Routes Healthcare Sunderland

Routes Healthcare Sunderland is a domiciliary care provider registered to provide personal care to people in their own homes. At the time of the inspection 17 people were using the service and being supported with personal care.

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

Staff were safely recruited and received an induction followed by training from the provider.

Training was monitored and staff were supported with regular meetings and supervisions. There were enough staff to meet people’s needs.

People and their relatives were very positive about the care provided. People told us they felt safe, and staff had the skills to support them. Relatives provided positive examples of how staff had helped improve people's lives since receiving support from the service.

The registered manager had an effective quality assurance system in place. Regular audits and checks were done. These were used to identify relevant actions and lessons learnt. People, relatives, staff and professionals were offered opportunities to provide feedback.

The service was following safe infection prevention and control procedures to keep people safe

Medicines were managed safely. Risks to people were assessed and action taken to reduce the chances of them occurring. The registered manager acted on feedback immediately. People were safeguarded from abuse.

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.

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 requires improvement (published 15 July 2022).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We carried out an announced comprehensive inspection of this service on 19 April 2022. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve staffing, safe care and treatment and good governance.

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

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

Routes Healthcare Sunderland is a domiciliary care agency providing personal care to people in their own homes. At the time of our inspection there were 38 people using the service. Everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal care, hygiene and eating. Where they do, we also consider any wider social care provided.

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

Medicines were not managed safely. People’s medicines were not always administered and recorded in line with best practice; we could not always be assured people had received their medicines as records were incomplete.

People were not always supported by trained and competent staff. Not all staff had completed all of the provider’s mandatory training, this included safeguarding, medicines administration and moving and handling modules.

People did not always receive care and support from sufficient numbers of staff to keep them safe and meet their needs. There was not always enough staff which led to family members being used to provide care as a contingency plan, this impacted on some people’s dignity. One person told us, “I normally have a team of four regular carers, but (staff absences) has impacted on my personal care”

The quality and assurance systems in place were not always effective. Shortfalls identified during the inspection process had not been identified as part of the provider’s audits and checks in place.

Care plans were created from holistic assessments. We found care plans were comprehensive and personalised, although they were not always monitored and updated to reflect people’s changing needs. People had personalised risk assessments in place, but we found that these were not always reviewed or present.

Comments from people were mixed about the support provided by staff. One person said, “The family were involved initially in the care plan but there has been no review and [Person] has been with the service since March 2021.”

Safe staff recruitment procedures were followed. There were appropriate pre-employment checks in place to make sure staff were suitable to carry out their role.

Staff supported people to make decisions following best practice in decision-making. Staff supported people to achieve their aspirations and goals. One person told us, “I couldn’t have picked a better package of care, the office continually contacts me to keep me informed.”

There were systems for dealing with complaints, safeguarding concerns, accidents and incidents. These helped ensure all incidents would be investigated.

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.

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

This service was registered with us on 30 November 2020 and this is the first inspection.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection.

We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to the safe and proper management of medicines, governance and staffing. This puts people at an increased risk of harm.

Please see the action we have told the provider to take at the end of this report.

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.