Archived: New Horizon Gloucester Limited

New Horizon Gloucester Limited is a domiciliary care agency providing care and support for two people in their own homes.

New Horizon Gloucester Limited had a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Risks to people’s safety were identified, assessed and appropriate action taken. People’s medicines were safely managed. There were sufficient staff for people’s needs recruited using robust procedures. People were provided with individualised care and support by staff that knew their needs well.

People were treated with kindness, their privacy and dignity was respected and they were supported to develop their independence and keep in contact with relatives. People were involved in the planning and review of their care and were supported to engage in activities or their choice.

Staff received support to develop knowledge and skills for their role and were positive about their work with people. The registered manager was accessible to people using the service and staff. There were improvements to systems to check the quality of the service provided including questionnaires for people using the service, their representatives and staff.

We reviewed the medication record keeping in place and found it had been improved. The information about medication available to staff was also more comprehensive. Other concerns, such as medication being locked away without consent had been addressed. Staff had also received an assessment of competency around medication administration.

One person told us 'staff know the routine I like'. They were happy that they 'got out and about enough'. We observed the member of staff supporting them engaging in conversation that was not limited to the person's immediate care needs.

Another person was less happy about the support they received. Their needs were complex and advice from professionals outside the service was being sought to guide the support they received.

Staff had received appropriate training, including safeguarding training. Both of the staff that we spoke with felt well supported and well trained. Staff were able to respond appropriately to questions about safeguarding and medication administration. Staff had not had their competency to administer medication assessed.

Daily records and records of medication administered were now being kept. There were some minor inconsistencies around the recording of medication but these were being addressed by the manager. The care plans and risk assessments in place were current, detailed and person centred.

The manager was monitoring the quality of the service by tracking complaints and incidents. There was evidence that actions were taken in response to complaints or untoward events.

Record keeping across the service was not good. Care records were not updated, daily care records and medication records were not completed, records of complaints were not made formally and records of learning from incidents were not produced.

We spoke with both people using the service. They felt involved in their care and were happy with the care being provided. We did find, however, that the needs of one person were potentially not being fully met. Staff were aware of this but the issues had not been adequately addressed.

We saw that complaints were not being fully tackled and recorded. The same problem existed around learning from incidents. This meant that unnecessary risks to people using the service were not being identified and managed. The views of vulnerable people were not being adequately listened to.

Although staff felt that training was good, training records were not accurate. It was not possible to identify which staff had received training and when this was due for renewal. This put people at risk of receiving care from staff without appropriate training. Staff knowledge of safeguarding procedures was not satisfactory.