Invicta 24 Plus

Updated 24 August 2021

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

This inspection was carried out by two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats and specialist housing.

At the time of the inspection the service did not have a manager registered with the Care Quality Commission. However, there was an interim manager in post who had applied to be the registered manager. The registered manager and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the provider or manager would be in the office to support the inspection. Inspection activity started on 27 April 2021 and ended on 4 May 2021. We visited the office location on 29 April 2021.

What we did before the inspection

We looked at the information we held about the service, which included previous inspection reports, information received from local authorities and members of the public and statutory notifications. Statutory notifications contain information providers are required to send to us about significant events that take place within services.

The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.

During the inspection

We spoke with seven relatives of people using the service. We also spoke with the manager, deputy manager, one of the company directors and two members of office-based staff. We looked at eight people’s care records including medicines records, and four staff files as well as other records relating to the management of the service.

After the inspection

We spoke with four members of care staff by telephone. We had further discussions with the management team to discuss the leadership of the service and we reviewed a range of documents we had requested the provider to send to us. These included policies and procedures, audits and survey results.

Updated 24 August 2021

About the service

Invicta 24 Plus is a domiciliary care agency providing personal care to 74 people at the time of the inspection. In some cases, the service provided live-in care staff.

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.

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

The service people received was not always safe, because some risk assessments lacked the personalised detail needed to fully inform staff how to care safely for them. Record keeping was not always sufficiently robust to demonstrate people received their medicines as prescribed. The provider was not able to demonstrate they had taken adequate action to address risks arising from some staff being unable to follow current guidance about the use of PPE during the COVID-19 pandemic. Although systems to assess the quality of the service did in most cases identify shortfalls in quality or safety, they were not always effective in making improvements to make sure people received the best and safest care the service could provide.

However, although improvements were needed to safety and governance systems, we were assured people were not at risk of immediate harm. This was because staff knew people well and received training in how to care for people safely, and more serious risks to people were appropriately assessed and documented.

There were systems to ensure there were enough staff, who were able to attend visits on time and spend enough time with people. Staff recruitment and safeguarding processes were set up to protect people from the risks of abuse, neglect or inappropriate care.

The service had recently recruited a new manager who was in the process of becoming registered with CQC. The new manager had put in place a service improvement plan and there was evidence of some improvements made as a result. There were plans to improve the quality of risk assessments, medicines audits, record keeping and recruitment which were the same areas we found needed improvement.

Staff treated people with respect and dignity, understood their diverse needs and respected their preferences. People received care that was compassionate and empathetic from staff who spent time getting to know them well.

The service had an open and inclusive culture. People, relatives and staff were consulted about their care or employment with the service and the provider listened to and acted on their feedback. People told us they felt comfortable approaching managers with any concerns.

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 requires improvement (published 20 August 2019). The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

We received concerns in relation to staff treating people with respect, moving and handling practices and management of infection risks, particularly in relation to COVID-19. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. We undertook a targeted inspection within the caring key question to check on the specific concern we had about staff treating people with respect. CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has remained the same. This is based on the findings at this inspection. We have found evidence that the provider needs to make improvement. Please see the safe and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Invicta 24 Plus on our website at www.cqc.org.uk.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

We have identified two breaches in relation to safe care and treatment and good governance. 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.