Outreach Office is a domiciliary care agency. It provides personal care to adults living in their own flats. At the time of this announced inspection of 24 September 2018 there were 16 people who were provided with personal care.

At our last inspection on 1 March 2016, the service was rated Good overall. We found the evidence continued to support the rating of Good overall and improvements had been made in the key question for Safe. There was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

The service continued to provide people with safe care. There were systems in place which were intended to minimise the risks to people, including from abuse and in their daily lives. There were enough care workers to cover people’s planned care visits. Recruitment of care workers was done safely. Where people required support with their medicines, these were administered as prescribed. There were infection control systems in place to reduce the risks of cross infection.

People continued to receive an effective service. People were supported by care workers who were trained to meet their needs. People were supported to have maximum choice and control of their lives and care workers cared for them in the least restrictive way possible; the policies and systems in the service supported this practice. Where people required support with their dietary needs, systems were in place to deliver this. People were supported to have access to health professionals where needed. The service worked with other organisations involved in people’s care to provide a consistent service.

People continued to receive a caring service. People had positive relationships with the care workers, team leaders and the registered manager. People’s dignity, privacy and independence were respected and promoted. People’s views were listened to and valued.

People continued to receive a responsive service. People received care and support which was assessed, planned and delivered to meet their individual needs. There were systems in place to support and care for people at the end of their lives, where required. A complaints procedure was in place and complaints were acted upon and used to improve the service.

People continued to receive a well-led service. There was a registered manager in post and they were building links with the local community to improve people’s lives. The service used comments from people and incidents in the service to learn from and to drive improvement. The service had a quality assurance system and shortfalls were identified and addressed. As a result, the quality of the service continued to improve.

Further information is in the detailed findings below.

We undertook an announced inspection of Outreach Office (DCA) on 1 March 2016. We gave the provider 48 hour notice of our visit to ensure the registered manager of the service would be available.

Outreach Office is a domiciliary care agency (DCA) and provides personal care services to people in their own homes. At the time of our inspection 18 people were receiving a personal care service.

At our last inspection in January 2014 the service was judged to be meeting all of the regulations we inspected at that time.

The service had a registered manager in place. 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.

Staff and people told us they were able to speak to the registered manager if they had any concerns. The service completed observations on all staff whilst they supported people and formal supervisions were in place to look at support and training for the staff. This meant that people were supported in their role.

The service was meeting the requirements of the Mental Capacity Act 2005. We asked staff on the day of the inspection there understanding of the Mental Capacity Act 2005, all the staff we spoke with said they would always assume people have capacity first. One staff member said” if I had a concern around someone’s capacity then I would speak to my manager straight away. “Staff understood how to help people make day-to-day decisions and were aware of their responsibilities under the Mental Capacity Act (2005).

Medicines were administered to people by trained staff and people received their prescribed medication when they needed it.

We spoke to four people who received care/support from Outreach Office, three relatives and three staff. The people we spoke with all said that they felt safe in their home whilst care and support was provided.

People had care plans in place which were individual to their own needs. These included risk assessments around support and also involvement from outside professionals.

Records we looked at and in our discussions with staff we found staff received regular training and were knowledgeable about their roles and responsibilities. They had the skills, knowledge and experience required to support people with their care and support needs.

People told us they were supported to eat and drink. Staff supported them to healthcare appointments when requested and provided personal care as required to meet people’s needs.

There were effective systems in place to monitor the quality of the service.

Outreach Office had a complaints procedure in place. People who used the service and staff knew how to complain. Complaints and compliments were dealt with in accordance with the agency policy.

There was an accident and incident file in place. Accidents had been recorded and actioned by the registered manager.

We spoke with five people who used the service. They told us they had been involved in making decisions about their care and were given opportunities to talk about how they wanted their care delivered. Comments included:

“Oh yes, they always ask, never just assume.”

“I am asked each time they come in what I want and can they do anything else for me.”

People told us they were happy with the care provided. One person said’ “I feel safe; they are always looking out for me.” Another said, “Everything is done with such thought for dignity.”

Appropriate arrangements were in place in relation to management of medicines. People we spoke with said they received their medication on time and when they needed it.

We found people were supported by sufficient numbers of qualified, skilled and experienced staff which met people’s needs. People we spoke with told us there were enough staff and their needs were met well.

There was an effective complaints system available and people who used the service knew how to use it if they needed it.

We spoke with four people who used the service or were representatives of people who used the service. They told us they were very satisfied with the care and support received. Their comments included:

“They are kindness itself, very polite and caring.”

“I feel very involved in Mum’s care, always able to comment and add to the care plans.”

“Standards of personal care are very good, Mum always looks so well cared for when we visit.”

“They treat me very well, make sure I get my pills on time, get me the doctor if I am not well.”

People who used the service or their representatives had no concerns over the safety of themselves or their family member. They said they felt they were “In safe and caring hands.”

People who used the service said staff were knowledgeable regarding their support needs. They spoke highly of the staff and said they were treated well. Their comments included:

“Staff seem very well trained.”

“Staff treat us very well.”

Staff and people who used the service said they felt the service was well managed and the manager was approachable and enthusiastic. They said they had confidence in the manager and that any issues brought to her attention were always dealt with properly and thoroughly.