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Archived: Rochdale DCA Good

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Reports


Inspection carried out on 2 February 2016

During a routine inspection

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 carried out on 23, 27 January 2014

During a routine inspection

We found that people’s needs were assessed and that people who used the service, their representatives and other healthcare professionals were involved in planning how care was delivered. We received positive comments from relatives of people who used the service as well as healthcare teams who commissioned care packages. One relative told us “They’re great, they’re [staff] all fabulous, I’ve got no problems”. A healthcare professional we spoke with described the staff and the service they provided as “Very professional”.

We saw that where people were assisted to take medication, there was an effective system in place to manage this.

The service monitored the quality of the care they provided by obtaining feedback from people, or their representatives about the care and support they received. There was also a complaints procedure in place. The service worked with healthcare teams to ensure the care they delivered met people’s needs.

During our previous inspection of this service, we noted concerns regarding record keeping. We saw that systems had been put in place to monitor the quality of people’s care records and staff employment and training records. We saw that the standard of records had improved.

Inspection carried out on 6 February 2013

During a routine inspection

As part of our inspection we spoke with the relatives of people who use the service and with healthcare teams who commission services from the agency.

People told us; “It’s an excellent service”, “We couldn’t have coped without them”, “They listen to me”, “The manager is prompt in responding to any issues or questions” and “Absolutely wonderful”.

Comments received from healthcare teams were also very complimentary about the service provided. These included; “The majority of the patients we commission care for are approaching the end of their life and they [the agency] respond quickly, efficiently and flexibly to our patients needs”, “The manager is highly professional in her approach” and “They are always able to provide skilled competent carers”.

Staff spoken with said they felt supported, received regular training and were confident any issues raised with the manager would be dealt with immediately.

Systems were in place with regards to staff recruitment and training and development. However improvements were needed to some of the records to show that dates of employment and relevant checks corresponded. Training records did not accurately reflect when courses had been completed by staff.

Improvements were also needed to some of the care records to ensure they provided staff with clear direction in the delivery of care.