Care Outlook (Brighton and Hove) is a domiciliary care agency. Personal care and support is provided for people living in their own home in the Brighton and Hove area and West Sussex. Care is also provided to people living in New Larchwood and Library Court two extra care housing developments run by a housing association. Care was provided to adults but predominantly older people, including people with a physical disability, people with a sensory loss and people with mental health problems or living with dementia. At the time of our visit around 192 people were receiving a service.

At the last inspection on 27 July 2015, the service was rated overall Good. At this inspection we found the service remained overall Good.

At the last inspection we found there was no record that people’s work history had been discussed to ensure there was evidence of a full work history with a written explanation as to any gaps when people were not working. At this inspection we found systems had been put in place to address this. However, we found policies and procedures had not always been followed in relation to written references being sought. This is an area in need of improvement. At the last inspection there were policies and procedures in place for staff to reference. They told us they had been taken through key policies and procedures as part of their induction, and knew where these were available to read should they need to. These had been updated to ensure current guidance had been considered. However, we found that staff had not been following the most up-to-date policy and procedures. We found at this inspection this had been addressed.

Systems had been maintained to keep people safe. People and their relatives told us they felt safe with the care provided. They knew who they could talk with if they had any worries. They felt they could raise concerns and they would be listened to. Assessments of risks to people had been developed. Staff told us they had continued to receive supervision, and be supported to develop their skills and knowledge by receiving training which helped them to carry out their roles and responsibilities effectively. People told us care staff had the knowledge and skills to provide their care and support.

People's individual care and support needs continued to be identified before they received a service. Care and support provided was personalised and based on the identified needs of each person. People told us they felt listened to, supported to be independent and they were involved in decisions about their care. One member of staff told us,” I always encourage independence even if they can only wash their hands and face.” Where people were unable to make decisions for themselves this had been considered under the Mental Capacity Act 2005, and appropriate actions continued to be followed to arrange meetings to make a decision within their best interests. Staff had a good understanding of consent.

People were happy with the care provided. People continued to be supported by kind and caring staff who treated them with respect and dignity. They were spoken with and supported in a sensitive, respectful and professional manner. People’s comments included, “The staff know what they are doing, very happy,” “Fabulous carers,” “Wonderful care staff,” and “They really do care.” If needed, people were supported with their food and drink and this was monitored regularly. People continued to be supported to maintain good health.

People, their relatives and staff told us the service was well led. One person told us the service was, “One of the best agencies.” Another person told us, “If I call the office I find the staff very helpful.” A member of staff told us, “It’s good, it’s busy. I like working here, it’s a family run business. The values are better. I like working with people who care. They will go out and do the job. Nobody says it’s not their job.” When asked what the service did well one member of staff t

All the people who use the service had been sent a quality assurance questionnaire by the agency in 2011, and twenty completed survey forms were returned. When respondents were asked what did they like about their home care service or if they had any other comments, comments included:

“Staff are friendly and helpful,” “I find it most excellent for the short time I have received it, and couldn't wish for better,” “Everything,” “I would never want to change from Care Outlook they are a great company and I feel I can always talk to someone if I have a problem,” “I would just like to say that all my care team have been very helpful and friendly towards me and I can't fault them in any way,” “Very caring and helpful, and “ Friendly carers, gives me more time to do other things now I have help.”

We spoke to three people receiving a service, and two relatives and they told us:

People expressed their views and were involved in making decisions about their care and treatment.

Peoples’ needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

Peoples’ care was provided by care workers understood their care needs. One person commented, “They are lovely people and do a very good job.”

People knew who to talk to if they had any concerns.

We spoke to the provider’s nominated individual, the manager, the administrator and five care workers during our visit. The care workers told us that they were very happy working for the agency, that the team worked very well together and that they had received the training, support and supervision they needed to meet individual people’s care needs.

This inspection took place on 27 and 28 July 2015 and was announced.

Care Outlook (Brighton and Hove) is a domiciliary care agency. Personal care and support is provided for people living in their own home in the Brighton and Hove area and West Sussex for the local authorities and people who pay privately. Care was provided to adults but predominantly older people, including people with a physical disability, people with a sensory loss and people with mental health problems or living with dementia. At the time of our inspection around 130 people were receiving a service.

On the day of our inspection, 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.

Policies and procedures to ensure safe recruitment practices were in place for staff. However, agreed procedures had not been followed. There was no record that people’s work history had been discussed to ensure there was evidence of a full work history with a written explanation as to any gaps when people were not working. This had not fully ensured the suitability of the new care staff to protect adults. This is an area of practice that needs improvement.

There were policies and procedures in place for staff to reference. They told us they had been taken through key policies and procedures as part of their induction, and knew where these were available to read should they need to. These had been updated to ensure current guidance had been considered. However, we looked at a sample of the policies and procedures and found that staff had not been following the most up-to-date policy and procedures. This is an area of practice that needs improvement.

People and their relatives told us that they or their relative were safe with the staff that supported them. Detailed risk assessments were in place to ensure people were safe within their own home and when they received care and support. One relative said, “They are all very trustworthy.” Another person told us, “I have no worries at all when they are in the house.” There were clear policies in place to protect people from abuse, and staff had a clear understanding of what to do if safeguarding concerns were identified.

People told us they always got their care visit, that they were happy with the care and the care staff that supported them. The times that care staff arrived to support people enabled people to have the agreed support provided. For example, to take their medicines at the right time. One person told us,” They go over and above what they need to do.” Another person told us,” She (the carer) never says no. She goes the extra mile for me and I couldn’t do without her. I would recommend this company to anybody who asked.”

Medicines were managed safely and people received the support they required from staff. There were systems in place to ensure that medicines were administered and reviewed appropriately.

People told us they were involved in the planning and review of their care. Where people were unable to do this, the manager told us they would liaise with health and social care professionals to consider the person’s capacity under the Mental Capacity Act 2005. Care staff had a good understanding of the need for people to consent to their care and treatment. People were consulted with about the care provided. They knew how to raise concerns or complaints. One person told us,” I’m absolutely happy.”

Care staff received an induction, basic training in areas such as caring for people living with dementia. Care staff had supervision in one to one meetings, spot checks and staff meetings, in order for them to discuss their role and share any information or concerns.

People and their relatives told us they were supported by kind and compassionate staff. One relative told us, “It’s lovely to see how they are with (my relative). They couldn’t be kinder. They do anything and everything and are always cheerful. It’s not like having strangers in the house because they are so kind.”

The registered manager, along with senior staff provided good leadership and support to the care staff. They were involved in day to day monitoring of the standards of care and support that were provided to people using the service.