The Horizon (New) Ltd

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management andgovernance assured high-quality, person-centred care; supported learning and innovation; andpromoted an open, fair culture.This is the first assessment for this newly registered service. This key question has been ratedgood. This meant the service was consistently managed and well-led. Leaders and the culturethey created promoted high-quality, person-centred care.

This service scored 71 (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 shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

The registered manager was clear on what good quality care looked like. They knew about people's needs and preferences, and how to support staff to deliver care to people that was centred around their needs and preferences. They told us, “My role is to build a team of staff who are well trained, compassionate and who enable our clients to live their best life.”

The provider had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

The service had an established registered manager in post, and staff spoke positively of the support they received from management team. People and their relatives said they felt comfortable raising any concerns; Although governance systems were not always effective, the management team was open, honest, and responsive to feedback, taking prompt action to address the shortfalls identified during the assessment. The leadership team said they attended provider meetings with the local authority, which helped them stay informed about changes or requirements in legislation and health and social care guidance. Health professionals we contacted shared positive feedback about the leadership team. One health professional commented, “This is a very well run service, the team are approachable and respond efficiently. The service had processes to ensure staff met together to discuss relevant aspects of their roles through meetings and training.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.

Staff felt confident to speak up and raise any concerning information with the registered manager. The service had a whistleblowing policy. We found not all staff were aware of this policy, but all told us they would not hesitate in raising concerns to the registered manager. Some of the comments from the survey included, “Management is excellent” and “I receive plenty of support, tailored to my needs. We received mixed feedback on staff morale, while most felt senior management were fair, some staff felt team leaders were not pulling their weight, created a them and us environment. We discussed this with the registered manager; they told us they would work with the team and provide training to the leaders to enable them to be aware of their actions on team cohesion.

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

The provider had an up-to-date equality and diversity policy. Feedback from staff indicated they felt supported. We spoke to staff who had been promoted to leadership positions. One member of the senior management team said, “I’ve always felt supported by management, especially when I wanted to take on more responsibility.” The registered manager told us they have invited staff to express their interest if they wanted to champion in roles such as fire safety, infection prevention control or areas in medication review.Staff were offered regular supervisions and spot checks.

The provider did not always have clear responsibilities, roles, systems of accountability or good governance. They did not always act on the best information about risk, performance and outcomes, or share this securely with others when appropriate.

The service had a registered manager who had responsibility for the day to day running of the service. Despite the service having evidence of systems of oversight and governance systems, they were not always effective in identifying issues such as incomplete employment histories. Supervisions and appraisals occurred regularly however 1 staff member was missing from the matrix. Fluid monitoring was inconsistent, with electronic records lacking detail and hydration targets, though handwritten notes were more thorough. Additionally, there was limited documentation of mental capacity assessments, with 1 case not reviewed since 2021 and updates not recorded using the provider’s formal tools.

However, the service had security measures to ensure all electronic information was stored safely and securely. The provider submitted information to partner agencies when required.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement.

The provider worked in partnership with other agencies, and this ensured positive outcomes for people and improved care. Staff monitored people’s wellbeing and any emotional distress. This information was shared with healthcare professionals to support any changes to people’s support plans.

Agencies confirmed the provider worked with them and responded to any recommendations. The registered manager worked in partnership with their staff team and the people using the service, in planning and delivering care.

The registered manager knew who to contact if people required additional support from other healthcare professionals such as GPs, occupational therapists and social workers.

The provider focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and shared good practice at provider forums. The provider had implemented an electronic system to ensure staff log in and out at the appropriate time. Staff and people were receiving monthly rotas rather than weekly. This allowed both staff and people to plan their own activities in advance. The provider was considering initiating a scheme where all carers will be recognised for their hard work and effort.