The inspection was announced and took place on the 6 and 8 September 2017. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be available in the office. It also allowed us to arrange to visit people receiving a service in their own homes.

This is the first inspection of the service since it was re-registered with a new location address with the Care Quality Commission in August 2016.

Horizon Care (South West) Limited is registered for the regulated activity ‘personal care.’ At the time of the inspection they provided personal care to around 280 people living in their own homes.

There is a registered manager in post who is also the provider. 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.

The service was a family run business and the management team were committed to providing a good quality, effective service to people. The provider said, “We are supporting vulnerable people, we need to get it right for them.” They did this by supporting staff well to promote a consistent staff team, listening to people’s views and looking at ways to continually improve. One person said, “They [the staff] are always lovely. They are reliable and courteous and very helpful. If they are late they ring me and apologise. I’ve never had to complain.” One relative told us, “It’s a gold star agency. [Carer’s name] especially is a superstar.”

People told us they appreciated the visits from staff who were always cheerful and treated them with respect. One person said, “Some [care workers] are wonderful, so nice and I have one care worker who is so helpful. They turned up with a bookshelf for me when I said I needed one. They are like family now.”

Care workers said they enjoyed working for the service. They were well motivated and committed to providing a service that was personalised to each individual. People were fully involved in planning their care and support and care plans were comprehensive to make sure staff had all the information required to support the person. This helped to make sure people received the support they wanted.

There were quality assurance systems which monitored standards and ensured any shortfalls were addressed. People and care professionals felt listened to and said they could speak with a member of the management team at any time. Any complaints, including smaller comments and ‘grumbles’ made were fully investigated formally and treated as learning to enable the service to improve.

People received effective, safe care which met their individual needs and preferences. People told us the service was flexible and made adjustments to accommodate their wishes and changing needs. For example, when people had health appointments or where two people had specific needs there was a contracted agreement that they had access to an on call number at any time which would ensure a visit to provide personal care. Where any concerns were raised about a person’s health or well-being prompt action was taken to make sure they received the support and treatment needed.

People were complimentary about the care workers who supported them. People told us staff were kind, caring and respected their privacy and dignity. There were sufficient numbers of staff employed to ensure people received their care and support at times of their choosing. The service were revising their care worker ‘runs’ to reduce the number of care workers that people received support from. They had recognised that some people, although receiving care from a regular group of care workers, sometimes had seven care workers in a week. However, people told us they knew who was coming to support t