The inspection took place on 22 August and 6 September 2018. The registered provider was given short notice of the visit to the office, in line with our current methodology for inspecting domiciliary care agencies. This was the first inspection since the new service provider registered with the CQC in January 2018. Although many of the staff transferred to the new company.

New Horizons is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older people and people living with dementia.

At the time of our inspection there were 40 people being supported that were receiving personal care. The location provided the regulated activity in Sheffield.

The service did not have a registered manager. 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.

At this inspection we found the service was rated overall as Requires Improvement.

We found risks had been identified and staff had knowledge of how to manage risks. However, we identified some risk assessments lacked detail to ensure staff had the up to date information to manage risks safely. Medicines were given as prescribed, but documentation could be improved.

People’s needs and choices were assessed and mental capacity assessments were undertaken. However, we found that best interests were not always clearly documented to show decisions where people lacked capacity were made in their best interests.

Quality monitoring systems were in place, although the registered provider had identified improvements were required in the governance and management structure to ensure they were fully implemented and embedded into practice.. They had made recent management changes to support staff which ensured the identified improvements were implemented and embedded into practice.

Everyone we spoke with, without exception, said they were very happy with the service they received. They told us no matter what staff member supported them, they were all able to meet their needs.

Staff told us they really enjoyed working for the agency and received support from the management team.

The recruitment processes were robust to ensure safe recruitment of staff to work with vulnerable people.

We saw people and their relatives had been consulted about the quality of the service. The provider had learnt lessons in that they were improving the management structure to provide better support and introducing new paperwork to ensure effective management, review and oversight.

There was a procedure in place to ensure any safeguarding concerns were addressed and reported. Staff had good knowledge of how to spot the signs of abuse and what action to take. People we spoke with and their relatives told us the service provided ensured safety.

People told us the staff were very caring, kind and compassionate. Staff respected people’s privacy and dignity and ensured their choices and decisions were sought.

The service supported some people to prepare and make meals. We found people were supported to received adequate nutrition and hydration.

People who required the involvement of health care professionals were assisted to obtain this support, when it was required.