Background to this inspection
Updated
3 August 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
One inspector carried out this inspection.
Service and service type
This service is a domiciliary care agency. It provided personal care to a person living in their own house.
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
This inspection was announced. We gave the service 24 hours’ notice of the inspection. This was because it was 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 3 July 2023 and ended on 10 July 2023. We visited the location’s office on 4 July 2023.
What we did before the inspection
For example: We reviewed information we had received about the service since the last inspection. 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 visited 1 person using the service and spoke with their relative over the telephone. We spoke with two health professionals. We also spoke with a director, the registered manager and 3 staff. We reviewed 1 person’s care records, 2 staff records and records relating to the day to day running of the service.
Updated
3 August 2023
About the service
New Horizons 24/7 Pvt Ltd is a domiciliary care service providing the regulated activity personal care to people living in their own home. 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 inspection, 1 person was receiving personal care.
People’s experience of using this service and what we found
Right Support:
Care records did not always reflect the person’s current needs. There were some needs which did not have a care plan or risk assessment in place. The gaps in the records did not always support staff to oversee the safety of the person. Staff were responsive when the person’s needs changed and embraced recommendations and guidance from health professionals. Staff acted quickly to manage the risks the person faced and ensured timely support was provided.
The person lived in their own home and was supported by staff to make choices about their living environment including the décor and were supported to access services to support with the upkeep of the environment. Staff knew how to manage the risks of cross infection. Staff understood the person’s needs, wishes and preferences and were supported to remain as independent as they could be. The person was encouraged to make their own decisions about all aspects of their life.
The person was 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.
Right Care:
The person had a core staff team in place who they knew extremely well and had led to meaningful and supportive relationships. This meant staff knew when changes in the persons health and well-being were taking place and allowed them to act quickly. However, staff worked excessive hours without breaks as recommended in health & safety legislation. This increased the risk of potential harm to the person. Staff received regular training to support them to carry out their roles safely, however not all of them had not received training to manage behaviours or in learning disabilities. The cultural needs of the person and staff were understood, and a diverse workforce was in place. The person received individualised care from kind and caring staff. They understood how to communicate with the person to make sure their needs were met.
Staff worked well with health and social care professionals to provide the right support to keep the person safe. They understood how to protect the person from poor care and abuse. Staff had received training about how recognise and report abuse and they knew how to apply it.
Right Culture:
Quality assurance procedures needed further development to ensure all aspects of the service were encapsulated. Staff said they felt supported in their roles. Leaders needed to be visible and responsive to ensure they had full oversight of the service. They embraced feedback to support ongoing development in the service.
The person had used the service for many years and had been supported by staff to live safely within their local community. They had continued to deliver a service to the person which supported them to live their best life.
Staff said they enjoyed working with the person and enjoyed the flexibility they received from the provider. Staff turnover was very low and had supported the person to develop and maintain meaningful relationships with the staff team.
Staff had a good understanding of supporting the person with all of their health and well-being needs and embedded training and national guidance to deliver the best care to the person. The culture of the service and its inclusivity had enhanced the person’s life. The ethos, values, attitudes and behaviours of the provider and the staff team supported the person to lead and inclusive and empowered life. The person was at the centre of their care.
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 10 December 2018).
Why we inspected
This inspection was prompted by a review of the information we held about this service.
Enforcement and Recommendations
We have identified breaches in relation to staffing, record keeping and oversight of the service.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will ask the provider to tell us how they will make changes to ensure they improve their rating to at least good. We will continue to monitor information we receive about the service, which will help inform when we next inspect.