Horizon Homecare (Southern) Ltd

Updated 11 November 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 two inspectors and three Experts by Experience who made calls to people using the service and their relatives. 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 is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 48 hours’ 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.

Inspection activity started on 13 October 2022 and ended on 19 October 2022. We visited the location’s office on 13 and 19 October 2022.

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 safeguarding teams. 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 21 people who used the service and nine relatives about their experience of the care provided. We spoke with and received feedback from 19 members of staff including the registered manager and deputy manager.

We reviewed a range of records. This included 20 people's care records and 10 medication records. We looked at four staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 11 November 2022

About the service

Horizon Homecare (Southern) Ltd is a domiciliary care service providing a regulated activity of personal care. The service was providing care and support to people in their own homes. 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. At the time of our inspection there were 217 people receiving personal care from the service.

People’s experience of using this service and what we found

Significant improvements had been made within the service. Systems and processes had been introduced and existing ones strengthened to ensure safety, quality and oversight. Improvement work was ongoing, and some systems needed to embed through the service.

People and their relatives told us Horizon Homecare (Southern) Ltd was a safe service. Staff told us overwhelmingly that improvements had been made to all aspects of the service especially in the past six months and they had confidence in the management team.

Medicines were managed safely, and people received their medicines as prescribed. Recording and staff training around medicines safety was improved. People’s risks had been identified, assessed and steps taken to mitigate harm. Staff knew people well. Work to improve the detail and quality of assessments was ongoing.

The service had reduced its care hours to ensure it had enough staff to complete visits to people safely. The introduction of an impact risk assessment, which was completed before a decision was made whether to accept or decline a new person to the service, meant this was only done when safe. A detailed pre assessment was completed for each person prior to the service starting and this ensured the service could meet their needs. Staff were safely recruited and there were many new roles introduced to strengthen the service and improve safety. Infection prevention and control procedures were clear, and staff followed them.

Improved staff compliance with the electronic care planning system meant that management staff had better oversight and information about people’s care and support needs were up to date. Frequent spot checks and supportive supervisions were held to maintain quality of service. Staff told us they felt supported and had access to a wide range of training and guidance in order for them to carry out their role well. The service was supported by a reliable out of hour on call service, staff told us this was an improvement in the past few months.

Where people were supported with food and drink this was done as planned and detailed records meant intake could be monitored where necessary. People had access to healthcare services as required and the service worked well with external professionals. People knew how to make a complaint and records showed complaints and concerns were dealt with.

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 received training in the Mental Capacity Act 2005 (MCA) and understood the importance of gaining consent before supporting people. People’s communication needs were known and recorded in their care plans. Care plans were detailed, person centred and in line with their specific individual health needs.

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. We considered this guidance as there were people using the service who have a learning disability and or who are autistic. We found that Horizon Homecare (Southern) Ltd was working within the principles of, ‘Right support, right care, right culture.’

Governance systems had been established and were operating effectively and the service was working on ensuring the improvements were embedded. People, relatives and staff knew the registered manager and felt confident any concerns raised would be dealt with. Staff were clear on their role and responsibilities. The registered manager kept themselves up to date and had a clear plan for the service. People had been asked for their input and feedback on the service.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was inadequate (published 29 March 2022) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

This service has been in Special Measures since 29 March 2022. During this inspection the provider demonstrated that improvements have been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.