Care Horizons Limited

Updated 13 June 2023

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 carried out by one inspector.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.

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 5 April 2023 and ended on 13 April 2023. We visited the location’s office/service on 12 and 13 April 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. 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 all this information to plan our inspection.

During the inspection

We spoke with 1 person receiving a service and 2 relatives about their experience of the care provided. We spoke with 3 team leaders, 2 care workers, the deputy manager and the registered manager. We sought feedback from 3 health and social care professional about their experience of working with Care Horizons.

We reviewed a range of records. This included 2 people’s care records. We looked at 5 staff files in relation to recruitment, training and staff supervision. A variety of records relating to the management of the service.

Updated 13 June 2023

Care Horizons Limited is a domiciliary care agency providing personal care to people in their own homes. At the time of our inspection there were 25 people using the service. Only 2 people were receiving support with personal care.

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.

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. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

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

Right Support:

People received the support they needed to keep them safe from risk of harm and meet their needs. Staff understood their responsibilities in respect of safeguarding. Procedures were in place to protect people from potential abuse and harm. People were supported to take their medicines safely.

People were supported to have maximum choice and control of their lives and staff them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Right Care:

Staff recruitment required improvement. We found the provider had not always followed safe recruitment procedures, which included reviewing past work history. Not all staff had completed an application form. We found no evidence that people had been harmed.

There were sufficient staff to support people with their care and support needs. Recruitment was ongoing and no new packages of care would be commissioned unless sufficient staff were available to support the person.

People had individual plans of care based on their needs and wishes. These were reviewed with the person to ensure the care was appropriate. Staff provided personalised care and support, enabling people to continue to live in their own homes. Relatives spoke positively about the support that was being provided.

Right Culture:

The governance systems in place did not always ensure all documentation was in one central place to demonstrate staff had been recruited safely. Where audits had been completed it was not clear what had been checked and what action had been taken to address the gaps or missing documentation in respect of staff recruitment.

The provider promoted a positive culture, staff felt supported and there was evidence of regular communication with staff, people, and their relatives. Staff spoke positively about the support from the management team.

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

Rating at last inspection and update

The last rating for this service was good (published 8 August 2018).

Why we inspected

We undertook this focused inspection due to the length of time since the last inspection. This report only covers our findings in relation to the Key Questions Safe and Well-led.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good based on the findings of this inspection. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. Please see the safe and well led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Care Horizons Limited on our website at www.cqc.org.uk.

Enforcement and Recommendations

We recommend the provider reviews their processes for the oversight of records relating to the safe recruitment of staff.

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.