Care Outlook (Brighton and Hove) was rated Requires Improvement overall following a focused inspection in May 2021, with breaches of Regulation 9 (person-centred care) and Regulation 17 (good governance) identified. Key failures centred on unpredictable and late care visits in mid-Sussex, care plans not reflecting actual delivery, and insufficient incident monitoring and oversight systems.
Concerns (7)
criticalMissed or late visits: “The morning call can be as early as 7:30am and as late as 10:45am. It is difficult to plan the day, very unsettling.”
criticalPerson-centred care
: “The provider had failed to ensure that people received care that was appropriate, met their needs and reflected their preferences. This is a breach of regulation 9.”
criticalGovernance: “The provider had not ensured they had effective systems and processes in place to assess and monitor the quality of their service. This is a breach of regulation 17.”
moderateIncident learning: “We could not see evidence of what further action had been considered or taken place subsequently to mitigate the risk of re-occurrence and keep people safe.”
moderateCare planning: “Information in people's care plans in respect to their preferences around call timings and tasks did not match the care that was scheduled and delivered.”
moderateLeadership: “The service had been without a manager registered with the CQC since January 2020... a significant amount of time had passed without the provider meeting this condition.”
minorCommunication with families: “A carer told me that [my relative's] hours have been cut... It was wrong that the carers told me and not the management.”
Strengths
· Medicines were managed appropriately; MAR audits undertaken and errors investigated.
· Staff followed infection prevention and control procedures effectively, using PPE correctly.
· Detailed risk assessments identified hazards and guided staff to reduce or eliminate risks.
· Staff recruitment had improved since last inspection, with employment histories and references checked appropriately.
· Staff felt supported in their roles and demonstrated good understanding of safeguarding.
Quality-Statement breakdown (14)
safe: Staffing and recruitmentRequires improvement
safe: Learning lessons when things go wrongRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Assessing risk, safety monitoring and managementGood
responsive: Planning personalised care to ensure people have choice and controlRequires improvement
responsive: Improving care quality in response to complaints or concernsGood
responsive: Meeting people's communication needsGood
responsive: End of life care and supportGood
well-led: Managers and staff clear about roles; quality performance and governanceRequires improvement
well-led: Engaging and involving people using the serviceRequires improvement
well-led: Continuous learning and improving careGood
well-led: Working in partnership with others; duty of candourGood
Care Outlook (Brighton and Hove) is a domiciliary care agency rated overall Good at this inspection, with four of five key questions rated Good. The sole area requiring improvement relates to recruitment procedures, where verbal references were accepted before written references were received, contrary to the provider's own policy.
Concerns (1)
moderateOther: “for some staff verbal references had been accepted so a new care worker could start work in advance of the written reference being received. This is an area in need of improvement.”
Strengths
· People and relatives consistently reported feeling safe and well-supported by kind, caring staff
· Comprehensive, personalised care and support plans regularly reviewed and updated with people's involvement
· Staff well-trained with ongoing supervision, appraisals, and support for professional qualifications
· Effective risk assessment processes with staff actively contributing to identifying and updating risks
· Strong leadership with approachable registered manager, clear management structure, and regular internal audits
Care Outlook (Brighton and Hove) was rated overall Good following its July 2015 announced inspection, with care that was largely safe, effective, caring, responsive and well-led. The Safe domain was rated Requires improvement due to incomplete recruitment record-keeping around work history gaps and staff accessing outdated policies and safeguarding guidance, though neither constituted a regulatory breach.
Concerns (3)
moderateRecord keeping: “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.”
minorGovernance: “A number of the policies being referenced in the agency were not the most up-to-date.”
minorSafeguarding: “There were clear systems on protecting people from abuse. Senior staff told us they were aware of and followed the local multi-agency policies... However, staff did not have access to the most recent guidance.”
Strengths
· People and relatives consistently reported feeling safe with care staff, with strong continuity of carer allocation.
· Medicines were managed safely with robust auditing and feedback processes.
· Care staff demonstrated compassion, kindness and respect, preserving privacy and dignity during personal care.
· Detailed, personalised care plans were in place and regularly reviewed with involvement of people using the service.
· Strong leadership with approachable management, regular supervision, spot checks, and staff meetings driving quality improvement.
Quality-Statement breakdown (14)
safe: Recruitment practicesRequires improvement
safe: Policies and procedures currencyRequires improvement