This inspection took place on 12,16 and 23 June 2017 and was unannounced. This was the first comprehensive inspection of the service since it was registered. The service was formally registered with the Commission in 2015.

Routes Healthcare is a domiciliary care agency providing care and support to people in their own home.

A registered manager was 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.

People told us they felt safe when receiving care. They told us that they trusted the care workers who supported them. People were protected as staff had received training about safeguarding and knew how to respond to any allegation of abuse. When new staff were appointed thorough vetting checks were carried out to make sure they were suitable to work with people who needed care and support. Systems were in place to manage people’s monies safely.

There were sufficient staff employed in small teams to provide consistent and safe care to people. People told us that staff attended calls on time and although there were some late calls and missed appointments, these were kept to a minimum. An on call out of hours system was in place to deal with emergency situations.

Staff had received training and had a good understanding of the Mental Capacity Act 2005 and Best Interest Decision Making, when people were unable to make decisions themselves. There were other opportunities for staff to receive training to meet people’s care needs.

Staff were aware of people’s nutritional needs and made sure they were supported with eating and drinking where necessary. People received their medicines in a safe way. People’s health needs were identified and staff worked with other professionals to ensure these were addressed.

People praised the kind and caring approach of staff. We observed staff interacting well with people. Staff were respectful and explained clearly how people’s privacy and dignity were maintained. Staff understood the needs of people and care plans were person centred. People and their relatives spoke positively about the care provided.

A complaints procedure was available and people said they knew how to complain, although most people commented they had not needed to. Where complaints had been received they had been satisfactorily resolved.

People had the opportunity to give their views about the service. There was regular consultation with staff, people and/or family members and their views were used to improve the service. Regular audits were completed to monitor service provision and to ensure the safety of people who used the service.

All people told us the management team was approachable and communication was effective to ensure staff were kept up to date about any changes in people’s care and support needs and the running of the organisation.