The Horizon (New) Ltd

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. This is the first assessment for this newly registered service. This key question has been rated good. This meant people were safe and protected from avoidable harm.

This service scored 78 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. For example, an incident record highlighted the requirement to review the way 1 person was supported in respect of their independence. The record required more detail about how learning was shared with staff and how the provider monitored learning had been embedded into practice. The registered manager and staff told us information on safety and good practice was discussed and shared during team meetings. A member of staff told us, “She is good at listening. She always makes sure there is enough staff or if we report something that needs to be fixed at the house or a lightbulb blows out, she will make sure it is replaced.”

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

The provider had a robust assessment process. Staff assessed people’s needs before they started to use the service. This helped to ensure the provider had information to enable them to meet people’s needs. The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed and monitored. They made sure there was continuity of care, including when people moved between different services. Records detailed a variety of external health and social care professionals had frequently been involved or consulted with during care reviews and health matters. One professional said, “The staff follow instructions and guidance, and they worked consistently to help stabilise [Person’s] placement.” People and their relatives were involved in the assessment process. A relative said, “My opinion around [Person’s] care is sought and considered”.

The provider worked well with people and healthcare partners to fully understand what being safe meant to them and the best way to achieve that. Staff had a clear focus on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse,discrimination, avoidable harm and neglect.

The provider always shared concerns quickly and appropriately. A health and social care professional told us, “.They involve us promptly to ensure people are protected. ”Staff confirmed they knew what to do in the event of an allegation of abuse being made. All staff completed safeguarding training, which was refreshed annually. Staff were aware of the reporting process for allegations of abuse. Policies and procedures guided staff on what to do if an allegation of abuse was made and how staff could raise concerns using the whistleblowing policy.

The provider always worked well with people to fully understand and manage risks by thinking holistically. Staff provided care that fully met people’s needs and was safe, supportive and enabled people to do the things that mattered to them.

Staff assessed risks and care plans provided guidance to staff on how to mitigate these. The registered manager and the deputy manager reviewed care plans and risk assessments to ensure they were reflective of the care and support staff provided. Risk assessments relating to medicines and health needs, mobility, swallowing risks and financial safety contained detail to guide staff and keep people safe. Where people had medical conditions which needed monitoring, there was clear guidance for staff enabling them to look out for any changes in people’s presentation.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The registered manager and the deputy manager assessed environmental risks and identified risks were handed over between staff and the management team. Staff had access to the information they needed to deliver safe care. The deputy manager told us about their electronic check in and out system to ensure staff were safe and people received calls in a timely manner. Office staff conducted routine spot checks to confirm staff competence in maintaining a safe environment, evaluate risks and identify any emerging needs in individuals or their surroundings.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

The provider safely recruited staff, and relevant checks were carried out before new staff started working at the service. This included criminal record and employment checks to confirm staff were suitable to care for vulnerable people. However, we found some staff recruitment records contained gaps between periods of employment which had not been documented. We raised this with the registered manager; they told us they would address these points in any future recruitment.

All new staff members completed an induction that included shadowing more experienced staff. Staff received regular training in line with their job role, formal competency checks, and they were provided with additional information via staff meetings and supervision.The registered manager monitored ongoing staff training compliance.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

The provider had appropriate policies and procedures to prevent and control any infection risks. These reflected national guidance. Staff were aware of good hygiene protocols. They told us they had received training in this area and regular ‘spot checks’ to ensure they were using personal protective equipment (PPE) correctly.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in their medicines planning, including when changes happened. Staff managed medicine administration safely, and records were up to date and accurate.Care plans included the support people needed with their medicines.

Staff used an electronic recording system for medicine administration. This meant the office staff could monitor this in real time and follow up any missed medicines promptly. Staff completed medication training, and the management team assessed their competency to ensure they understood how to administer medicines safely. Staff promptly reported any changes to people’s medicines to the registered manager and deputy manager.