13 October 2022
During a routine inspection
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.