Care Outlook (Oxford)

Care Outlook Oxford is a domiciliary care agency. It provides personal care to people living in their own homes in Oxford and the surrounding areas. The service was providing personal care for 35 people.

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

Care Outlook Oxford ensured people received safe care from skilled and knowledgeable staff. People told us they felt safe receiving care from the service. Staff understood their responsibilities to identify and report any concerns. The provider had safe recruitment and selection processes in place.

Risks to people's safety and well-being were managed through a risk management process. There were sufficient staff deployed to meet people's needs. Medicines were managed safely and people received their medicines as prescribed.

We received positive feedback from all people and relatives. The feedback reflected staff were very kind, caring and committed. People complimented the continuity of care provided by regular staff which contributed to building of meaningful relationships. Staff recognised what was important to people and ensured an individually tailored approach that met people's personal needs, wishes and preferences was delivered.

People were supported by caring staff that knew them well. People were supported to maintain relationships with their families and friends. People's independence was promoted, and they received support to achieve their goals and reduce social isolation.

People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the procedures in the service supported this practice. People were supported to maintain good health and to meet their nutritional needs.

The service was well-led by a new manager who was committed to improving people’s care. The manager had only been in post for two months and had already identified areas to improve and was working through an action plan. The provider had quality assurance processes in place which were effectively used to drive improvement.

Rating at last inspection:

At our last inspection we rated the service good. Our last report was published on 8 June 2017.

Why we inspected:

This inspection was part of our scheduled plan of visiting services to check the safety and quality of care people received.

Follow up:

We will continue to monitor the service to ensure that people receive safe, compassionate, high quality care. Further inspections will be planned for future dates.

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

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 the director of operations.

At the last inspection on 11 April 2016, we asked the provider to take action to make improvements and make sure people’s capacity assessments were completed in line with the Mental Capacity Act 2015 (MCA) and that staff had a good understanding of the MCA. At this inspection on 10 May 2017 we found the actions had been completed.

The registered manager and staff had a good understanding of the MCA. Where people were thought to lack capacity to make certain decisions, assessments in relation to their capacity had been completed in line with the principles of the MCA.

People who were supported by the service felt safe. Staff had a clear understanding on how to safeguard people and protect their health and well-being. People received their medicines as prescribed.

There were enough suitably qualified and experienced staff to meet people's needs. The service had robust recruitment procedures and conducted background checks to ensure staff were suitable for their roles.

People had a range of individualised risk assessments in place to keep them safe and to help them maintain their independence. Where risks to people had been identified, risk assessments were in place and action had been taken to manage the risks. Staff were aware of people’s needs and followed guidance to keep them safe.

Staff received adequate training and support to carry out their roles effectively. People felt supported by competent staff that benefitted from regular supervision (one to one meetings with their line manager) to help them meet the needs of the people they cared for.

People’s nutritional needs were met. People were given choices and were supported to have their meals when they needed them. Staff treated people with kindness, compassion and respect and promoted people’s independence and right to privacy. People received care that was personalised to meet their needs.

People were supported to maintain their health and were referred for specialist advice as required. Staff knew how to support people during end of life care.

Staff knew the people they cared for and what was important to them. Staff supported and encouraged people to engage with a variety of social activities of their choice in the community.

The service looked for ways to continually improve the quality of the service. Feedback was sought from people and their relatives and used to improve the care. People knew how to make a complaint and complaints were managed in accordance with the provider’s complaints policy.

Leadership within the service was open and transparent. People, their relatives and staff were complimentary about the management team and how the service was run.

The registered manager informed us of all notifiable incidents. The registered manager had a clear plan to develop and further improve the service. Staff spoke positively about the management support and leadership they received from the management team.

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.

We found people had care plans in place which enabled care workers to support them in the way they wanted to be supported. One person told us 'they came and discussed everything with us first' another person told us 'I had everything explained to me; I knew what my care would be'.

We found that the service protected people and delivered care. We found people were cared for, or supported by suitably qualified, skilled and experienced staff. One care worker we spoke with informed us 'I filled in an application form, and then had an interview; they contacted my references and did a CRB" (Criminal Records Bureau check).

Care workers were trained and supported to deliver good care. People we spoke with were complimentary about the staff, one person told us 'they are excellent and know exactly how to care for me, I am very satisfied'. Another person told us 'the carers are very good they are much better than the previous service we used, they know what they are doing and do it very well'.

We found the service had quality assurance methods in place which involved people who used the service. One person told us' they come and see me and check that I am happy with my care'. Another person told us 'they come and do checks on a regular basis, it is very reassuring'.