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Inspection carried out on 2 May 2018

During a routine inspection

Horizons is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

This unannounced comprehensive inspection took place on 2 and 3 May 2018.

Horizons are registered to provide accommodation and personal care for up to 13 people. At the time of the inspection nine people were living at the home.

The home 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.’

People told us they felt safe with the staff and living at the home. There were clear systems in place to safeguard people from the risk of harm. Staff had completed training in safeguarding people and spoke knowledgeably about how to raise concerns if they suspected people were being abused. The registered manager had raised safeguarding concerns to the relevant authorities when necessary.

People’s needs were assessed and planned for. People were provided with care and support that took into account their personal wishes and preferences. People had good access to healthcare and staff referred people appropriately to health care professionals. Health professionals supplied positive written feedback on the service people received at horizons.

The provider had an established system for ensuring people were recruited to work in the service safely. Recruitment systems were robust and staff were trained to ensure they could care and support people safely and consistently. There were enough appropriately trained staff available on each shift to ensure people were cared for safely. Staff received appropriate training which was refreshed at regular intervals. Staff told us they felt well supported by the management team.

People’s medicines were managed safely and administered as prescribed.

People’s rights were protected because staff acted in accordance with the Mental Capacity Act 2005 (MCA). Staff ensured decisions were made in people’s best interests and followed any conditions placed on their Deprivation of Liberty Safeguards.

People told us they enjoyed living at Horizons and said the staff were friendly, caring and treated them with kindness and patience. Relatives were very happy with the care and service provided by the home. Staff knew people very well and cared for them in the way they preferred. Staff knew what was important to people and supported them as individuals.

People were supported to take part in a range of activities and hobbies they enjoyed. People said they really enjoyed taking part in their voluntary work and attending their college courses. People were supported to remain as independent as possible to ensure their health and well being was maintained or improved.

People were provided with a choice of healthy home cooked food and drink that ensured their nutritional needs were met. People told us they enjoyed the food and they could choose what they wanted to eat if they wanted something different to the menu. People enjoyed observing the staff preparing and cooking the meals and taking in the atmosphere of the kitchen.

People told us they knew how to make a complaint and said staff listened to them and took action if they needed to raise concerns or queries. Records showed complaints were investigated in accordance with the provider’s complaint policy.

People, relatives and staff told us they felt the service was well led, with a clear management structure in place. There were governance systems in place to assess and improve the quality and safety of the service and to ensure people were supported in a safe, effective and caring way.

Inspection carried out on 1 February 2016

During a routine inspection

This inspection took place on 1 and 4 February 2016 and was unannounced. One inspector visited the service on both days and was supported by a specialist occupational therapy advisor on one of the days. Horizons are registered to provide accommodation and personal care for nine people. At the time of the inspection there were six people living permanently at the home. Horizons also provided a respite service. There was a registered manager at the home at the time of the inspection. 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.

People told us they felt safe living at the home. Staff spoke knowledgably on how to prevent, identify and report abuse and the provider had a system in place to protect people from the risk of harm. There was one occasion where the manager had not notified the commission of a safeguarding alert they had made to the local authority. This was an area of improvement for the home.

People’s needs were assessed and they were involved in planning and reviewing their care needs. Staff supported people in accordance with their wishes, protecting people’s privacy and maintaining their dignity.

People said they had enough to do and didn’t get bored. Staff ensured the environment was suitable and promoted people’s independence by supporting them to decide what they wanted or needed to do, and asking them what they needed help with.

There were robust recruitment systems in place and staff were trained to make sure they understood how best to support or help people. Staff told us they were well supported and found supervision and appraisals helped them to understand their role.

People told us they felt the service was well led and that they were listened to. There were systems in place to monitor and improve the quality of the service provided and staff said they felt people received a high quality of service.

Inspection carried out on 13, 14 November 2013

During a themed inspection looking at Children's Services

As part of this unannounced inspection we spoke with three people. One person we spoke with told us they liked living at the unit, they said, �I get more freedom�.

Another person smiled and gave the �thumbs up� sign when we asked them about the quality of care, staff and activities.

We spoke with six members of staff including the manager. Staff spoke positively about the unit. One told us, �It�s a privilege to work here, the young people are amazing�.

People�s views and experiences were taken into account in the way the service was provided and delivered in relation to their care.

People experienced care, treatment and support that met their needs and protected their rights. We observed that staff supported people in an attentive and dignified way.

People�s health, safety and welfare was protected when more than one provider was involved in their care and treatment, or when they moved between different services. This was because the provider worked in co-operation with others.

People who use the service were protected from the risk of abuse because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening.

People were cared for, or supported by, suitably qualified, skilled and experienced staff.

The provider had an effective system in place to monitor the quality of the service and to manage risks to people�s health, safety and welfare.