CQC report explained · a residential care home
What the CQC found at The Horizon
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- People were protected from abuse and avoidable harm, and there were enough staff. Inspectors found some health risks had not been assessed and recorded, and some recruitment checks were incomplete.
- Effective?
- Good
- People's needs were assessed and care plans were reviewed. Staff had induction, training and supervision, and people were supported with food, healthcare, oral hygiene and lawful decision-making.
- Caring?
- Good
- Inspectors observed staff responding with kindness and respect. People and relatives spoke positively about the care.
- Responsive?
- Good
- Care plans recorded people's needs, choices and preferences, and people and relatives were involved in planning and reviewing care. People were supported to live as independently as possible.
- Well-led?
- Good
- There was a clear management structure and regular quality checks. The manager responded positively to the minor issues found and provided evidence that they had been addressed.
What inspectors found, September 2021
Rated Good; inspectors found safe, kind and well-managed care, with some records and checks needing improvement.
This was an unannounced planned inspection on 30 June 2021. The inspector spoke with four people, managers, relatives and staff, observed care, and checked care, medicines, recruitment and management records.
People said they felt safe and were happy living in the home. Inspectors found enough staff, safe medicines practice, clean surroundings, suitable training, kind care and support for people's health, choices and independence.
Some checks were not fully recorded. Certain health risks had not been assessed and written down, employment gaps had not always been explored, and medicine audit checks were not formally recorded. The manager said these issues would be addressed, and later sent evidence that they had been dealt with.
The overall rating was Good. Safe, Effective and Well-led were each rated Good. This was unchanged from the previous Good rating published on 20 December 2017.
People felt safe
People and relatives told inspectors they felt reassured and safe in the home.
“People told us they felt safe living at The Horizon.” from the report
Kind and respectful care
Inspectors saw staff respond to people's needs with kindness and respect. Relatives also confirmed that staff were caring.
“We observed staff responding to people's needs with kindness and respect.” from the report
Safe medicines practice
People received medicines on time and as prescribed. Records had no gaps, and staff were trained and checked as competent.
“People received their medicines on time and as prescribed.” from the report
Good infection control
The home was clean, staff had access to protective equipment and COVID-19 procedures were in place.
“We observed the home to be clean.” from the report
Involved and supported people
People, relatives and health professionals were involved in care planning. People were supported to make choices and remain independent.
“People were empowered to live an independent life as possible and were encouraged to be involved in all aspects of their care and support.” from the report
Some health risks were not recorded
needs fixingCertain risks linked to people's health and medical conditions had not been assessed and documented. The manager said this would be addressed immediately.
“However, we did find that certain risks associated with people's health and medical conditions had not been assessed and documented.” from the report
Recruitment records were incomplete
needs fixingAll four staff files checked had not always included a full employment history, and gaps had not always been explored.
“for all four staff files that we looked at we found that a full employment history had not always been provided and gaps in employment had not always been explored.” from the report
Medicine audits were not formally recorded
minorDaily and weekly medicine checks took place, but the home did not formally record that these audits had been completed. The manager agreed to introduce a recording process.
“However, these were also not formally recorded.” from the report
- 01How have you updated the assessments and written guidance for the health and medical risks identified at the inspection?
- 02How do you now check full employment histories and investigate any gaps before staff start work?
- 03How are daily and weekly medicine audits recorded and checked now?
- 04Can you show us evidence that the issues identified at the inspection were addressed?
- 05How will you involve our relative and us in care planning and regular reviews?
This was an unannounced planned inspection that looked at the overall quality of the home, including infection prevention and control; Safe, Effective and Well-led were rated, while Caring and Responsive were not separately rated in the report. This explanation was written from the published report of 11 September 2021 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, December 2017
Rated Good; inspectors found safe, kind and personalised care, with all five areas rated Good.
This was an unannounced, comprehensive inspection on 15 November 2017. Inspectors spoke with people living at the home, relatives, staff and a healthcare professional. They also observed care and checked care plans, risk assessments, medicines records, staff files and quality checks.
The home supported up to eight people with mental health needs. Five people were living there at the time. People and relatives said they felt safe and were happy with the care. Inspectors found detailed risk assessments, safe medicines systems, suitable staff checks and a clean home.
Care was planned around each person's needs, preferences and history. Staff knew people well, supported their independence and treated them with dignity. The home also supported healthcare, activities, hobbies and contact with relatives.
The overall rating was Good, and each of the five areas was rated Good. This means inspectors found the service met the relevant standards at the time of this inspection. It had remained Good since the previous inspection on 8 July 2015.
Personalised care planning
Care plans included people's backgrounds, life histories, preferences and support needs. They were developed and reviewed with people, relatives and healthcare professionals.
“Care plans were person centred and gave detailed information about people, their backgrounds and life history including details of the relationships that they had with relatives and friends.” from the report
Safe medicines
People received medicines safely and on time. Records were complete, staff had medicines training and competency checks, and medicine audits were recorded.
“People were observed to receive their medicines safely and on time. Medicine Administration Records (MAR) had been completed fully and appropriately and no omissions in recording were noted.” from the report
Respect and independence
Staff supported people to make choices, maintain privacy and dignity, and develop their independence. People's cultural, religious and personal needs were recorded.
“Care staff demonstrated how they promoted people's independence on a day to day basis.” from the report
Positive relationships
Inspectors saw trusting relationships between staff and people. Staff understood people's personalities and mental health needs and used this knowledge to support their wellbeing.
“Relationships had been established based on mutual trust and respect.” from the report
Open management
Managers were visible and available. Staff felt listened to, and the home used audits, meetings and feedback to monitor and improve care.
“The registered manager and deputy manager had a number of systems in place to monitor and improve the quality of care.” from the report
Inspectors raised no specific concerns in this report.
- 01How are each person's mental health risks reviewed, and how are staff told about any changes?
- 02How do you check that medicines continue to be given safely and that medicine audits are recorded?
- 03How will my relative be involved in creating and reviewing their care plan?
- 04What activities and community access would be available for my relative, including if they did not want to join a structured activity?
- 05How can relatives raise a concern or complaint, and how will the home respond?
This was an unannounced comprehensive inspection covering all five questions, and the ratings for all five areas were Good. This explanation was written from the published report of 20 December 2017 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of The Horizon
3 rated inspections over 6 years: the service has held its Good rating throughout.
- September 2021Goodcurrent ratingstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2017Goodstayed GoodSafe: GoodEffective: GoodWell-led: Good
- August 2015GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2014
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- September 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 13 January 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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What to check when you visit
At least 100 live-in carers within about an hour of Enfield
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £980 to £1,260 a week. 79 can care for a couple. 11 years' experience on average.
“Over the time he spent with them he got to know our parents very well and became like part of the family, even joining in family celebrations.”
“Charity would take Nan on holidays day trips and shopping adventures”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.