Archived: Horizonz Care

Updated 20 January 2017

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.

This inspection took place on 6 January 2016 and was unannounced. The inspection team consisted of four adult social care inspectors and one adult social care inspection manager.

Before the inspection we reviewed all the information we held about the service including notifications, and we spoke with the local authority safeguarding team. We had also received information of concern from an anonymous source regarding the staff recruitment, staff training, medicines management and concerns to people’s safety and welfare. At the time of the inspection a Provider Information Return (PIR) was not available for this service. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. On this occasion we had not asked the provider complete this document.

During our visit we spent time looking at nine people’s care and support records. We also looked at 17 records relating to staff recruitment and training, and various documents relating to the service’s quality assurance. We also spoke with the registered person, care co-ordinator and a senior support worker. On 11 January 2016 one inspector telephoned and spoke with two people who used the service and six relatives of people who used the service. On 12 January 2016 two inspectors visited four people in their own homes and spoke with them and/or their relatives. One inspector also spoke with six staff on 13 January 2016, including two who had stopped working for the service within the last four months.

Updated 20 January 2017

The inspection of Horizonz Care took place on 6 January 2016 and was unannounced. Horizonz Care was registered with the Care Quality Commission in April 2014. This was the first inspection of the service since their registration.

Horizonz Care is registered to provide personal care. Care and support is provided to people who live in their own homes within the Kirklees area. One the day of our inspection 27 people were receiving support with personal care.

The registered provider is also the registered manager for the service. 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 2008 and associated Regulations about how the service is run.

During our inspection we found people were not adequately protected from the risk of harm or abuse. We noted examples of incidents which had not been always been referred to the local authority safeguarding team and the registered person had failed to report these matters to the Care Quality Commission. This demonstrated a breach of Regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 and a breach of Regulation 18 of the Care Quality Commission (Registration) Regulations 2009.

Risks to people’s welfare had not been robustly assessed and relevant risk assessments had not always been implemented. Staff had not been assessed to ensure they were safe and competent to administered peoples medicines. Records relating to peoples medicines were inadequate. This demonstrates a breach of Regulation 12 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Recruitment of staff was not robust. We found staff were employed without references and we were not always able to evidence a Disclosure and Barring Service (DBS) had been completed for all staff. This demonstrated a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

People we spoke with did not feel staff had the skills to meet their needs. Evidence to support staff had completed relevant training, was lacking. Staff told us they shadowed a more experienced staff member when they commenced employment but this process was not formally recorded or evaluated. Feedback from the registered person, care co-ordinator and staff was conflicting regarding supervision; however, we did not see any recorded evidence of staff supervisions to monitor staff performance and development. This evidence demonstrates a breach of Regulation 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We saw that where people lacked capacity about their care and support, a record of this assessment had not been completed. This demonstrated a breach of Regulation 11 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

Although people told us most staff were caring and kind, we found staff did not consistently respect people’s privacy or dignity. This demonstrated a breach of Regulation 10 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014

Each person had a care and support plan in place which recorded their individual support needs at each allocated call.

People were aware of how to complaint but complaints were not formally logged, investigated or acted upon. This demonstrated a breach of Regulation 16 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014

Staff personnel files and both paper and digital records for people who used the service were not stored securely. The organisation did not have an effective quality assurance and governance system in place to drive continuous improvement. There was no system to ensure the views of people who used the service were routinely gathered and acted upon. This demonstrated a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014

The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘Special measures’.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months. The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.

You can see what action we told the provider to take at the back of the full version of the report.