Routes Healthcare Tameside

Updated 25 November 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Our inspection took place on 11 and 12 October 2017 and was announced. The provider was given 48 hours' notice, because the location provides a domiciliary care service and we needed to be sure that someone would be available at the office. The visit was undertaken by an adult social care 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. The expert by experience telephoned people using the service or their families on the 11 October 2017.

The provider completed a Provider Information Return (PIR) in March 2017. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. Prior to the inspection we reviewed information we held about the service, including: The provider’s PIR and notifications the provider had sent us about safeguarding and other significant events. We looked at any feedback we had received about the service.

We contacted the Clinical Commissioners Group (CCG) and contracts and quality monitoring teams in Tameside for feedback prior to the inspection. We received feedback from the CCG, which we used to help plan our inspection. No significant concerns were raised. Shortly after the inspection we contacted Stockport continuing healthcare team, who provided positive feedback on the service.

With their permission we visited two people and spoke with nine people who used the service, six relatives of people supported by the service, 11 members of staff, the registered manager, one nurse, the Human Resources and Development manager, and eight care workers. We also spoke to one community nurse during the inspection.

We looked at the care records for four people and the medication records for two people who used the service. We also looked at a range of records relating to how the service was managed including three staff personnel records, training records and policies and procedures.

Updated 25 November 2017

We inspected Routes Healthcare Tameside on 11 and 12 October 2017. We gave the provider 48 hours' notice that we would be visiting the office to make sure that the appropriate people would be there to assist us with our inspection. This was the first inspection after the service registered with the Care Quality Commission in May 2016.

Routes Healthcare Tameside is a domiciliary care agency that works closely with healthcare commissioning teams in supporting people 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. At the time of our inspection 29 people were receiving a service.

The service had a registered manager. 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.

People received extremely personalised care which was delivered in accordance with their wishes and lifestyle. The service employed a nurse, who with the support of care coordinators, carried out assessments which looked at people's interests and lifestyle choices as well as their needs. This enabled them to match people to staff who shared their values and therefore helped them to build relationships. This had proved valuable when working with people who found it hard to accept help.

Staff developed exceptionally positive and caring relationships with people and their families. Staff were very motivated and demonstrated a commitment to providing the best quality care to people in a compassionate way. People told us their privacy and dignity was maintained at all times.

There was a clear management structure in place and oversight from the provider. There were systems in place to monitor the safety and drive the continuous improvement of the quality of the service provided. A comprehensive programme of audits and checks were in place to monitor all aspects of the service, including care delivery, accidents and incidents, health and safety and medicines. Audits resulted in clear action plans to address shortfalls or areas of improvement.

The manager displayed good leadership qualities, drive and enthusiasm. They empowered staff to provide care that was tailored to people's individual needs. Without exception, people, their relatives and professionals told us they experienced and we observed, compassionate care from staff who strove for excellence. This ensured the service was run in the best interest of people who used the service.

Risks that were associated with people's care were assessed and managed well. Where people received support from staff with taking prescribed medicines, this was done in a way that ensured people were supported with their medication safely.

Safe recruitment procedures were followed before new staff were appointed. Appropriate checks were undertaken to ensure staff were of good character and were suitable for their role. The staff induction programme was comprehensive. Staff views were very positive about the support, guidance, training and supervision they received.

People were safe because staff had received training and understood the different types of abuse and knew what actions they should take if they thought that someone was at risk of harm. Staff were knowledgeable about the actions to take in the event of emergencies and about how the risks to people in respect of their care should be managed.

Staff demonstrated an in-depth awareness of the principles of the Mental Capacity Act 2005 and associated Deprivation of Liberty Safeguards (DoLS) within a community setting. The service was in the process of incorporating a section in people’s care plans that assessed their mental capacity.

Some people received support with their food and nutrition. Where this was the case their nutritional needs and preferences were recorded in their care records. The service worked with external professionals to maintain and promote people's health and wellbeing.

There was a complaints procedure available which enabled people to raise any concerns or complaints about the care or support they received. People told us they felt able to raise any concerns with the registered manager and felt these would be listened to and responded to effectively and in a timely manner.