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Care Outlook (Forest Hill) Requires improvement

Reports


Inspection carried out on 6 August 2019

During a routine inspection

About the service

Care Outlook (London office) is a domiciliary care service which provides personal care to people living in their own homes. 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. At the time of the inspection there were 700 people receiving care and support for personal care.

People’s experience of using this service and what we found

Risks to people were not consistently managed. Risk assessments and care plans had conflicting information and guidelines for staff were not always clear.

People’s medicines were not always managed safely. Important information about how to take certain medicines was not available to staff. Risks associated with some medicines were not identified.

The service had received a high number of complaints related to late and missed visits. Complaints were not always managed in line with the provider’s policy. There were quality monitoring systems in place, but these were not always effective as they had not resolved the issues we found.

The provider had safe recruitment processes and staff received appropriate induction and ongoing training to ensure they would be competent to fulfil their role.

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 told us the staff were kind and caring. People were supported to be active and involved in every day choices. People's privacy, dignity and independence was maintained.

People and their representatives were involved in decisions about their care and support needs. Staff knew people’s preferences and needs well and delivered person-centred care. Communication needs were assessed and documented, and staff knew the best way to communicate with people.

We have made a recommendation about how the service should improve the process for documenting people’s capacity to consent to their care and support.

Rating at last inspection

The rating for this service was good (published 14 March 2017).

Why we inspected

This was a planned inspection based on the previous rating of good.

Enforcement

We have identified breaches in relation to the management of risks including those related to medicines, safe staffing and the quality monitoring process and acting on complaints. Please see the action we have asked the provider to take at the end of this report.

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.

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

Inspection carried out on 24 January 2017

During a routine inspection

This inspection took place on 19, 24 and 26 January 2017 and was announced. This was the first inspection of regulated activity carried on by the provider at this location.

Care Outlook (London Office) is a domiciliary care agency providing personal care and support to people in their own homes. At the time of the inspection the service was providing support to 501 people. The provider met a range of needs including those of older people, people with physical disabilities and people with a learning disability.

The service had a registered manager at the time of the inspection. 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.

The provider helped to keep people safe by assessing and managing their risks. Staff received training in safeguarding and understood how to identify abuse and the actions they should take if they suspected it. Staff were recruited through a robust process and there were enough staff to deliver care and support to people. Staff supported people to receive their medicines in line with the prescriber’s instructions. People were protected by the infection prevention and control practices of staff.

People received care and support delivered by trained and supervised staff. Managers and staff understood their responsibilities in relation to the Mental Capacity Act 2005. People received the support they required to eat and drink enough and staff ensured that people had ready access to healthcare professionals when required.

Staff were caring and kind towards people. People were treated with dignity and respect. Staff promoted people’s independence and people were encouraged to make decisions. People approaching the end of their lives were supported with end of life care plans.

People received personalised care that met their individual needs. People’s needs were assessed and they were involved in the care plans designed to meet their needs. The level of support people required was reviewed regularly. The service responded to complaints in a timely and appropriate manner.

The service had a registered manager. Staff felt supported by their line managers. Quality audits and checks were undertaken to review and improve the quality of the service. The provider worked in partnership with other agencies.