Archived: Horizon Care Agency

Updated 7 April 2015

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

The inspection of Horizon Care Agency took place on 5 and 7 January 2015 and was announced to the provider two days before our visit. We did this because the registered manager is sometimes out of the office supporting staff or visiting people who use the service. We needed to be sure that they would be in. One inspector undertook the inspection with an expert by experience making telephone calls to people using the service and staff. An expert by experience is a person who has experience of using or caring for someone who uses this type of care service.

Before the inspection visit we reviewed the information we held about the service. During our inspection we went to the provider’s head office and spoke to the registered manager, the care plan manager, a care manager and the trainer/human resources manager, reviewed the care records of ten people that used the service, reviewed the records for four staff and records relating to the management of the service. After the inspection visit we undertook phone calls to nine care workers and 16 people that used the service. We also visited four people in their own homes with their permission and relatives of two people that used the service. We also spoke with four health professionals.

Updated 7 April 2015

We undertook an announced inspection of Horizon Care Agency on 5 and 7 January 2014. We told the provider two days before our visit that we would be coming. Horizon Care Agency provides personal care services to people in their own homes and occasionally provides care workers to other services registered with CQC. Horizon Care Agency is a large domiciliary care agency and at the time of our inspection over 220 people were receiving a personal care service. The agency employed approximately 86 care workers as well as care managers and administration staff.

At our last inspection in June 2014 the service was not meeting all the regulations inspected. The service was non compliant with outcomes 9 Medication and 21 Records. We received an action plan detailing how the agency were addressing the issues and during this inspection we found the issues had been addressed as described. Medication information was clear in care plans and medication records completed correctly.

The service has a registered manager. 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 and associated Regulations about how the service is run. The registered manager and office staff were accessible and overall people were happy with the service provided. The agency were responsive to people’s changing needs, for example, sending managers to visit people to review care plans, check they were happy with the service and covering staff if there was a delay due to an incident.

Most people praised the service and had no concerns about the standard of care provided by the agency. However, we received a mixed response from people using the service, relatives, social care professionals and staff about the quality of communication and “unprofessional” or “rude” attitude at times when contacting the management/office team. Although most people who used the service, staff and relatives, felt able to speak with the registered manager and office staff and provided feedback on the service, around 11 people and a group of staff as well as four social care professionals commented on attitude. There was also a comment relating to an occasional “blunt and rude” attitude of office staff in the last inspection report.

The service undertook regular spot checks and care reviews to review the quality of the service provided and had good systems to manage recruitment, staff competency and training, sickness levels and staff issues. People were kept safe and free from harm. There were appropriate numbers of staff employed to meet people’s needs and provide a reasonably flexible service. When people’s care initially began it could take a few weeks for care workers to become more regular as space was found within care workers rotas. People were given weekly rotas so they knew which care worker would be visiting.

Staff received regular training and were knowledgeable about their roles and responsibilities. They had the skills, knowledge and experience required to support people with their care and support needs.

Staff knew the people they were supporting and provided a personalised service. Care plans were in place detailing how people wished to be supported and people were involved in making decisions about their care. People told us they liked the staff and felt cared for and treated with dignity and respect. For example, “The girls are lovely just perfect, I’m happy with the care” and “I have no complaints, they are all extremely nice and very caring”. Concerns and complaints were recorded including telephone concerns and these were dealt with well.

People were supported to eat and drink as required by the information in their care plans. Staff supported people to attend healthcare appointments and liaised with their GP and other healthcare professionals as required to meet people’s needs. Staff had a good understanding of the Mental Capacity Act (2005) and how to manage decision making where people using the service were living with diminished mental capacity.