This inspection took place on 25 September 2018 and was unannounced. Outlook House is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion.

Support was provided to up 12 adults 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, either on the ground or first floors, with en-suite facilities. The service is near to local shops and facilities and public transport. The service also has its own transport, which was used to get people to and from any activities that were arranged. A learning centre, which was on site, provided an educational and training facility to promote people’s independence. This was also used by people from the provider’s other two services. Ten 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. Since the last inspection a new manager had commenced working in the service. The CQC has not yet received their application to become the registered manager.

At the previous inspection on 11 July 2017, the service received a rating of ‘Requires Improvement’. This was because we found guidance had not been followed in relation to legionella. Checks to ensure hot water was at a safe temperature, to protect people, had not been maintained. There also was a lack of regular and effective auditing and monitoring of the quality of the service in all areas. At this inspection we found this had been rectified.

People and their relatives told us that people were safe. They told us they could raise concerns and know they would be listened to. Policies and procedures were in place to safeguard people. Staff were aware of what actions they needed to take, in the event of a safeguarding concern being raised. There were systems to manage medicine safely. The building and equipment had been subject to regular maintenance checks. Infection control procedures were in place.

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. A member of staff told us, “There is a lot of choice offered here. There are always options. “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.

People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. People were treated with respect and dignity by staff who were kind and caring. One person told us, “I love it here. The people are lovely. The staff are lovely. “People were spoken with and supported in a sensitive, respectful and professional manner.

Staff told us they were supported to develop

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

During our visit we spoke with three people who used the service. We also spoke with four members of staff. These were the managing director, senior director of personnel and training, senior director of health safety and welfare and a support key worker. We also looked at meeting minutes and surveys to help us understand the views of the people who used the service.

The people we spoke with told us they felt happy living at Outlook House. One person who used the service told us “I like living here we have good activities”. Another person told us “my support worker is caring”.

Staff we spoke with felt the home was a great place to work and all the staff really care. One member of staff told us “we do a great job in helping people to become more independent”. Another member of staff told us “we like to see our resident’s progress in life and we help them to become more independent, I love it here every day is different”.

We looked at four care plans, four staff records and observed levels of staff. We saw the service had enough experienced and skilled staff to meet people’s needs.

During the inspection visit we spoke with the residents who were keen to tell us how they spent their time and described the activities they were involved with on a weekly basis. One person told us how she had now been enrolled into college and was very excited about starting her new course in September. Another resident told us how she had a number of jobs and how staff helped her organise herself to get to each one on time. A resident who had now moved to the independent living facility of the Outlook Foundation explained how he was working with the maintenance staff helping with the refurbishment programme at Outlook House.

The residents that we spoke with told us that they enjoyed living at Outlook House and were given choices about how they spent their time. They described how supportive staff were in helping them to make informed decisions in all areas of their lives.

This inspection took place on 29 May and 3 June 2015 and was unannounced.

Outlook House provides accommodation and personal care for up to 12 people between the age of 18-25 years of age with learning disabilities or autism and 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 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 organisation’s other two services can also use. Six people were living in the service at the time of our inspection, with three people in the service during our inspection.

The service had a registered manager, who was present throughout the inspection, who has been in their current post for a number of years and knew the service well. 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.

People were cared for by staff who had not all been recruited through safe procedures. 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 premises were safe and well maintained. The environment was clean and spacious which allowed people to move around freely without risk of harm. However, the checks of the hot water temperature being delivered to protect people had not been maintained. Systems to protect people against Legionella had not yet been implemented.

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 care and support plans and risk assessments were detailed and reviewed regularly. People told us they had felt involved and listened to.

Where people were unable to make decisions for themselves the staff were aware this had to be considered under the Mental Capacity Act 2005, and the 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.

People told us they felt safe. They 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.

People said the food was good and plentiful. 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. 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. Training records were kept up-to-date, plans were in place to promote good practice and develop the knowledge and skills of staff.

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.

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. The registered manager told us that senior staff carried out a range of internal audits, and records confirmed this. The registered manager also told us that they operated an 'open door policy' so people living in the service, staff and visitors could discuss any issues they may have.

We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have asked the provider to take at the back of this report.