We inspected Care Outlook Oxford on 11 April 2016. The inspection was announced. Care Outlook Oxford is a domiciliary care agency in Oxford that provides care to people in their homes in and around Oxford. At the time of this inspection, the agency was supporting 63 people. There was a registered manager in post. 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 registered manager worked closely with a director of operations.
The provider had systems in place to manage and support safe administration of medicines. However, Medicine Administration Records (MAR) were not always completed accurately.
The registered manager understood their responsibilities in relation to the Mental Capacity Act 2005 (MCA). The MCA provides a legal framework to assess people’s capacity to make certain decisions, at a certain time. However, staff had limited awareness of the MCA.
People were asked for their consent before care was carried out. However, the registered manager and other senior staff were not clear on their responsibilities to ensure the service completed their own mental capacity assessments if it was thought a person may lack the capacity to make certain decisions.
The registered manager informed us of all notifiable incidents. The service had quality assurances in place. However, these quality assurance systems were not always effective. The registered manager had a clear plan to develop and improve the service. Staff spoke positively about the management and direction they had from the manager. The service had systems to enable people to provide feedback on the support they received.
People who used the service felt safe. The staff had a clear understanding of how to safeguard people and protect their health and well-being. Staff had a good understanding of their responsibilities to report any suspected abuse. The service had sufficient numbers of suitably qualified staff to meet people’s needs. Staff told us there was an open culture at the service and were clear about the action they would take to keep people safe. People and staff were confident they could raise any concerns and these would be dealt with.
There were enough suitably qualified and experienced staff to meet people needs. People had a range of individualised risk assessments in place to keep them safe and to help them maintain their independence. Where required, staff involved a range of other professionals in people’s care.
People felt supported by competent staff. Staff benefitted from regular supervision (one to one meetings with their line manager) and yearly appraisals to reflect on their practice and develop their skills. Staff received training specific to people’s needs.
People and their relatives described the staff as excellent and providing very good care. There was a strong emphasis on key principles of care such as dignity, privacy, individuality, right to make decisions and right to lead as normal a life as possible. People felt they were treated with kindness and their privacy and dignity were always respected. Staff had developed positive relationships with people.
People’s needs were assessed and care plans enabled staff to understand how to support people. Changes in people’s needs were identified through regular reviews. People's interests and preferences were discussed during assessments and these were used to plan their care. The service was flexible and responded positively to people’s requests.
The registered manager had a clear vision for the service which was shared throughout the staff team. The vision was promoting independence and allowing people to live a normal life. This was embedded within staff practices and evidenced through people’s care plans. Staff felt supported by the registered manager and the provider.
Leadership within the service was open and transparent at all levels. The provider had systems to enable people and their relatives to provide feedback on the support they received.
We have made a recommendation about good, effective quality control systems and policies.
We identified one breach of the Health and Social Care Act 2008 (Regulated Activity) Regulation 2014. You can see what action we have required the provider to take at the end of this report.