New Horizon Care

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. At our last assessment we rated this key question good. At this assessment the rating remains good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. The registered manager told us people’s needs were assessed when they started to use the service, and these were used to inform care plans and risk assessments. The assessments were undertaken with input from the person and their representatives, where appropriate. A person told us, “I did help write the care plan; the staff write information on their iPad.” Where people were unable to contribute to detailed planning, relatives confirmed they had been involved and consulted alongside health and social care professionals involved in the person’s care. A relative told us, “There was an assessment and there is a care plan. Staff call me very month and run through everything, like medication, to make sure it is up to date.” People’s care plans included assessments of their needs, wishes and aspirations to ensure the service was able to meet these. Staff developed support plans with people which focused on what was important to them and goals they wanted to achieve

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. Where required, staff completed specialist training to meet people’s needs. This included supporting people with autism, a learning disability and epilepsy. People and their representatives, where appropriate, were involved in the planning of their care. The clinical lead ensured delegated healthcare tasks were undertaken in line with best practice. People’s records included the support they required with their food and drink. Most people were happy with the support they received. A relative told us, “Staff do [Name’s] breakfast and a sandwich at lunch and in the evening, they put a microwave meal in for [Name].” A second relative described how managers had acted on concerns they had around staff support with meals. They told us, “Staff didn’t know what they were cooking or making. They put salad with gravy and salad with cheesecake. One of the staff goes shopping with [Name] now and the food preparation does look better."

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. Staff worked collaboratively with other professionals to ensure people received coordinated and safe care. They described regular interaction with external agencies, including GPs, community nurses, physiotherapists, district nurses and social workers. Records showed where staff had concerns, they escalate this to appropriate agencies.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support. Relatives described positive communication with staff when incidents or changes in needs occurred. For example, staff consulted with relatives to mitigate the risk of falls and injuries for people. A relative told us, “Staff always report if [Name] says they have fallen, even though there is no evidence they have. They let me know straight away to monitor things.” Staff had recorded information about people’s healthcare needs in assessments and care plans. There was guidance and information for staff about how these needs should be monitored and met. People and relatives told us staff supported them to access external healthcare services, including routine healthcare and specialist services. A relative told us, “[Name] has their observations done with every shift so we can monitor them as they are non-verbal. Staff come straight to me if there is a change in anything.”

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves. People’s care plans included clear objectives and desired outcomes they wanted from their care. For example, one person had identified an outcome that they wanted to go out into the local community and develop their social skills and confidence. Their care plan showed staff regularly supported them to do this. Staff maintained daily records which monitored people’s health, wellbeing and achievements; though we found records were not completed to a consistent standard. The registered manager was aware of this and was working with staff to embed improvements.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. People consented to their care and treatment. They confirmed they were offered choices; these were respected and clearly documented in their care plans. People were asked to agree and consent to care plans. The registered manager was in the process of transferring paper copies of mental capacity assessments into electronic care plans so these were easily accessible for staff. Some people lacked the mental capacity to make certain decisions about their care. The registered manager assessed these and consulted with people’s representatives and followed legal requirements to help ensure decisions were made in their best interests. Staff were able to describe how they supported people to make choices and decisions where they were unable to clearly communicate these. For example, through visual cues or key words. A staff member told us, “When someone is having food and they are non-verbal, we might need to give support with eating, if I see them pushing the plate away, I might try again, but if they push it away 2 or 3 more times, it might mean at the minute they don’t feel like eating, I then record and report to my superiors or give a few minutes and try again. They cannot tell me they don’t want to eat, but their action will tell you. Maybe if it continues and they don’t need to eat you might need to get medical attention. Their actual behaviours are a form of communication.” These practices demonstrated that staff understood and applied consent principles in daily care.