Background to this inspection
Updated
27 July 2022
The inspection
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 Health and Social Care Act 2008.
Inspection team
The inspection was carried out by an inspector and an Expert by Experience. 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 specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is bought or rented and is the occupant’s own home. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service. This service is also a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community.
Registered Manager
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.
At the time of our inspection there was no registered manager in post. A manager was in post, who had not yet registered with CQC, and left the service shortly after we inspected.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider would be in the office to support the inspection.
Inspection activity started on 26 May 2022 and ended on 8 June 2022. We visited the location’s office on 26 and 30 May 2022 and undertook calls with staff between 6 and 8 June 2022.
What we did before the inspection
We reviewed information we had received about the service. We requested feedback from the local authority and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. Healthwatch told us they had not visited the service or received any comments or concerns. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with six people and four relatives about their experience of the care provided. We spoke with 10 members of staff including the manager, the regional manager, the manager responsible for training, the care manager, the quality monitoring officer, the team leader and care workers.
We reviewed a range of records. This included seven people's care records and medicines records. We looked at two staff files in relation to recruitment, staff supervision and training. A variety of records relating to the management of the service, including checks and audits.
After the inspection
We continued to seek clarification from the provider to validate evidence found. We looked at training records, policies and procedures.
Updated
27 July 2022
About the service
Care Outlook (Bellerophon house) is an extra care service and domiciliary care service providing personal care to younger people, older people and a person with a learning disability. People lived in flats within Bellerophon House in Rochester, Kent and in their own houses and flats in the community within the Medway area. At the time of our inspection there were 66 people using the service (19 people within Bellerophon House and 47 in the community).
Not everyone who used the service 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.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
People’s experience of using this service and what we found
The service was not always able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.
Right support:
Individual risks were not always assessed and managed to keep people safe. Risk assessments were inconsistent and did not always detail the relevant information staff would need to meet people's assessed care and 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. Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcome. Staff supported people to play an active role in maintaining their own health and wellbeing.
Right Care
Care was person centred and flexible to meet people’s needs. People were supported by a kind and caring staff team who treated them with respect. People's rights were promoted, and they were protected from discrimination. Staff understood their responsibilities to protect people from abuse and knew how to report concerns should they need to.
Right Culture
There was a positive ethos at the service and people were involved in planning their own care and were encouraged to give their views about the support they received. People were supported to develop their skills and to be as independent as possible. The service had enough appropriately skilled staff to meet people’s needs and keep them safe.
People gave us positive feedback about their care and support. They told us, “They don’t rush me. They’re very good. They’re patient”; “We have a good relationship”; “They’ve been really nice and supportive”; ‘I’ve got quite friendly with a couple of the ladies [staff]. We often have a good laugh and a chat” and “They’re lovely and they do all the things I need doing.”
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 the service under the previous provider was good (published on 17 March 2020.)
Why we inspected
This is the service’s first inspection since registering with the Care Quality Commission as a new legal entity on 4 February 2021.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified a breach in relation to risk management at this inspection. Please see the action we have told the provider to take at the end of this report.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.