This inspection took place on 11 July 2017 and was unannounced. Outlook House provides accommodation and personal care for up to 12 people of 18 years and above. Support was provided to people with learning disabilities or autism and who may also have a sensory impairment. People were supported to develop their life skills and increase their independence. Accommodation is in a large period house. People have single occupancy rooms with en suite facilities either on the ground or first floors. The service is near to local shops and facilities and public transport. The service also has its own transport which can be used to get people to and from any activities that are arranged. A learning centre on site provides an educational and training facility to promote people’s independence, and which people from the provider’s other two services can also use. Six people were living in the service at the time of our inspection, but one person was away on holiday with their family.
The service did not have a registered manager. 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. A new manager had commenced working in the service in May 2017, but the CQC had not yet received their application to become the registered manager.
Staff and relatives told us the service was going through a significant period of change with a change of senior staff including the responsible person for the organisation and a new manager had been recruited. There had been work undertaken in the improvement of the internal décor of the building and new systems and processes were being looked at and starting to be implemented. One member of staff told us, “(Responsible individual's name) has added colour to the place with the refurbishment and new furniture, there’s a can do attitude, never negative.” Another member of staff told us, “It’s improved immensely and communication is better.” A further member of staff told us, “(Staff member’s names) are brilliant and the new manager is fantastic and just what we need. We lacked strong leadership and someone to get our ideas and lead us. (Manager’s name) has lots of knowledge and it feels safer. We’ve got good plans in place.”
At the last inspection on 29 May and 3 June 2015 we found people were cared for by staff who had not all been recruited through safe procedures which was a breach of the regulations. Recruitment checks such as a criminal records check and two written references had not always been received prior to new staff working in the service. The provider sent an action plan to the CQC as to how this would be addressed. At this inspection we found this had been rectified. At the last inspection we found areas in need of improvement. Guidance had not been sought in relation to legionella and checks of the hot water temperature had not been fully maintained. Senior staff showed us that guidance had been sought. To fully address these issues an external company had been commissioned to start to undertake all the water checks in July 2017, but this had not yet commenced and fully embedded into the practice of the service. At this inspection we found there was a lack of regular and effective auditing and monitoring of the quality of the service in all areas. These are areas of practice in need of improvement.
People's individual care and support needs were assessed before they moved into the service. Care and support provided was personalised and based on the identified needs of each individual. People were supported to develop their life skills and increase their independence. People, where possible, were being supported to move onto supported living accommodation for people with a learning disability. This is where people receive support to enable them to take control of their life. People’s support plans and risk assessments were detailed. Relatives told us they felt people were involved and listened to. One relative told us, “They have adapted things for him and he loves coming back here when he’s been at home, I feel now that he’d be confident to tell staff anything.”
Where people were unable to make decisions for themselves the service had considered the person’s capacity under the Mental Capacity Act 2005, and had taken appropriate action to arrange meetings to make a decision within their best interests.
People were treated with respect and dignity by the staff. They were spoken with and supported in a sensitive, respectful and professional manner.
Relatives told us they felt people were safe in the service. One relative told us, “It’s great here he settled in well and is really happy, they action things straight away. He does a lot of things, there is always something going on. They keep me informed of everything.” People knew who they could talk with if they had any concerns. They felt it was somewhere where they could raise concerns and they would be listened to. There were systems in place to assess and manage risks and to provide safe and effective care.
Staff told us that an individual’s dietary requirements formed part of their pre-admission assessment and people were regularly consulted about their food preferences.
People had access to health care professionals. They had been supported to have an annual healthcare check. All appointments with, or visits by, health care professionals were recorded in individual care plans. There were procedures in place to ensure the safe administration of medicines. People were supported to take their medicines and increase their independence within a risk management framework.
There were sufficient numbers of suitable staff to keep people safe and meet their care and support needs. The number of staff on duty had enabled people to be supported to attend educational courses, participate in voluntary work and in social activities in the community. One relative told us, “There are lots of activities, they do everything, his favourites are swimming but he has a choice and they don’t push him.” Staff told us they were supported to develop their skills and knowledge by receiving training which helped them to carry out their roles and responsibilities effectively.
Staff told us that communication throughout the service was good and included comprehensive handovers at the beginning of each shift and regular staff meetings. They confirmed that they felt valued and supported by the managers, who they described as very approachable. One member of staff told us,” It’s a lovely home with good potential.”
People and their representatives were asked to complete a satisfaction questionnaire, and people had the opportunity to attend weekly residents meetings. We could see the actions which had been completed following the comments received.