Background to this inspection
Updated
24 May 2022
The inspection:
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team: Two inspectors and two experts by experience carried out this inspection. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service.
This service is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to older people.
Notice of inspection: This inspection site visit took place on 13 April 2022 and was announced. We gave the service five days’ notice the inspection visit, because this is a large service and we wanted to be sure the office staff would be available for the inspection.
What we did:
Before the inspection: We reviewed information we had received about the service. We sought feedback from the local authority who work with the service. The provider was not asked to complete a Provider Information Return prior to this inspection. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We used all this information to plan our inspection.
During the inspection: We spoke with 11 people and 14 relatives to ask their views about the service. We spoke with five members of care staff, and the registered manager and the Operations Support Manager. We reviewed records, including the care records of 11 people using the service, recruitment files and training records for 11 staff members. We also looked at records related to the management of the service such quality audits, accident and incident records, and policies and procedures.
Updated
24 May 2022
About the service:
Care Outlook is a domiciliary care agency which provides care to people 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 350 people were receiving personal care.
People’s experience of using this service:
Risks were not always identified or updated, and risk management plans were not always in place to manage these risks. People's medicines were not always safely managed. People and/or their relatives were not involved in planning their care and support and care plans were not always updated. Staff were not deployed to meet people’s needs in a timely manner Feedback had been sought from people about the service, but the provider did not always act upon and rectify shortfalls identified. The provider's quality assurance systems were not effective.
People told us they felt safe. The provider's recruitment process was robust, and staff were recruited in line with the recruitment policy. Assessments were carried out prior to people joining the service to ensure their needs could be met. There were appropriate adult safeguarding procedures in place to protect people from the risk of abuse. People were protected from the risk of infection. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. The provider worked in partnership with other agencies to ensure people's needs were planned and met.
Rating at last inspection: The last rating for this service was Good (published 2 July 2019)
Why we inspected: We received concerns about late visits, neglect, and poor medicines management. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service. We have identified breaches in relation to safe care and treatment, staffing, fit and proper persons employed, and good governance.
Please see the action we have told 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 reinspection programme. If we receive any concerning information we may inspect sooner. 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.