We carried out a review of the data available to us about Care Horizons 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 Care Horizons Limited, you can give feedback on this service.
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.
The inspection was carried out by one adult social care inspector. This service is a domiciliary care service. It provides personal care to people living in their own houses and flats. It provides a service to older and younger adults. At the time of this inspection the service was providing a service to nineteen people, two of which received the regulated activity of personal care. The services were managed from an office in South Gloucestershire.
There was 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. The registered provider was also the registered manager for the service.
The feedback we received from everyone we spoke with was very positive throughout. Those people who used the service including relatives and staff, expressed satisfaction and spoke highly of all staff and the support provided.
The safety of people who used the service was taken seriously and the registered manager and staff were aware of their responsibility to protect people’s health and wellbeing. There were systems in place to ensure that potential risks to people’s safety and wellbeing were identified and addressed.
The staff were motivated and proud of the service. They were fully supported by the registered manager, deputy and team leader. A programme of training and supervision enabled them to provide a good quality service to people. The registered manager, and all staff understood the principles of the Mental Capacity Act (MCA) 2005 and, worked to ensure people's rights were respected.
The registered manager ensured that staff had a full understanding of people’s care needs and had the skills and knowledge to meet them. People received consistent support from staff who knew them well. People had positive, caring relationships with the staff and were confident in the service. There was a strong emphasis on key principles of care such as compassion, respect and dignity and promoting independence. People who used the service felt they were treated with kindness and said their privacy and dignity was always respected.
People received a service that was based on their personal needs and wishes. Changes in people’s needs were quickly identified and their care package amended to meet their changing needs. The service was flexible and responded very positively to people’s requests. People who used the service felt able to make requests and express their opinions and views.
People benefitted from a service that was well led. The vision, values and culture of the service were clearly communicated to and understood by staff. The provider/registered manager had implemented a programme of ‘planned growth’ that had been well managed. They were committed to continuous improvement and demonstrated strong values and a desire to learn about and implement best practice throughout the service.
The registered manager and deputy demonstrated a good understanding of the importance of effective quality assurance systems. There were processes in place to monitor quality and understand the experiences of people who used the service.