Background to this inspection
Updated
29 April 2021
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
This inspection was carried out by three inspectors and two Experts by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 25 March 2021 and ended on 6 April 2021. We visited the office location on 25 March 2021.
What we did before inspection
We reviewed information we had received about the service since their last inspection. We sought feedback from healthcare professionals. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection
During the inspection we spoke with 20 people, eight relatives and 14 members of staff including care workers, care coordinators the registered manager, operations manager, compliance manager and the managing director. We reviewed a range of records including care plans, medicine records, staff recruitment files, policies and procedures and records relating to the management of the service.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at quality assurance records and staff training.
Updated
29 April 2021
About the service
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.