We visited eight people in their homes to find out their views on the services they have received from Horizon Care Agency. We looked at the documents held in their homes that described their care needs and how they wanted to be assisted. We also saw the records completed by care workers after each visit that described the care they had provided.Most people told us they were generally happy with the service they received. They told us they liked most of the care workers and found they were usually friendly, kind and respectful. Comments included: 'the care workers are so good to me'.
However, we also found that, for most people, while they were generally satisfied with the care provided, there were also a number of things that could be better. We also found a number of areas where people had been placed at risk due to poor procedures followed by the agency.
Some of the people we met said they were satisfied with the times the care workers visited, and they had a regular team of care workers who knew them well and understood their care needs. However, some people told us they did not know who would be visiting, or at what times. They said it would be helpful if they could receive written notification to let them know who will be visiting them and on what day and time each week. Some people said that they became anxious if the care workers did not arrive at the right time. Comments included 'The care workers are late sometimes, maybe ten minutes over the half hour, and this makes me feel a bit down sometimes as I have to wait in bed remembering my late husband'. The agency told us that they usually ring people if the care worker has been delayed but some people said that care workers often did not arrive at the correct times. Comments included 'Care workers don't often ring if they are late so I just wait'.
We looked at the information held in each person's home about the assistance they needed from the care workers. We found that the agency had not drawn up their own care plan for each person. There were no lists of tasks that had been agreed with each person, or any explanation of how the person wanted the task to be carried out. Some people who had a regular team of care workers said that the care workers knew them well and understood how they wanted to be helped. However, some people told us about minor irritations when care workers didn't do certain things. An example of this was one person who said they were upset when care workers did not switch electrical appliances off after using them. The person said they did not want to have to tell every care worker on every visit the tasks they wanted carried out, or how the tasks should be completed.
Some people we visited had complex health and care needs, and for these people the lack of detailed care plans presented a significant risk. However, the agency told us that where people's needs were complex, or where they needed two care workers on each visit, new care workers would always be accompanied for the first visit by an experienced care worker who knew the person's care needs well.
Most of the people we visited said they knew the telephone number of the agency and would ring the agency if they had any concerns. However, one person told us they were unhappy with the service and did not know how to complain. The written information given to each person about how to complain, or who to contact, was incorrect. There was no explanation about the process the agency would follow if they received a complaint, or the timescales for response. One person told us they had been unhappy about the manner of one care worker. They told another care worker, who spoke to the manager and the care worker has not been sent again. However, when we asked the agency for evidence of any complaints they had received this matter had not been treated as a complaint, and therefore we could see no evidence of any investigation that had been carried out to find out what had happened and ensure it does not happen again.
Most people told us they were satisfied with the level of competency of the care workers. However, some people said some care workers appeared to be young and inexperienced, especially those who had recently been recruited. When we talked to the provider and looked at the training records we found that the level of training provided to some care workers was poor. The providers told us they were aware of the need to improve training and had already begun to look at training needs.