Archived: Positive Horizons Limited

Positive Horizons Ltd is a domiciliary care agency providing personal care to 65 people in their own homes at the time of the inspection. 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

Exceptional care was provided by all the staff and people spoke extremely highly of the care provided. The registered manager and provider were passionate about delivering an outstanding and high-quality service. People were cared for by compassionate staff who respected people’s privacy and dignity Promoting people’s independence was a high priority for all staff. A client welfare officer role had been introduced leading to improved communication with people. Systems ensured that people and their relatives were central to care planning and were partners in their own care.

The service was outstandingly well-led. The registered manager and provider led a positive culture of high quality, person-centred care and service improvement. The service worked in partnership with other agencies to lead by example in the area. People and staff felt involved in the service and feedback was consistently sought to drive quality. Staff wellbeing was considered a priority and the provider understood this enabled good quality care for people.

People were cared for in a safe manner. Staff were appropriately recruited and trained to enable safe care. There were enough staff to deliver care across the geographical area. Risks were managed and appropriately recorded. People received their medicines as prescribed and good infection control practice was in place. Lessons were consistently learnt when things went wrong.

People’s needs and choices were acknowledged and respected. Care was planned to ensure people’s needs were met in a person-centred manner. Staff were effectively trained in a wide range of topics. Staff worked closely with other healthcare professionals to ensure people were supported to live healthier and independent lives. People were supported to eat and drink enough.

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 care and support was planned in partnership with them. Any concerns or complaints were addressed and followed up in an appropriate and respectful manner. People were supported to have a comfortable and dignified death when care was at the end of their lives.

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 25 January 2017).

Why we inspected

This was a planned 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.

We carried out this inspection on 6 December 2016. It was an announced inspection, which meant the provider knew we would be visiting. This was because we wanted to make sure the registered manager, or someone who could act on their behalf, would be available to talk with us.

At our last inspection on 13 May 2013, we found the service was meeting all standards assessed. It was compliant with the regulations and no concerns were identified.

A registered manager was 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.

Staff were appropriately recruited, trained and supported. They had undergone a comprehensive induction programme and, where necessary, had received additional training specific to the needs of the people they were supporting. Communication was effective and regular meetings were held to discuss issues and share best practice. Staff understood their roles and responsibilities and spoke enthusiastically about the work they did and the people they cared for.

The provider had detailed policies and procedures relating to medicines management. Staff understanding and competency regarding the management of medicines was subject to regular monitoring checks and medicines training was updated appropriately.

Staff knew the people they were supporting and provided a personalised service and used effective systems for gaining consent. Individual care plans, based on a full assessment of need, were in place detailing how people wished to be supported. This helped ensure that personal care was provided in a structured and consistent manner. Risk assessments were also in place to effectively identify and manage potential risks.

Where people lacked the mental capacity to make decisions the home was guided by the principles of the Mental Capacity Act 2005 (MCA) to ensure any decisions were made in the person’s best interests.

Systems were in place to effectively monitor the safety and quality of the service and to gather the views and experiences of people and their relatives. The service was flexible and responded positively to people’s changing needs and any issues or concerns raised. People and their relatives told us they were confident that any concerns they might have would be listened to, taken seriously and acted upon.

People said they were happy with the care and support they received, and felt that their needs were being met. One person told us 'the service is better and more professional than our previous service; I couldn't be better looked after.' Another person told us 'the service is flexible and centred around what we want.'

People received a reliable service as they received the help they needed at their preferred times. People usually received consistent care from regular staff who knew their needs. People said they liked the staff that supported them, and described staff as caring and good at their job.

People had agreed to the care and treatment they received.

People felt listened to and able to express their views about the service.

Relatives said they were more than happy with the care their family member received, and felt involved in decisions about their care and treatment. One relative told us ' the staff are professional; I can't fault the service.' Another relative told us 'the staff are brilliant and they really care.'

Robust recruitment procedures were in place to ensure that people were cared for by suitably qualified, skilled and experienced staff.

People felt that the service was well run. Systems were in place to monitor the quality of services provided, and to identify and manage risks to people who use the service and others.