Routes Healthcare Wirral received an overall Good rating on its first CQC inspection, with Safe rated Requires Improvement due to incomplete risk monitoring records, inconsistent medicine administration gaps, and a missing best interest decision for a person lacking capacity. Strengths included kind, consistent staffing, strong incident learning, proactive management, and positive feedback from people and relatives.
Concerns (4)
moderate
Record keeping
: “records to evidence the support provided to mitigate risks, were not always robustly completed, such as repositioning charts.”
moderateMedication management: “records showed that on occasion, the required four-hour gap between doses was not always adhered to although the calls were scheduled four hours apart.”
moderateConsent / capacity: “one person had been assessed as lacking capacity to consent to their care, but there was no best interest decision recorded.”
minorMedication management: “When people were prescribed topical creams and required support from staff to apply them, records were not always in place to record the administration of the creams.”
Strengths
· People and relatives felt safe with the support provided and staff were knowledgeable about safeguarding procedures.
· Sufficient safely recruited staff with consistent small teams supporting people, and adequate travel time between visits.
· Effective infection prevention and control procedures with appropriate PPE provision and training.
· Lessons were learnt from incidents and learning was shared with the staff team.
· Person-centred care plans co-created with people and relatives, reflecting individual choices and preferences.
Quality-Statement breakdown (21)
safe: Assessing risk, safety monitoring and management; Using medicines safelyRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Staffing and recruitmentGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Ensuring consent to care and treatment in line with law and guidanceRequires improvement
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies to provide consistent, effective, timely care; Supporting people to live healthier livesGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: Meeting people's communication needsGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Continuous learning and improving careGood
well-led: Promoting a positive culture that is person-centred, open, inclusive, and empoweringGood
well-led: How the provider understands and acts on the duty of candour; Managers and staff being clear about their rolesGood
well-led: Engaging and involving people using the service, the public and staff; Working in partnership with othersGood