Background to this inspection
Updated
15 October 2021
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
This 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 home. People are supported with their personal care needs. People are supported to participate in a range of activities and experiences to develop their confidence and independence and to provide relatives and carers with respite breaks. This inspection looked at people's personal care.
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
This inspection was announced. We gave the service less than 24 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 23 September 2021 and ended 5 October 2021. We visited the office location on 23 September 2021.
What we did before the inspection
We reviewed information we had received about the service since the last inspection together with information we had asked the service for in preparation for this inspection. This included some people’s care plans, staffing and training information. 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 this information to plan our inspection.
During the inspection
We spoke with the registered manager, who is also the provider, four support workers a team leader and one person who received support with a regulated activity.
We reviewed a range of records. This included multiple medication records. We looked at three 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 spoke with four relatives of people who used the service.
Updated
15 October 2021
About the service
New Horizons Broad Oak Limited is a domiciliary care agency. The service provides support to adults who have a learning disability, physical disabilities, autism and other complex needs.
Care is provided in people’s own homes, at the New Horizons Resource centre, the New Horizons respite Caravan in Seasalter and in the community. People receive care on a one to one basis, unless additional staffing needs are identified.
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. At the time of the inspection, the service supported 31 people, 19 of whom required support with their personal care.
People's experience of using this service and what we found
People were unable to tell us about the service they received so we spoke with their relatives. Feedback from relatives was positive. They were complementary of the service commenting on the compassion and dedication of the staff and registered manager. One relative commented, “I don’t know what we would do without them. I can’t praise them enough, particularly their support through the lockdown."
People received safe care and support, their relatives were confident staff understood people’s individual needs well and associated risks. Care plans contained detailed risk assessments, which reduced identified health risks together with any environmental risks to people and staff.
Medicines were safely managed and administered. Although we asked the registered manager to review the storage of medicines and arrange refresher training for some staff about how to administer a specific medicine.
Robust recruitment processes were in place. This prevented unsuitable staff from working with people. Staff were skilled in carrying out their role, most had completed vocational diplomas in addition to mandatory training.
The staff team worked in partnership with relatives. This ensured people received everyday support for their care and health needs, together with support to attend health care appointments.
The registered manager and staff we spoke with knew what their responsibilities were about keeping people safe from the risk of abuse. Spot checks, home visits and relatives’ feedback requests ensured continuous oversight so that people and staff were safe.
Staff were caring and always protected people’s dignity and independence both within their homes and in the community. Staff had the information they needed to support people to make choices and recognised that people had the right to make their own decisions.
Staff and relatives told us continuity of staff was good and they always knew in advance who was coming to support them. Relatives confirmed staff always arrived when expected and they had never been let down by missed calls. Relatives were confident about raising concerns or complaints but had not had the need to do so.
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.
The service was able to demonstrate how they were meeting the underpinning principles of Right support, right care, right culture.
Right support:
• The model of care maximises people’s choice, control and independence
Right care:
• Care is person-centred and promotes people’s dignity, privacy and human rights
Right culture:
• The ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives
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 needs were assessed prior to receiving support including their protected characteristics under the Equalities Act.
The service had an effective system in place to assess, monitor and improve the quality and safety of the services provided. Appropriate action was taken to monitor accidents and incidents; the rate of which were very low. There was a process to gain feedback from people, their relatives and staff and to use this to improve people's experience of the service.
The registered manager was also a joint provider of the service and understood their responsibility to operate the service in line with their regulatory responsibilities.
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 11 October 2019).
Why we inspected
We undertook this inspection as part of a random selection of services rated Good and Outstanding to test the reliability of our new monitoring approach. We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
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.