Care Outlook (Twickenham))

Care Outlook (Twickenham) is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults. At the time of the inspection, there were 140 people receiving the regulated activity personal care.

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 this service and what we found

People received care and support from staff that knew how to identify, respond to and escalate suspected abuse. Risk assessments were comprehensive and gave staff adequate guidance on how to identify and respond to known risks. People received their medicines as prescribed. Staffing levels were adequate and staff underwent robust pre-employment checks to ensure their suitability for the role. Infection control practices were in line with good practice.

Staff received on-going training and reflected on their working practices to drive improvements. Newly employed staff received comprehensive induction training and shadowed senior staff prior to working without direct support. Staff were aware of the action to take when they identified people were unwell and people were supported to access food and drink that met their dietary needs.

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.

Care plans were comprehensive and gave staff a clear insight into the people they supported. Care plans were regularly reviewed. Complaints were investigated and where possible a positive resolution sought. The provider had an end of life policy in place.

New management in place had made a clear impact on the oversight of the service. Audits were carried out to monitor the service provision. People, their relatives and staff spoke positively about the registered manager and confirmed there had been positive changes since her employment. The registered manager was aware of their responsibilities under the duty of candour and was keen to work in partnership with other stake holders.

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

Rating at last inspection

The last rating for this service was requires improvement (published 31 October 2019) and there were multiple breaches of regulation. 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 improvements had been made and the provider was no longer in breach of regulations.

Why we inspected

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective, Responsive and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for the key question Caring not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has remained the same. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Care Outlook Twickenham on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Care Outlook (Hounslow) is a domiciliary care agency providing personal care to 141 people at the time of inspection.

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 this service and what we found

People did not always receive their visits at the time they required. Medicines were not always recorded as safely administered. Some concerns were raised in relation to infection control practices. Additional checks were required to ensure that staff recruitment checks were sufficient.

Staffing levels were not sufficient in meeting people's needs.

There were plentiful concerns in relation to communication across the office team, and management support. Quality assurance audits were not always effective in identifying areas for improvement. Staff did not always receive regular supervision and people, relatives and staff did not always feel their concerns were addressed.

Improvements were needed to ensure that staff training was up to date and staff received appropriate levels of support.

Records showed that people were referred to appropriate healthcare professionals, however some people were not confident this would happen.

The provider had recognised improvements were needed to ensure people’s end of life wishes were captured. Care records reflected people’s preferences. Written complaints were suitably addressed.

Staff were generally caring and treated people with respect, whilst supporting them to be independent.

Risks to people were sufficiently assessed so that staff were able to support them. Staff knew how to report any potential safeguarding allegations.

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.

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 28/11//2018 and this is the first inspection.

Why we inspected

This was the service's first inspection.

We have found evidence that the provider needs to make improvements. Please see the Safe, Effective, Responsive 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

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

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.