This inspection visit took place on 17 January 2018 and was announced. Routes Healthcare DCA is a privately owned domiciliary agency. They are situated on the Metropolitan Business Park just off Preston New Road in Blackpool. The agency provides personal care to people in their own homes. The service covers a wide range of dependency needs including adults, children, people with a learning disability, people with mental health problems and younger adults. At the time of our inspection visit the service supported 89 people.

There was a registered manager in place. 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.

At the last inspection on 09 February 2016 the service was rated Good. At this inspection we found the service remained Good.

We spoke with two people supported by the service and ten family members. They told us staff who visited them were polite, friendly and caring. They told us they received patient and safe care and they liked the staff who supported them. Comments received included, “I get the same group of carers and they are really good. I feel safe with them because they are kind and caring towards me .I like all my carers.” And, “Our package is working really well. The carer supporting [relative] has been brilliant. ”

During this inspection people supported by the service told us staff were usually reliable. They told us they were contacted if staff were running late with their visits for any reason.

The service had systems in place to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff had received safeguarding training and understood their responsibilities to report unsafe care or abusive practices.

Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. These had been kept under review and were relevant to the care provided.

Staff had been recruited safely, appropriately trained and supported. They had skills, knowledge and experience required to support people with their care and social needs.

Staff responsible for assisting people with their medicines had received training to ensure they had the competency and skills required. People told us they received their medicines at the times they needed them.

The service had safe infection control procedures in place and staff had received infection control training. Staff wore protective clothing such as gloves and aprons when needed. This reduced the risk of cross infection.

People were supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice.

People’s care and support was planned with them. People told us they had been consulted and listened to about how their care would be delivered.

Staff supported people to have a nutritious dietary and fluid intake. Assistance was provided in preparation of food and drinks as people needed.

People were supported to have access to healthcare professionals and their healthcare needs had been met.

People told us staff were caring towards them. Staff we spoke with understood the importance of high standards of care to give people meaningful lives.

The service had information with regards to support from an external advocate should this be required by people they supported.

People told us staff who visited them treated them with respect and dignity.

People who used the service and their relatives knew how to raise a concern or to make a complaint. The service had kept a record of complaints received and these had been responded to in a timely manner.

The service used a variety of methods to

This inspection visit took place on 09 February 2016 and was announced.

At the last inspection on 06 May 2014 the service was meeting the requirements of the regulations that were inspected at that time.

Routes Healthcare DCA is a privately owned domiciliary agency. They are situated on the Metropolitan Business Park just off Preston New Road in Blackpool. The agency provides personal care to people in their own homes. The service covers a wide range of dependency needs including adults, children, people with a learning disability, people with mental health problems and younger adults.

At the time of our inspection visit Routes Healthcare DCA provided services to 15 people.

There was a registered manager in place. 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.

We found recruitment procedures were safe with appropriate checks undertaken before new staff members commenced their employment. Staff spoken with told us their recruitment had been thorough and professional.

Staff received regular training and were knowledgeable about their roles and responsibilities. They had the skills, knowledge and experience required to support people with their care and social needs. On the day of our inspection visit we observed five new staff members at the services office base undertaking their induction training. We also spoke with two permanent staff members who were completing refresher training on medication awareness and moving and handling techniques. This ensured staff regularly had their knowledge and skills updated.

People supported by the service told us the staff who visited them were polite, reliable and professional in their approach to their work. One person said, “I have had some very unpleasant experiences with other care agencies. Routes have been a god send to me and my [relative]. I cannot praise them high enough.”

The registered manager had systems in place to record safeguarding concerns, accidents and incidents and take necessary action as required. Staff had received safeguarding training and understood their responsibilities to report any unsafe care or abusive practices.

The registered manager understood the requirements of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). This meant they were working within the law to support people who may lack capacity to make their own decisions.

Staff knew the people they were supporting and provided a personalised service. Care plans were in place detailing how people wished to be supported. People were involved in making decisions about their care.

Risk assessments had been developed to minimise the potential risk of harm to people during the delivery of their care. These had been kept under review and were relevant to the care being provided.

Staff managed medicines safely. They gave them as prescribed, stored and disposed of them correctly. People were able to manage their own medicines if they were able to do so safely. People said staff gave them their medicines when they needed them.

People told us they were usually supported by the same group staff. This ensured people were visited by staff who understood their support needs and how they wanted this to be delivered.

The service had a complaints procedure which was made available to people they supported. People we spoke with told us they knew how to make a complaint if they had any concerns.

The registered manager used a variety of methods to assess and monitor the quality of the service. These included satisfaction surveys, spot check and care reviews. We found people were satisfied with the service they received.

During this inspection the Inspector gathered evidence to help answer our five key questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led? During the inspection we looked at the services quality monitoring procedures, care and staff recruitment records and procedures the service had in place to safeguard people from unsafe practices. The Inspector also gathered information from people using the service by telephoning them.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read our full report.

Is the service safe?

People told us they felt safe and their rights and dignity was respected. They told us they were receiving safe and appropriate care which was meeting their needs. Safeguarding procedures were in place and staff understood how to safeguard the people they supported. The service had policies and procedures in relation to the Mental Capacity Act and Deprivation of Liberty Safeguards although no applications had needed to be submitted. Relevant staff had been trained to understand when an application should be made and in how to submit one. This meant that people would be safeguarded as required. We found recruitment practices were safe and thorough. This ensured people working for the agency were fit to work with vulnerable people.

Is the service effective?

People’s health and care needs had been assessed with them, and they were involved in writing their plans of care. Specialist dietary needs had been identified where required. Care plans had risk assessments completed to identify the potential risk of accidents and harm. Staff members we spoke with confirmed guidance was provided to ensure they provided safe and appropriate care. We found care plans were flexible, regularly reviewed for their effectiveness and changed in recognition of the changing needs of the person. People spoken with said their care plans were up to date and reflected their current needs.

Is the service caring?

We spoke with people being supported by the service. We asked them for their opinions about the staff that supported them. Feedback from people was positive. One person we spoke with said, “The staff that support my husband are excellent. They understand his complex needs very well which is very important to us. They give great thought into matching appropriate staff to support him. They are very professional in keeping his care plan up to date and involving us in his reviews of care”. Another person said, “I couldn’t be happier with the service I am receiving. The staff that support me are brilliant. I have the same group of staff visiting me and they understand my needs very well”. People using the service and their relatives completed an annual satisfaction survey. Where shortfalls or concerns had been raised these were taken on board and dealt with. People’s preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people’s wishes.

Is the service responsive?

People being supported told us the agency was providing a reliable, flexible service which was meeting their needs. They said the agency was well run, provided good value for money and responded professionally to requests to changes to their visits. One person said, "I am in full control of my care package and have a say which staff can support me. I control the management for the rota's of staff supporting me. This works very well between myself and the agency". Another person said, “They go the extra mile to accommodate us if we require changes to our visits”. People knew how to make a complaint if they were unhappy. One person said, “I have raised concerns with the service in the past. I was satisfied how these were dealt with”. We looked at the services complaints log and noted all concerns raised with them were being responded to appropriately. The service worked well with other agencies and services to make sure people received care in a coherent way.

Is the service well-led?

The service had a quality assurance system in place. Records showed that identified problems and opportunities to change things for the better were addressed promptly. As a result the quality of the service was continuously improving. Staff had a good understanding of their roles and responsibilities. People we spoke with said they received a good quality service at all times.