Horizons Care Limited

Updated 18 November 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection was completed by 1 inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 7 November 2022 and ended on 10 November 2022. We visited the location’s office/service on 7 November 2022.

What we did before inspection

We reviewed information we had received about the service since they registered with CQC. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used information gathered as part of monitoring activity that took place on 19 October 2022 to help plan the inspection and inform our judgements.

During the inspection

We spoke with 1 person who used the service and gained feedback from 4 relatives about their experience of the care provided. We spoke with 5 members of staff including the registered manager and care workers.

We reviewed a range of records. This included 2 people’s care records and medication records. We looked at 2 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

Updated 18 November 2022

About the service

Horizons Care Limited is a domiciliary care agency. They provide personal care to people living in their own homes. Not everyone who used the service received personal care. 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 3 people were receiving personal care.

People’s experience of using this service and what we found

Risks to people had not always been assessed or mitigating strategies recorded. However, people told us they felt safe with the support they received.

Medicine management required improvement to ensure people received medicines as prescribed.

Oversight of the service required improvement. We found no evidence of systems and processes being in place to audit records or check all information was up to date, factual and relevant.

People’s needs were assessed before they started to use the service. Care plans held information regarding people’s needs, likes and dislikes. However, care plans required more person centred information within them to support new staff to understand and get to know people and their needs.

People were supported by staff who knew them well and were kind and caring. Staff received training to ensure they had the skills and knowledge to support people.

People were supported with any communication needs they have. Care plans included how a person communicated and any aids that were required to facilitate effective communication.

People were protected against abuse. Policies and procedures were in place and staff were trained and understood how to recognise and report any potential abuse. Injuries were recorded and actions taken when appropriate.

Staff felt supported by the registered manager and were able to raise any concerns they may have. Staff told us the registered manager listened to them and they felt valued at work.

People had their health needs met as required. Staff supported people to access health appointments or shared information with their relatives for them to arrange any appointments or referrals, when appropriate.

People and relatives were positive about staff that supported them and regarding the management of the service

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. Policies and systems in the service supported this practice.

Staff worked well with professionals from other agencies such as other care agencies, district nurses, speech and language therapists and GP’s.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service was registered with us on 5 August 2019 and this is the first inspection.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to risk assessment, medicine management and oversight of the service at this inspection.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.