Horizon Care & Welfare provides personal care to people in their own homes. People who used the agency included older people, younger adults with physical and mental health needs and children with disabilities. The service cared for people from all backgrounds. However, the service was part of a charity which was set up to support the Somalian community. Support provided included advice on welfare, housing, health plus interpreting services. In this way the service had strong links with the local community. There were 77 people using the service at the time of this inspection.

This inspection took place on 1 March 2018. We gave five days’ notice to the provider to ensure someone was available to assist us with the inspection.

We last inspected the service in January 2016 and found the provider was meeting the fundamental standards. We rated the service ‘Good’ overall.

The provider did not always assess risks to people’s care in line with best practice as part of doing all they could to reduce the risks. This meant written guidance for staff in reducing risks, such as those relating to medicines, infection control, falls, eating and drinking and behaviours which may challenge the service were lacking for some people. The provider did not always manage people’s medicines safely as systems were not in place to audit medicines records frequently to check people received their medicines as prescribed.

People felt safe with the staff who cared for them and there were systems in place safeguarding people from abuse and improper treatment. There were enough staff deployed to care for people and the provider checked staff were suitable to work with people through recruitment checks.

Staff received the support they required to understand and meet people’s needs. The provider trained new staff with a suitable induction and an annual training programme. Staff received regular supervision with annual appraisal.

People were supported to maintain their health and with eating and drinking. People received care in line with the Mental Capacity Act 2005 (MCA).

The provider consulted with people as part of assessing their needs and also reviewed any professional reports. The provider developed care plans based on their assessments which guided staff about people and their needs. People were involved in decisions regarding their care.

Staff were caring and understood the people they cared for. Staff treated people with respect and maintained their privacy and dignity. Staff supported people to maintain their independence.

The complaints process in place remained suitable and people were confident the provider would respond appropriately to any concerns or complaints.

The registered manager and staff understood their role and responsibilities. The provider had systems in place to assess, monitor and improve the service, although systems to check risk assessments and medicines management required improving.

The provider gathered feedback from people and relatives regarding the quality of care and carried out observations of staff to check they provided care at the expected standard. The provider communicated openly with staff and external professionals.

This inspection took place on 19 January 2016 and was announced. We told the provider two working days before our visit that we would be coming. At our last inspection in July 2013 Cornerstone House was meeting the regulations inspected.

Cornerstone House provides help and personal care to adults and children in their own homes. The agency provides support to people from all backgrounds including the Somalia community as well as to other black and minority ethnic residents. At the time of our inspection 42 people were receiving care and support from this service.

The service had a registered manager in post. 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.

People and their relatives told us they felt safe and that staff treated them well. There were processes in place to help make sure people were protected from the risk of abuse and staff were aware of safeguarding vulnerable adult’s procedures and understood how to safeguard the people they supported.

Staff were up to date with training and the service followed appropriate recruitment practices.

People’s individual risk was assessed to help keep them safe. Staff supported people to attend appointments and liaised with their GP and other healthcare professionals to help meet their health needs.

When required people were asked about their food and drink choices and staff assisted them with their meals. People were supported to take their medicine when they needed it.

People and their relatives thought staff were caring and respectful. Staff knew the people they were supporting and provided a personalised service for them. Staff explained the methods they used to help maintain people’s privacy and dignity.

People and their relatives told us they would complain if they needed to, they all knew who the manager was and felt comfortable speaking with her about any problems.

People were contacted regularly to make sure they were happy with the service. Senior staff carried out spot checks to review the quality of the care provided.

Horizon Care and Welfare Association currently provides support to nine people and employs six carers. The provider also gives an advice and support service to local Somali residents for welfare benefits and access to other local services.

We spoke with three people who use the service to find out what they thought about the quality of care and support they received. People we spoke with were satisfied with the service they had received. One person said 'the carers are very nice to me, I'm very happy’. Another person told us 'they are very good I have no complaints’. People we spoke with said staff treated them well and were nice to them.

We spoke to the manager and one care worker. We found there were effective recruitment procedures in place for new staff and staff told us they felt properly supported to provide care to people using the services.

We spoke with two people who use the service to find out what people thought about the quality of care and support they received. People we spoke with were satisfied with the service they had received. One person said ‘I’m very happy with them’. Another person told us ‘Everybody is good’. One person said staff were able to speak the same language as them which was important as it meant staff could understand what they wanted. People we spoke with said staff treated them well and treated them and their homes with respect.

This review of compliance focussed on the systems and processes of the agency itself. There were no service users present.