Outlook Care

Updated 22 April 2020

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

The inspection team included a lead inspector and a second inspector who visited the service’s office in Billericay, Essex, with an inspection manager who was observing the inspectors’ practice. The lead inspector and three additional inspectors visited supported living schemes on separate days.

An Expert by Experience made phone calls to families of people who used the service. 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 provides care and support to people living in supported living settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

At our last inspection there had been one registered manager. They had now left and been replaced by two managers who were registered with the Care Quality Commission.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 three weeks’ notice of the inspection and office visit. This was so staff could prepare people for our inspection. During this time the provider sent us current information about the people who used the service to help us plan the visits to individual schemes.

We gave individual schemes 24 hours’ notice of our visit. This is because we needed to ask people’s permission to visit their homes.

Inspection activity started on 6 February 2020 and ended on 12 March 2020. We visited the office location on 26 February 2020.

What we did before the inspection

Prior to the inspection we gathered and reviewed information we held about the service, including

information we had received from the provider. The provider is required to notify us of deaths and other incidents that occur within the service, which enable the Commission to monitor any issues or areas of concern.

We used the information the provider sent us in the provider information return. This is information

providers are required to send us with key information about their service, what they do well, and

improvements they plan to make. This information helps support our inspections.

We used all of this information to plan our inspection.

During the inspection

During our office visit we met with two registered managers, the Director of Care and Support and the nominated individual. A nominated individual has overall responsibility for the provision of the registered service. We also spoke to a number of staff involved in coordinating care, quality, recruitment and training.

The expert by experience spoke with nine relatives for feedback about their views about the service.

We visited five supported living schemes spread over a wider geographical area. We spoke with or had contact with numerous people, including a focus group of five people who used the service. We also spoke to senior and care staff working at the schemes.

We reviewed a range of records. This included care records for ten people who received care from the service. We looked at a variety of records relating to the management of the service, including ten staff files.

After the inspection

The provider sent us a large amount of information to support the inspection, as requested. We contacted a number of stakeholders for their view on the service and had responses from three local authority commissioners.

Updated 22 April 2020

About the service

Outlook Care - Unit 6 Shelduck House, Billericay is a supported living service providing personal care for approximately 130 people. Support is primarily provided to people with learning disabilities or autistic spectrum disorder.

Support is provided in approximately 20 supported living schemes based across South Essex and East London, ranging from shared houses to large complexes of individual flats, with shared communal areas. The level of support varies from minimal support to intensive 24-hour care to meet people’s complex needs. Not everyone who used the service at the time of the inspection 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

At the last inspection, we rated the leadership of the service as outstanding. At this inspection, we found the leadership provided high quality management which we rated as good. People and their families gave us positive feedback about the service, and we found examples of exceptional person-centred leadership and care. However, the provider was still working towards ensuring people experienced consistently outstanding care across the service.

We were assured by the provider’s commitment to promote exceptional care. In particular, we found the service was outstandingly effective, which provided a good foundation to achieve a consistent standard of care.

When we last visited the service, the registered manager was implementing guidance to minimise the risk of choking. On our return we found these improvements had been sustained and represented an example of best practice, reflected in positive improvements to people’s quality of life and safety. The provider had shared this learning in a positive, pro-active manner. Staff had embraced the guidance. They focused on ensuring people enjoyed what they ate and drunk, respecting their preferences and cultural needs.

Senior staff used best practice to select local staff teams who worked effectively to deliver person-centred care. Staff had varied opportunities to develop their skills, including attending training which involved the people who used the service. Staff worked well with external health professionals to enable people to develop skills so they could take control of their health 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. Technology was used creatively to minimise restrictions and improve people’s quality of life.

There was a new management structure which was ensuring a more consistent quality of care. The culture of the organisation was open. People, families and staff were encouraged to speak out and were confident they would be listened to. Comprehensive quality checks included people who used the service and highlighted areas for improvement which were acted on promptly. The provider worked well with external organisations and was committed to promoting best practice in their sector.

Risk was well managed across the service. Staff supported people to stay safe, whilst promoting their independence. Detailed risk assessments provided staff with the information about people’s individual circumstances. People received the necessary support to take their medicines safely. There were enough staff to meet people’s needs.

People received support from stable and caring staff teams who knew them well and treated them with respect and dignity. Staff promoted people’s voice and ensured they were involved in making decisions about their care. Staff worked in an inclusive manner with people to maximise their independence.

Care and support was tailored around people’s needs, adapting flexibly when their needs changed. Staff supported people to develop their interests and keep in touch with their local community, families and friends. There were arrangements in place to meet the needs of people who required end of life care. People felt able to complain if they were unhappy with the quality of care.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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 good, with outstanding in well-led (published 20 September 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.