Background to this inspection
Updated
12 May 2023
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
Inspection team
This inspection was carried out by 1 inspector, 1 assistant inspector and an Expert by Experience.
An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was not a registered manager in post. A manager was in post who was in the process of registering.
Notice of inspection
We gave the service 72 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or manager would be in the office to support the inspection.
Inspection activity started on 6 March 2023 and ended on 29 March 2023. We visited the location’s office on 6 March 2023.
What we did before the inspection
We reviewed information we held about the service. We sought feedback from the local authority, professionals who work with the service and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with 2 people who use the service and 3 relatives about their experience of the care provided. We spoke with 11 staff members including the manager and carers. We spoke with 1 healthcare professional who worked with the service.
We reviewed a range of records including 3 people’s care and medication records. We looked at 3 staff files in relation to recruitment and supervision. We reviewed records relating to the management of the service, including policies and procedures, training data and quality assurance records.
Updated
12 May 2023
About the service
Routes Healthcare Leeds is a domiciliary care agency providing personal care to people living in their own homes. This includes people living with physical disabilities and learning disabilities. At the time of our inspection the service was providing personal care to 9 people.
People’s experience of using this service and what we found
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.
People’s experience of using this service and what we found
Right Support:
Information was mostly adapted in line with the accessible information standard.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People were involved in their care and their independence encouraged. Staff knew people’s communication style and supported them to make choices about their care and support.
Right Care:
Staff cared for people in a kind and respectful way. They had the required skills and experience to care for people and meet their individual needs. Staff worked with other agencies to achieve good outcomes for people.
People were safeguarded from the risk of abuse. Risks to people’s health and safety were effectively managed, including Infection Prevention and Control (IPC) risks.
Right Culture:
Systems and processes in place to monitor the service were not effective in identifying and addressing areas requiring improvement.
There were enough staff to support people however contingency planning for staff absence was not always robust. Medicines management and care records were not always in place or accurately completed.
People were supported to lead inclusive lives. They were encouraged and supported to access the community and participate in activities they enjoyed.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was inadequate (published 12 August 2022). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found that some improvements had been made and the provider was no longer in breach of regulation 12, regulation 13 and regulation 18. The provider remained in breach of regulation 17.
At our last inspection we recommended that the provider review guidance on managing medication safely in the community and take action to update their practice. At this inspection we made a further recommendation regarding medicines management.
This service has been in Special Measures since 12 August 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection. We have found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.
You can see what action we have asked the provider to take at the end of this full report.
Enforcement and Recommendations
We have identified breaches in relation to good governance at this inspection. Please see the action we have told the provider to take at the end of this report.
We have made recommendations regarding staffing contingency, medicines records and staff meetings.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.