral is received and may only continue for a few days.

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. At Routes Healthcare – Rochdale the registered manager was also the area manager for the Routes Healthcare group. They were at the Rochdale office three or four times each week and were available on the telephone at other times. A new manager had been appointed for the Rochdale office and they will apply to become the registered manager when they take up their post. An on call system was available outside of office hours.

All the people we spoke with told us that they felt safe being supported by staff from Routes Healthcare – Rochdale. One person told us, “I can’t speak highly enough of them (the staff); there’s not one that isn’t nice.” Staff had received training in safeguarding adults and knew the correct action to take to protect people from the risk of abuse. All staff said the registered manager and the care co-ordinators would listen to any concerns they raised.

Where Routes Healthcare – Rochdale had responsibility for administering medicines they were administered safely. Medication Administration Records (MAR) were audited weekly. Any errors were investigated. Staff training was provided for staff in the hand writing of medicines prescribing instructions on to the MAR sheets accurately and with two staff signing to state they were correct.

We saw that two families, where staff supported people through the night, would leave medicines out for staff to administer during the night if required. The details on when this would be required were not recorded and relied on the families informing the staff accurately. This meant that staff may be unsure of the prescribed instructions for people’s medicines where families took the lead in managing the medication.

Risk assessments were in place which provided guidance to staff about how to manage the identified risks. Care plans were in place which gave clear information and guidance to staff. The plans were regularly reviewed to ensure that the information reflected people’s current needs. This enabled the staff to support people effectively and safely.

People and relatives told us that support visits were not missed. Due to the nature of supporting people at the end of their lives the times of visits sometimes varied if people required additional support. Staff teams were organised on an area basis which enabled people to receive support from the same members of staff. Staff covered each other when one was ill or on annual leave. Agency staff were not used. This helped to ensure that staff knew the people they support well.

A business continuity plan was in place. Contingency plans were made in case of staff sickness or bad weather affecting staff being able to support people as planned.

The manager and staff demonstrated a good understanding of the Mental Capacity Act 2005 (MCA). Best interest meetings had taken place where a p

Inspection areas

Safe

Good

Updated 2 April 2016

The service was safe.

People who used the service told us they felt safe with the staff that supported them. Risk assessments were in place which provided guidance to staff about how to manage the identified risks.

Where Routes Healthcare – Rochdale had responsibility for administering medicines they were administered safely. Where families had responsibility for medicines some medicines were left out by the family for staff to give to the person. Guidance for staff in these instances was not recorded.

A robust system of recruitment was in place. Staff had received training in safeguarding adults and knew the correct action to take to report any concerns.

Effective

Good

Updated 2 April 2016

The service was effective.

The service was meeting the requirements of the Mental Capacity Act 2005 (MCA). Best interest meetings were held when a person did not have the capacity to make a particular decision.

Staff had received the induction and training they required to carry out their roles effectively. Annual appraisals were held. Staff felt supported by the managers and spoke with them weekly, however they did not receive formal supervisions.

We saw that people’s health needs were met. Where it was part of the support provided we saw that people’s nutritional needs were met.

Caring

Outstanding

Updated 2 April 2016

The service was very caring.

People who used the service and their relatives spoke extremely positively about the kindness and caring attitude of the staff. People had strong relationships with staff, felt that staff understood their needs well and went ‘the extra mile’ for them.

Due to the nature of palliative care, staff would stay longer with people if they needed additional support. If staff were delayed this was communicated to the other people who used the service.

Staff showed a clear understanding of privacy, dignity and respect. The service asked about values during the interview process.

Monthly phone calls and six monthly questionnaires were used to gain feedback from people who used the service and their relatives.

Responsive

Good

Updated 2 April 2016

The service was responsive.

The service responded quickly to requests for support for people at the end of their life wanting to return to their home.

Person centred care plans were in place. The plans were regularly reviewed and updated with the people who used the service, their relatives and the local authority

People told us that they received the support they required. There was system in place to record, investigate and learn from complaints.

Well-led

Good

Updated 2 April 2016

The service was well led.

The service had a manager who was registered with the Care Quality Commission.

People, their relatives and staff spoke positively about the registered manager, care co-ordinators and other office staff. They said they were approachable and supportive.

A robust system of audits was in place to monitor the quality of the service. This function had been strengthened with the appointment of a Clinical governance lead for the Routes Healthcare group.