Invicta Care and Training Ltd

At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

About the service

Invicta Care and Training Ltd is a domiciliary care agency and provides personal care and support to people who require assistance in their own home. Not everyone using the service received personal care. CQC only inspects where people receive personal care, which is help with tasks relating to personal hygiene and eating. Where they do, we also consider any wider social care provided. The service supported 54 people at the time of the inspection.

People’s experience of using this service and what we found

Right Support:

We received some feedback about instances of staff lateness and timekeeping concerns. Staff were recruited safely. Staff were provided with an induction, training and support and had their competencies assessed to ensure they supported people in line with their identified care needs. Safeguarding policies and procedures were in place. People were protected from the risk of abuse. Staff had received training and understood how to keep people safe and who to report to if they had any concerns. People's care plans and risk assessments were reviewed in a timely manner. People received the support they needed to take their medicines safely. Staff followed the correct infection control practices.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Right Care:

People and their relatives were positive about the care they received and said staff were kind and helpful. People told us they were involved in pre-admission assessments and their views were listened to. Staff understood how to respect and promote privacy and dignity. Choice of meals and drinks were offered to people which respected their likes and dislikes.

Right Culture:

The registered manager and staff were clear about providing person-centred care to people. They had a good knowledge of the service and understood the needs of people they supported. Staff supported people to lead inclusive and empowered lives. The registered manager worked with the local authority safeguarding and commissioning team to carry out their regulatory responsibilities. The provider increased the number of quality checks to monitor the service and identify any areas for improvement.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good (published 22 May 2021).

Why we inspected

The inspection was prompted in part due to information of concerns received including safeguarding, staffing and training. A decision was made for us to inspect and examine those risks.

We found no evidence during this inspection that people were at risk of harm from these concerns. Please see the Safe, Effective and Well-led sections of this full report.

Recommendations

We have made a recommendation about monitoring staff deployment.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Invicta Care and Training Ltd provides care at home to people. They provide personal care to adults who may be living with dementia or have disabilities.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of our inspection six people received the regulated activity of personal care.

People’s experience of using this service and what we found

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People and relatives told us they were happy with the service provided and felt safe with the care provided. They confirmed their care was provided in a dignified and respectful manner.

Staff were recruited using a robust recruitment protocol and had been provided with support, supervision and training to ensure they cared for people appropriately. The registered manager completed competency assessment for staff to ensure they administered medicines and supported people in a safe manner.

Care plans were person centred and contained guidance for staff about how people wanted their care to be provided. Care plans and their associated risk assessments were reviewed to reflect people's changing circumstances.

The registered manager undertook checks and audits to evaluate the quality of the service provided and had effective systems in place to monitor service provision.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update:

The last rating for this service was requires improvement (published 20 February 2020) and there were multiple breaches of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations. The service is now rated good overall.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Invicta Care and Training Ltd on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Invicta Care and Training Ltd provides care at home to people. They provide personal care to adults who may be living with dementia or have disabilities.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. At the time of our inspection 11 people received the regulated service of personal care.

People’s experience of using this service and what we found

During this inspection we found whilst some of the concerns identified at previous inspections had been addressed or at least improved, further concerns were identified which were breaches of the regulations. This meant the service provision had overall deteriorated since our last inspection.

The provider was not using robust recruitment processes to recruit staff in a safe manner. This was because some staff application forms were not fully completed. There was no evidence gaps in the information requested was checked to ensure staff education and work history was stated in its entirety.

The registered manager, whilst informing the local authority of safeguarding adult concerns, had failed to inform the CQC. This is a legal requirement therefore the provider had breached the regulations.

The provider’s paperwork for assessing staff competency in their induction, shadowing and their administration of medicines was not completed in a comprehensive manner. This was because the paperwork did not always state the care workers name or where the assessment had taken place and we could therefore not be sure if the competency assessments had taken place as planned.

People’s care plans and risk management information has improved in terms of person-centred content. However, two care plans we looked at had not been reviewed in a timely manner to ensure the people’s support needs were being met and to reflect the changes to their service provision.

The provider demonstrated they were working with a quality assurance consultant to make improvements. They had completed an action plan a week prior to our inspection which stated how some of the issues we found would be addressed. However, there was no evidence of regular auditing of records throughout the year and the findings were identified too late to ensure concerns had been addressed in a timely manner.

Notwithstanding the above people and relatives spoke positively about the care workers who they found friendly and kind. They told us most care workers arrived on time and they had a consistent service. However, one relative had negative experiences of staff not always attending the calls as scheduled.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

The registered manager and care workers supported people to access appropriate health and social care for their well-being and took steps to ensure people ate well and drank enough to remain hydrated.

People and relatives found the registered manager approachable and found they listened to their concerns and addressed any issues.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection (and update)

The last rating for this service on the 29 October 2018 (published on 09 January 2019) was requires improvement. At that inspection we identified breaches of Regulation 12 (Safe care and Treatment) and Regulation 17 (Good governance).

