Routes Healthcare Leeds

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.

Routes Healthcare Leeds is a domiciliary care agency. It provides personal care to people living in their own houses and flats. At the time of our inspection 19 people were receiving a regulated activity. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

People's experience of using the service and what we found

We were not assured care provided was always safe. Risks to people's care were not fully assessed, planned, or documented. We were not assured people’s risks were assessed and we referred our concerns to the local safeguarding team.

We identified widespread shortfalls in the way the service was managed. The provider failed to implement effective processes to assess and monitor the quality of the service and to identify the issues found during our inspection. An example was a failure to disseminate knowledge found from lessons learnt with staff. There were also issues with the management of staffing which included not providing staff with the appropriate support and failing to ensure training was up to date. Care plans lacked detail in relation to specific areas of people's care and needs. We found gaps in peoples documentation.

People and relatives shared positive feedback about the care provided and praised care staff for their kind approach. One person said, “Yes they turn up, they’ve never missed a call and they’re not as late as the others and they will ring me”.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection

This service was registered with us on 9 April 2020 and this is the first inspection.

Why we inspected

The inspection was prompted in part due to concerns received about people's safety. A decision was made for us to inspect and examine those risks.

You can see what action we have asked the provider to take at the end of this full report.

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 discharge our regulatory enforcement functions required to keep people safe and to hold providers to account where it is necessary for us to do so.

We have identified breaches in relation to safeguarding, safe care and treatment, staffing and good governance at this inspection.

Full information about CQC's regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it. And it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

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.

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.

If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.