Background to this inspection
Updated
20 November 2019
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 Care Act 2014.
Inspection team
The inspection was completed by one inspector.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service had a manager registered with the Care Quality Commission. 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.
Notice of inspection
We gave the service four days’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection. We also needed time to gain contact details and consent to speak with people and their relatives.
Inspection activity started on the 9th September 2019 and ended on the 11th September 2019 when we visited the office location.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with four people and six relatives about their experience of the care provided. We spoke with five members of staff including the nominated individual, the registered manager, senior care staff and care staff. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed a range of records including five people’s care records, medicine records and risk assessments. We also reviewed records relating to the management of the service including quality audits, accident and incident analysis, compliments and complaints files and staff meeting minutes. We looked at three staff files in relation to recruitment and staff supervision.
After the inspection
We spoke with one health and social care professional who regularly visit the service.
Updated
20 November 2019
About the service
Positive Horizons Ltd is a domiciliary care agency providing personal care to 65 people in their own homes at the time of the inspection. Not everyone who used the service received personal care. The Care Quality Commission (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.
People’s experience of using this service and what we found
Exceptional care was provided by all the staff and people spoke extremely highly of the care provided. The registered manager and provider were passionate about delivering an outstanding and high-quality service. People were cared for by compassionate staff who respected people’s privacy and dignity Promoting people’s independence was a high priority for all staff. A client welfare officer role had been introduced leading to improved communication with people. Systems ensured that people and their relatives were central to care planning and were partners in their own care.
The service was outstandingly well-led. The registered manager and provider led a positive culture of high quality, person-centred care and service improvement. The service worked in partnership with other agencies to lead by example in the area. People and staff felt involved in the service and feedback was consistently sought to drive quality. Staff wellbeing was considered a priority and the provider understood this enabled good quality care for people.
People were cared for in a safe manner. Staff were appropriately recruited and trained to enable safe care. There were enough staff to deliver care across the geographical area. Risks were managed and appropriately recorded. People received their medicines as prescribed and good infection control practice was in place. Lessons were consistently learnt when things went wrong.
People’s needs and choices were acknowledged and respected. Care was planned to ensure people’s needs were met in a person-centred manner. Staff were effectively trained in a wide range of topics. Staff worked closely with other healthcare professionals to ensure people were supported to live healthier and independent lives. People were supported to eat and drink enough.
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.
People's care and support was planned in partnership with them. Any concerns or complaints were addressed and followed up in an appropriate and respectful manner. People were supported to have a comfortable and dignified death when care was at the end of their lives.
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 this service was good (published 25 January 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.