Date of assessment 12 – 16 January 2026. This assessment was announced. New Horizon Care is a homecare service which also provides clinical support for people with complex healthcare needs. This includes services to adults with learning disabilities. We assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted. We found people received care in accordance with this guidance and care workers and staff had received appropriate training relating to people with a learning disability and autistic people. Not everyone who used the service received the regulated activity personal care. CQC only assesses 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 our assessment there were 35 people using the service. Risks were being assessed, and measures were in place to reduce the risks of avoidable harm and abuse. Where we had identified improvements needed in risk assessments, we were assured this was being addressed. Incidents, safeguarding concerns and complaints were analysed and lessons learned to reduce future risks. However, further improvements were needed to ensure monitoring and analysis of incidents where people had become distressed to ensure they were sufficiently robust and effective. People received the support they required with their medicines, and these were regularly reviewed. People were supported to maintain good health and well-being and received good clinical oversight and support with complex health needs. Staff were deployed in sufficient numbers to meet people’s needs and keep them safe, though some people and relatives had concerns around staff consistency and skills in some services. The registered manager was aware of this and had identified improvements at the time of our inspection visit. People were treated with kindness and compassion. Staff protected their privacy and dignity. They treated them as individuals and supported their preferences. People’s consent was sought and they were supported to identify and achieve meaningful goals and aspirations, including hobbies and interests. People were enabled to be as independent as possible. People had choice in their care and were encouraged to maintain relationships with family and friends. There were systems in place for people and their representatives, where appropriate, to give feedback about their care, including making complaints. The provider and registered manager had developed systems to maintain good oversight of the service. They used lessons learnt to develop and improve the service. Overall, people and relatives had confidence in the management team and felt any issues were quickly responded to and resolved. Staff were mostly positive about changes in leadership and management as bringing much needed stability and improvements. Staff supported the provider’s values of people being in control and at the centre of their care. They were committed to enabling people to achieve the best possible outcomes from their care and support.
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This targeted inspection of New Horizon Care focused solely on infection prevention and control concerns, finding no evidence of risk to people from COVID-19 or other infections. The overall rating remains Good from the previous comprehensive inspection published March 2018.
Strengths
· People and relatives felt protected from COVID-19 and other infections
· Staff demonstrated correct use of PPE including masks, gloves, aprons and visors
· Staff had access to regular COVID-19 testing with considerations for clinically vulnerable staff
· Policies and procedures in place for infection prevention and control
· Staff trained in infection prevention including COVID-19 and safe use of PPE
Quality-Statement breakdown (1)
safe: S5 Preventing and controlling infectionNot rated
New Horizons Care received an overall rating of Requires Improvement following a July 2014 announced inspection, with breaches of Regulations 20 and 22 identified relating to inadequate record keeping and insufficient staffing levels. Caring was rated Good, but persistent missed calls, poor contingency planning, outdated care records, and infrequent staff supervision drove Requires Improvement ratings across the remaining four key questions.
Concerns (9)
criticalStaffing levels: “Every time there's holiday or sickness I know there will be problems as office says cannot fulfil night shifts as not enough support workers.”
criticalMissed or late visits: “People experienced missed or late calls, and were not always communicated about changes of support workers.”
criticalRecord keeping: “Care plans and risk assessments were dated 2012. Medication records showed that they had not been completed since April 2014.”
moderateStaff training: “We were concerned that the training plan did not fully consider the training needs of agency or relief staff.”
moderateSupervision / appraisal: “Formal one to one opportunities to discuss and review practice, training and development needs was infrequent.”
moderateGovernance: “Whilst the registered manager said 'spot checks' were carried out to check the practice of support staff, these were infrequent and not recorded.”
moderateCare planning: “Electronic records we looked at in the office did not match up with the sample of care plans and documentation we looked at that was kept in people's own homes.”
minorComplaints handling: “We first raised concerns two years ago about missed or late calls and again recently, not a lot changes. I don't feel important.”
minorConsent / capacity: “The provider needed to develop a more consistent approach to the MCA to ensure people's rights were fully protected.”
Strengths
· 100% of questionnaire respondents said support workers treated them with dignity and respect.
· 94% of people stated the service helped them be as independent as possible.
· Clinical lead and second consultant enabled clinical support and advice to be available at all times.
· Staff received individual training for people with complex health conditions.
· Accidents and incidents were recorded and lessons learnt were discussed in team meetings.
Quality-Statement breakdown (14)
safe: Staffing levels and contingency planningRequires improvement
safe: Missed and late callsRequires improvement
safe: Safeguarding awareness and pre-employment checksGood
effective: Training for agency and relief staffRequires improvement
effective: Supervision and appraisal frequencyRequires improvement
effective: Health needs assessment and care plan instructionsGood
caring: Dignity, respect and person-centred supportGood
caring: Involvement of people in recruitmentRequires improvement
New Horizons Care was rated Good overall following a January 2016 inspection, with Requires Improvement for Effective due to inconsistent application of the Mental Capacity Act, gaps in staff DoLS understanding, and supervision not always delivered in line with policy. The service demonstrated clear strengths in safety, person-centred care, staff training, and responsive governance, though it had operated without a registered manager since September 2014.
Concerns (4)
moderateConsent / capacity: “Not all staff were able to demonstrate that they had an understanding of the Act and how it might apply to the people who used the service. We found that there was a reliance on relatives to make decisions.”
moderateLeadership: “The service did not have a registered manager. The previous registered manager had left in September 2014.”
minorSupervision / appraisal: “supervisions were not always happening within the time frame. One staff member told us that their supervision had been cancelled and had not been rearranged.”
minorCommunication with families: “One person said, 'The way the company works and their lack of communication is the problem.' A relative said, 'It's the cover arrangements. Not knowing sometimes what is happening.'”
Strengths
· People and relatives consistently reported feeling safe, with risks assessed, managed and regularly reviewed
· Staff received role-specific and person-specific training including competency assessments by a trained nurse
· Medicines were administered safely using MAR charts and stock checks
· People were involved in recruiting their own support staff and in planning and reviewing their care
· Complaints were handled confidentially and in line with policy, with accessible complaints procedures commissioned
Quality-Statement breakdown (17)
safe: SafeguardingGood
safe: Risk assessment and managementGood
safe: Medication managementGood
safe: Recruitment practicesGood
effective: Staff training and competencyGood
effective: Supervision and appraisalRequires improvement
effective: Mental Capacity Act and DoLS complianceRequires improvement
New Horizon Care, a domiciliary and supported living service in Market Harborough, was rated Good overall at its February 2018 inspection, maintaining its previous Good rating from January 2016. The service demonstrated consistent strengths across all five key questions, with personalised care, robust safeguarding, effective leadership and well-embedded quality assurance systems.
Strengths
· Staff received safeguarding training and understood how to recognise and report abuse
· Individualised risk assessments covered complex areas of behaviour, physical health and wellbeing
· Consistent staffing arrangements with relatives informed of any lateness
· Medicines managed safely with MAR records completed accurately and competency observations conducted
· Staff received induction including Care Certificate and ongoing personalised training
Quality-Statement breakdown (21)
safe: Safeguarding and risk managementGood
safe: Staffing and recruitmentGood
safe: Medicines managementGood
safe: Infection controlGood
safe: Incident recording and learningGood
effective: Needs assessment and care deliveryGood
effective: Staff training and skillsGood
effective: Nutrition and hydration supportGood
responsive: Consistency of case managementRequires improvement
responsive: Accuracy and consistency of care recordsRequires improvement