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Care Outlook (Twickenham)) Requires improvement

We are carrying out a review of quality at Care Outlook (Twickenham)). We will publish a report when our review is complete. Find out more about our inspection reports.


Inspection carried out on 14 October 2019

During a routine inspection

About the service

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

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.


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.