At this inspection not enough improvement had been made because we found further concerns. We found breaches of Regulation 12 (Safe care and treatment), Regulation 19 (Fit and proper persons employed), Regulation 9 (Person centred care) and a continuing breach of Regulation 17(Good governance).

Why we inspected

This was a planned inspection based on the previous rating

Enforcement

We found no evidence during this inspection that people had been harmed but this was the third consecutive inspection where the service has been rated as requires improvement and where the provider has been unable to make and sustain improvements in all areas of the service. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

At our last inspection on 24 August 2017 we found a breach of the regulations in safe care and treatment. This was because the provider did not have an effective system to assess the risks to people using the service and did not have measures in place to minimise the risk to people.

Following the last inspection, we asked the provider to complete an action plan to show what they would do by November 2017 to improve the key questions safe and well-led to at least good. At this inspection we found the provider had improved their risk assessment process. However, there were still some risks that were not fully assessed and guidance was not always provided to staff.

This service 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 people with a range of needs including older adults, some of whom were living with dementia, people with a learning disability or autistic spectrum disorder and people with mental health needs.

Not everyone using The Winning Box 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. At the time of our inspection ten people were receiving a service from The Winning Box, nine of whom received a service of personal care.

There was a registered manager in post who was also the owner of the business. 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.

Staff had received medicines administration training but we found one person was being supported with their medicines when their care plan had not addressed the support the person required with their medicines.

Furthermore, at the last inspection not all care plans were person centred. Once again, although work had been undertaken to address this, it was not completed at the time of our inspection. As such people’s diverse support needs were not specified and there was no background information to place people in the context of their life.

The registered manager audited people’s records and had identified shortfalls. However, these had not been addressed in a timely manner.

We identified two breaches of regulations. These were in relation to safe care and treatment and good governance. You can see what action we told the provider to take at the back of the full version of the report.

The registered manager audited daily communication records to ensure all safeguarding adult concerns were reported appropriately. Care workers demonstrated they knew how to recognise and report abuse.

The registered manager had attended training to support them to work in line with the Mental Capacity Act 2005. They understood the need to ensure people’s representatives had the legal authority to make decisions on their behalf.

The provider recruited staff following their recruitment procedures and recruited enough staff to meet people’s care needs. People and relatives told us that care workers usually attended calls in a punctual manner. They described care workers as, “good” and “very caring,” and often had the same familiar care staff to work with them or their family member.

Care workers had received infection control training and were provided with personal protective equipment to avoid cross contamination in people’s homes.

The registered manager told us how they were learning as they grew and were reviewing their systems and documentation to ensure they offered a quality service to people. They were working with a consultancy company to support them through this process. The provider had invested in an electronic monitoring system and had recruited specialist staff to support them to create good office systems.

Staff had received appropriate training and supervision to support them to meet the demands of their role.

People were supported to eat healthily and drink enough. The registered manager had supported people and relatives to access the appropriate health and social care.

Invicta Care and Training Ltd is a domiciliary care agency who is registered with the Care Quality Commission to provide personal care to adults who require support. The service was registered on the 17 November 2016 and has not been inspected before. At the time of inspection, the service was offering personal care services to two people.

There was 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’s relatives spoke very positively about Invicta Care and Training Limited staff and the registered manager. Relatives described staff as very caring and kind.

However, we found the provider was not undertaking robust risk assessments when there was a risk to people’s safety so appropriate plans could be put in place to mitigate risks. Therefore, we found a breach of the regulations with regard to safe care and treatment.

We found that whilst care plans were clear about the tasks to be undertaken during each care call there was a lack of detail for staff about how the person wanted the care undertaken to fully reflect their wishes and preferences.

The provider had recruited sufficient staff to meet the needs of the people they supported and to ensure they could provide cover in an emergency or to cover a new package of care. The provider recruited staff in a safe manner.

Staff were provided with induction training to ensure they were equipped to carry out their duties appropriately. Staff shadowed the registered manager providing care prior to commencing their role and were introduced to the people they were going to provide care to.

The service worked within the principles of the Mental Capacity Act 2005. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. The policies and systems in the agency supported this practice.

Relatives confirmed they had been involved in people’s care planning and the person’s individual history and aspirations were contained in the care plan for staff to learn about the person.

The provider had a complaints policy and procedure. This was contained in the service user guide for people’s reference. The registered manager described clearly how they would investigate complaints and address them speedily.

The registered manager had systems and processes in place for communication with people, relatives and their own staff, and for monitoring the quality of the service provided. However, the systems had not identified the areas for improvements we found so the provider could address these.

The provider acted on feedback they received to improve the service. The commissioning body had visited the service, and the provider and registered manager had made changes to their systems following the visit demonstrating that they were working in partnership.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in regards to safe care and treatment. You can see what action we told the provider to take at the back of the full version of the report.