New Horizons 24/7 Pvt Limited Also known as New Horizons Pvt Limited

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.

New Horizons is a domiciliary care agency. It provides personal care to adults who require support with their mental wellbeing and for people with learning disabilities who are living in their own homes in the community. Not everyone using New Horizons receives regulated activity. CQC only inspects the service being received by people provided with 'personal care': help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

The service had a registered manager. A registered manager is a person who has registered with the CQC 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 person using the service told us that they felt safe with the service provided. Support workers had a good understanding of safeguarding, what their responsibilities were and could clearly tell us what action they would take if they had any concerns. Support workers received safeguarding

training to protect both adults and children.

The person’s care needs were assessed and a detailed person-centred care plan was in place to meet the person’s needs. Care was delivered by support workers who knew the person very well, promoted their independence and understood how to support them.

Where risks of potential harm had been identified we found that there were risk assessments in place that recorded actions staff could take to reduce the potential for harm.

Medicines were being administered and managed safely by trained and competent staff.

We saw that support workers supported the person to have maximum choice and control over their life. Support was delivered in the least restrictive way and encouraged the person’s independence.

Support workers understood their responsibilities in relation to respecting the person’s privacy and dignity.

There were enough support workers in place to provide safe and consistent care. We saw that the provider regularly reviewed the staffing levels to ensure care was provided by a consistent support team which meant that there were minimal changes to the person’s routine.

We observed that support workers had very positive relationships with the person and their relative.

Support workers were patient, kind and respectful. They took time to talk to the person and answered any questions. We saw that support workers were aware of how to respect privacy and dignity and sensitively supported the person to manage their emotional and personal care needs.

Robust recruitment systems were in place to ensure that suitable people were employed to work with vulnerable people.

A training programme was in place that enabled support workers to provide person-centred care.

Support workers received regular supervision and an annual appraisal which allowed the registered manager to plan any additional training to develop support workers practice.

The person using the service was supported to have maximum choice and control of their life and support workers supported them in the least restrictive way possible; the policies and systems in the service support this practice.

The service had an effective complaints process in place and this was effectively communicated to people. The service actively encouraged feedback about the service they provided.

There were systems in place for the provider to monitor and audit the quality of the service provided including an action plan showing any lessons learnt.