We carried out a review of the data available to us about New Horizons Broad Oak Limited on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about New Horizons Broad Oak Limited, you can give feedback on this service.
New Horizons Broad Oak Limited is a domiciliary care agency. The service provides support to adults who have a learning disability, physical disabilities, autism and other complex needs.
Care is provided in people’s own homes, at the New Horizons Resource centre, the New Horizons respite Caravan in Seasalter and in the community. People receive care on a one to one basis, unless additional staffing needs are identified.
Not everyone who used the service received personal care. The Care Quality Commission (CQC) only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of the inspection, the service supported 31 people, 19 of whom required support with their personal care.
People's experience of using this service and what we found
People were unable to tell us about the service they received so we spoke with their relatives. Feedback from relatives was positive. They were complementary of the service commenting on the compassion and dedication of the staff and registered manager. One relative commented, “I don’t know what we would do without them. I can’t praise them enough, particularly their support through the lockdown."
People received safe care and support, their relatives were confident staff understood people’s individual needs well and associated risks. Care plans contained detailed risk assessments, which reduced identified health risks together with any environmental risks to people and staff.
Medicines were safely managed and administered. Although we asked the registered manager to review the storage of medicines and arrange refresher training for some staff about how to administer a specific medicine.
Robust recruitment processes were in place. This prevented unsuitable staff from working with people. Staff were skilled in carrying out their role, most had completed vocational diplomas in addition to mandatory training.
The staff team worked in partnership with relatives. This ensured people received everyday support for their care and health needs, together with support to attend health care appointments.
The registered manager and staff we spoke with knew what their responsibilities were about keeping people safe from the risk of abuse. Spot checks, home visits and relatives’ feedback requests ensured continuous oversight so that people and staff were safe.
Staff were caring and always protected people’s dignity and independence both within their homes and in the community. Staff had the information they needed to support people to make choices and recognised that people had the right to make their own decisions.
Staff and relatives told us continuity of staff was good and they always knew in advance who was coming to support them. Relatives confirmed staff always arrived when expected and they had never been let down by missed calls. Relatives were confident about raising concerns or complaints but had not had the need to do so.
We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.
The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.
Right support:
• The model of care maximises people’s choice, control and independence
Right care:
• Care is person-centred and promotes people’s dignity, privacy and human rights
Right culture:
• The ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People’s needs were assessed prior to receiving support including their protected characteristics under the Equalities Act.
The service had an effective system in place to assess, monitor and improve the quality and safety of the services provided. Appropriate action was taken to monitor accidents and incidents; the rate of which were very low. There was a process to gain feedback from people, their relatives and staff and to use this to improve people's experience of the service.
The registered manager was also a joint provider of the service and understood their responsibility to operate the service in line with their regulatory responsibilities.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (published 11 October 2019).
Why we inspected
We undertook this inspection as part of a random selection of services rated Good and Outstanding to test the reliability of our new monitoring approach. We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
New Horizons Broad Oak Limited is a domiciliary care agency. The service provides family support and individualised personal care to mostly younger people with complex learning disability needs. This is provided in their own homes, at New Horizons Resource centre, at New Horizons Caravan in Seasalter and in the community. Care is provided on a one to one basis unless additional staffing is identified. People are also supported to enjoy respite breaks away from home. The service supported nine people that required support with their personal care on a regular basis and a further two people when they were supported in respite.
Not everyone who used the service received personal care. The Care Quality Commission (CQC) only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People's experience of using this service and what we found
People were unable to tell us about the service they received so we spoke with their relatives. Relatives universally told us that they thought their loved ones were safe in the care of service. They spoke positively of the dedication, kindness and caring attitudes shown by of the registered manager and staff to the people they supported and to relatives.
Staff understood people’s individual needs well and associated risks they may be subject to. They worked in partnership with relatives to ensure people received the everyday support for their care and health needs they required. Relatives referred to their relationship with staff as being 'part of a team'.
Relatives said staff treated people with respect and managed their personal care in a manner that protected their dignity even when out in the community.
Relatives were consulted about their family members care and the records the service maintained of peoples support needs were discussed with them. Records viewed reflected the needs people had regarding their personal care, socialisation, health and behaviours that needed to be considered. People were provided with care tailored to their individual day to day needs and delivered in accordance with current good practice.
People were asked for their consent to the support staff provided them with. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Risks people may experience were assessed and reviewed to ensure they remained safe and free from harm.
Relatives told us that staff supported them to attend health care appointments with their loved one where necessary. People were supported to expand their experiences in the community, participating in a range of activities that staff monitored to ensure they continued to enjoy them.
Relatives told us they were confident of raising any concerns or complaints to the registered manager and that these would be investigated and acted upon immediately.
Staff and relatives told us that good continuity of staff was maintained and people were never let down by staff not turning up. Relatives told us that staff had the right skills and staff told us they received the right training and support to carry out their role.
The registered manager was a visible and hands on manager who had a finger on the pulse of the service. Systems were in place to support them to monitor the service and the delivery of care and support. Staff spoke positively about working in the service, they thought there was good communication and team support. Staff thought the registered manager was a good inspirational leader who set the bar high for them.
The registered manager and staff took appropriate action in regard to accidents, incidents, complaints and feedback from people to learn from these and improve people's experiences of support from the service.
The registered manager was also a joint provider of the service and understood their responsibility to operate the service in line with their regulatory responsibilities.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection: The last rating for this service was Good (published January 2017).
Why we inspected
This was a planned comprehensive inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
New Horizons provides family support and individual personal care to people in their home environment and on a one to one basis in the community. On the day of our inspection eight people were receiving personal care.
There was a registered manager in post who was also one of the providers. 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 were kept safe from harm because staff understood their responsibility to protect them from abuse and poor care. People’s risks were assessed and staff were provided with management plans to support people in the least restrictive manner. Staff maintained a consistent approach to support people when they became anxious or presented with behaviours that challenged their safety. There were processes in place to ensure staff were suitable to work with people in a caring environment. The provider maintained a flexible approach to staffing to support people and their families.
People received their medicines and staff had recorded them accurately. Staff understood the importance of supporting people to make choices for themselves and recognised how they expressed themselves. Staff provided people with food and drink which met their needs. People were supported to maintain their mental, physical and psychological wellbeing.
Staff developed kind, caring and considerate relationships with people which recognised their independence and promoted their dignity and respect. People and their relatives were supported to maintain their relationships.
Staff provided personalised care which reflected people’s likes and dislikes because they knew them well. People were encouraged to try new activities and staff recorded what they did or did not enjoy to ensure what they did met their preferences.
Relatives were asked for their views on the service, supported to raise concerns and felt they were listened to by a provider who cared for them. Staff were provided with information about people and supported to raise queries. There were processes in place to ensure the service improved when shortfalls were identified. The registered manager understood the requirements of their role.
People's relatives told us that they had been involved in planning their relatives care and had given their consent for the support provided. One person commented, 'We have used New Horizons for a long time. We met and discussed what support was needed and it is reviewed every so often'.
We saw that support plans which were personalised, regularly reviewed for their effectiveness and kept up to date to reflect the changing needs of the people using the service. People told us that the care and support needed was reviewed regularly to assess people's changing needs.
The provider had effective recruitment and selection procedures in place and carried out relevant checks on staff. Staff were supported to deliver care and support safely and to an appropriate standard through training and one to one supervision.
People told us that they had been asked for feedback on the service they received at their reviews and we saw that surveys were carried out. People said that they felt confident that they would be listened to if they raised an issue and that it would be acted on. One person told us, 'I would phone the manager if there was a problem. I know they would deal with it straight away'.