Background to this inspection
Updated
9 October 2019
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 Care Act 2014.
Inspection team
The inspection visit was carried out by one inspector, supported by an assistant inspector who made telephone calls to people, relatives and staff.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
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 18 September 2019 and ended on 19 September 2019. We visited the office location and made telephone calls to people, relatives and staff on 18 September 2019 . We spoke to one relative on 19 September 2019.
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. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with ten people and relatives about their experience of the care provided. We spoke with eight members of staff including the provider and registered manager, the Human Resources Officer and the Compliance Officer.
We reviewed a range of records. This included four people’s care records and medication records. We looked at four 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.
After the inspection
We received further information from the registered manager confirming the completion of actions taken following our recommendation.
Updated
9 October 2019
About the service
New Horizons Homecare Service Limited is a domiciliary care agency providing personal care to 45 people at the time of the inspection. 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.
People’s experience of using this service and what we found
Consent to care was sought and recorded however it was not always clear whether they had capacity to consent and others had the legal authority to make decisions on their behalf.
We have made a recommendation about recording people's consent and relatives legal authority to act on someone's behalf.
People’s needs and choices were assessed and met. Staff training was comprehensive and thorough. New staff received an induction and shadowed experienced staff members. Staff were supported through appraisals and supervisions and were encouraged to develop. People were supported to eat and drink where this was required and encouraged to eat where they were nutritionally at risk. Procedures were in place to ensure information to support people was shared and discussed appropriately with health professionals, where necessary. 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 and their relatives were positive about the service and the care and support they received. Risks associated with care and the environment were recorded and monitored. People’s needs were assessed and used to determine staff numbers, rotas were produced in advance and people received consistent support. Staff were recruited using established practices. Procedures were in place to administer medicines safely. The use of personal protective equipment was described in care plans and was available to staff. Systems were in place to learn from incidents and actions to improve took place and were recorded.
Compliments and surveys showed people were happy with the service they received. Care plans recorded people had been involved in their care planning and in regular reviews. Daily log books showed how people’s privacy and dignity were respected.
Care plans contained information for staff to support people according to their needs. Concerns and complaints were logged, monitored and responded to by involving the person and checking they were satisfied with outcomes. Actions were taken to improve where necessary. People were asked about their end of life wishes.
Managers were clear about their vision for the service, there was an open-door culture and discussions with people, relatives and staff were encouraged. A governance framework was in place which involved regular checks and audits. Managers understood their regulatory responsibility; a discussion was held about safeguarding notifications. Annual surveys took place for people, relatives and staff; feedback from these was analysed and actions taken to improve the service. Plans were in place to produce a survey to gather feedback from professionals. Managers took opportunity to learn and improve. Managers worked in partnership with other organisations to develop and improve the service.
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 requires improvement (published 3 October 2018).
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.