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Date of assessment: 23 September 2025 to 7 October 2025. Horizon Care (South West) Ltd is a domiciliary care agency. It provides personal care to people living in their own homes. Not everyone using the service received a regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. We carried out this assessment as we had received some information of concern. At the time of this assessment, 236 people were receiving personal care from the service. We carried out onsite and offsite assessments. We assessed all quality statements under the 5 key questions: Safe, Effective, Caring, Responsive and Well-led. We found 9 breaches of the legal regulations in relation to safeguarding, safe care and treatment, person-centred care, consent, staffing, dignity and respect, notifications, governance and fit and proper persons employed. At this assessment, the overall rating was Inadequate. We found significant shortfalls in the standard of care being delivered. Risk assessments and care plans were not routinely completed with people or reviewed. Consequently, staff did not have the information necessary to provide safe and person-centred care, and care plans did not always reflect people’s current care needs. Daily care records contained minimal information, undermining the ability of both the provider and external professionals to evaluate the effectiveness and safety of care. People’s medicines were not always managed safely. Safeguarding procedures were not robust, placing people at risk of harm. Staff were not allocated travel time between visits. This meant people did not consistently receive their support at the times and for the duration commissioned, and visits could be rushed. There was insufficient evidence staff had received all required training to allow them to meet people’s individual needs safely. Staff also lacked regular supervision and support to reflect on their practice and maintain their well-being. Concerns raised were not consistently acknowledged or acted upon, and the provider did not always demonstrate a responsive approach to resolving issues. Recruitment processes failed to ensure staff were suitably skilled and safe to work with vulnerable people. The service did not always recognise or meet individuals’ equality and diversity needs or uphold people’s human rights. The provider did not supply accurate, accessible, and up-to-date information in formats tailored to the communication preferences and needs of service users. The provider did not have effective systems in place to monitor how the service was operating and as a result had not identified that people were being exposed to a significant risk of harm. They had not always worked effectively with external organisations to monitor and review the safety and quality of care. The provider expressed a commitment to working collaboratively with the local authority and CQC to improve the effectiveness and safety of the service and ensure they met regulatory requirements. Many staff expressed positive views about the support they received and the overall management of the service. We heard about examples of person-centred care which had met people’s individual needs. We observed some compassionate and caring practice from a long-standing member of staff. They had developed a trusting relationship with the people they were supporting and had a detailed understanding of their needs and preferences. In instances where CQC have decided to take civil or criminal enforcement action against a provider, we will publish this information on our website after any representations and/ or appeals have been concluded. This service is being placed in special measures. The purpose of special measures is to ensure that services providing inadequate care make significant improvements. Special measures provide a framework within which we use our enforcement powers in response to inadequate care and provide a timeframe within which providers must improve the quality of the care they provide.
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