Archived: Care Outlook (West London)

Updated 6 December 2017

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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.

This inspection took place on the 25 and 26 October 2017 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be available.

One inspector undertook the inspection and an expert-by-experience carried out telephone interviews of people who used the service and relatives. An expert-by-experience is a person who has personal experience of using or caring for someone who has used this type of care service. The expert-by-experience at this inspection had personal experience of caring for older people.

Prior to the inspection we reviewed the notifications we had received from the service, records of safeguarding alerts and previous inspection reports. Registered providers need to send notifications to the CQC about certain changes, events and incidents that affect the service or the people who use it.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.

During the inspection we spoke with the registered manager, director of operations and three office based staff that were responsible for recruitment and training, monitoring the management of medicines and checking compliance with visit times. We reviewed the care records for eight people using the service, the employment folders for seven care workers, training records for all staff and records relating to the management of the service. The expert by experience contacted by telephone 11 people who used the service and three relatives. We sent emails for feedback to 54 care workers and received comments from four care workers.

Updated 6 December 2017

We undertook an announced comprehensive inspection of Care Outlook (West London) on 25 and 26 October 2017. We gave the provider two working days’ notice as the location provided a service to people in their own homes and we needed to confirm a manager would be available when we inspected.

Care Outlook (West London) is a domiciliary care agency that provides personal care to around 140 people in their own homes in the London Borough of Hounslow. The majority of people receiving care had their care packages funded by the local authority and other people were funding their own care.

We previously inspected Care Outlook (West London) on 26 and 27 September 2016 where we identified breaches of regulations in relation to the management of medicines, recruitment practices, mental capacity assessments, person-centred care planning, quality assurance and records. During the October 2017 inspection we found improvements had been made in relation to recruitment and person-centred care planning. Some improvements had been made in relation to the other areas but further improvements were required.

At the time of the inspection a registered manager was 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 provider had a procedure in place for the safe management of medicines but care workers did not always complete records relating to medicines use as required by the provider’s own systems. We have made a recommendation to the provider regarding this.

Care workers used an electronic call monitoring system to record their arrival and departure times to monitor the visits but some care workers were not always deployed so they had travel times included in their rota. They therefore did not always arrive, leave on time or stayed the full length of the visits.

The provider had procedures in place in relation to the Mental Capacity Act 2005. The process in place to assess a person’s capacity to make decisions relating to their care did not always ensure people rights were upheld. This was being reviewed by the provider.

Improvements had been made in relation to the effectiveness of the audits completed but there were a few areas where further improvements were needed and where the governance systems needed to be more robust.

We found a number of breaches of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These breaches related to need for consent (Regulation 11), staffing (Regulation 18) and good governance of the service (Regulation 17). You can see what action we told the provider to take at the back of the full version of this report.

The provider had robust recruitment practices in place which provided information to enable them to assess an applicant’s suitability for the care worker’s role.

People told us they felt safe when they received care in their own home. The provider had processes to respond appropriately to any reported safeguarding concerns as well as incident and accidents.

Care workers had received the necessary training, supervision and appraisals they required to deliver care safely and to an appropriate standard.

People felt the care workers were kind and caring as well as respecting their privacy and dignity when they provided support.

The care plan identified the person’s religious and cultural needs as well as their preference for a male or female care worker.

Care plans identified how the person wanted their care provided. An assessment of a person’s support needs was carried out before home care started to ensure the person’s care needs could be met.

The provider had a complaints process in place and people receiving support from the service or relatives of people using the service knew how to raise a concern if they needed to.

People told us they felt the service was well-led but did raise some concerns regarding care workers travel time.

People using the service had been asked their views on the quality of the service provided.