Invictus Plus Care

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We reviewed 8 quality statements for this key question. Staff were trained and knowledgeable about the people they supported. Staff knew how to escalate any concerns and understood their responsibilities in relation to safeguarding. The provider had recruited staff safely. Risk assessments were in place and reviewed.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and their relatives told us they felt staff were knowledgeable about the person they supported. Comments included, “The carers are well trained and it can be observed just with the way they manage [person] and giving him nice meals and lots of drinks”, “They are well trained to meet all of [person’s] everyday needs”. One person told us a new carer had accompanied their regular carer to shadow and learn.

Learning from safeguarding and local authority quality team feedback was shared with staff. This was done via encrypted messaging or in team meetings. One staff member said, “They [management team] send us messages via [a digital messaging service] telling us about an incident. And they tell us to check on the care plan if something changes because of an incident.” Management told us staff were up to date with their mandatory required training. Management told us they monitored the service using audits which showed where lessons had been learned following any reported incident.

Minutes of meetings showed the registered manager used staff meetings to provide training and updates for staff. The training matrix showed staff had completed mandatory and specific training topics according to people’s individual needs. Audits shared by the provider showed they reviewed practice following any reported incident.

People and their relatives told us they felt safe using the service. People told us staff were trained in using equipment. Comments included, “The carers are well trained in using the equipment that is in place to transfer [person]” and, “My relative has a [equipment name] and the carers are well trained in using this and [person] is safe.” However, one person told us the staff were sometimes a little quick and they had to tell them to slow down.

Staff knew how to escalate health concerns. Comments from staff included, “I had someone unwell the other day. I rang 999, called the office and documented it on the incident form. The client was very weak but didn’t need to go to hospital” and, “If I noticed a wound that was new, I would contact the office…and they would then refer to the GP or district nurse.” Managers told us they liaised with health and social care professionals for expert guidance on how to safely support people. This was confirmed when reviewing people’s care records.

A health professional we spoke with said, “The manager responded quickly to my enquiry about a change of equipment. They wanted to come out and do side by side home visit with a manager and the moving and handling lead at the patient's home and me. It was really important to make sure we all knew what we were doing. It doesn’t happen much, but they were really keen and it was good for the patient, me and for Invictus.”

Records showed the service had liaised with an occupational therapist regarding an assessment for one person. In another instance, the service had engaged with a speech and language therapist (SALT). Audits confirmed the appropriate processes were followed to provide information to health and social care colleagues and organisations.

People and their relatives told us they felt safe. One person’s relative said, “My [relative] is beyond doubt very safe with the carers. They have got to know my [relative] well and [relative] likes them” and, “They are very aware of [person’s] mobility issues and the carers always walk beside [person] to ensure [they] are safe.” Another person said, “I am safe with my carers. I was very ill once when the carer arrived and she called the ambulance and my relative and stayed with me until the ambulance arrived.” One person’s relative said, “[Person] is safe with the carers and we have developed a trust and rapport to allow us to go out for a few hours, in the knowledge that [person] is being well looked after.”

Staff completed safeguarding training and understood their responsibilities to report concerns. One staff member said, “If I saw bruises on anyone, I would report it to the office.” Another member of staff said, “We must protect the clients from harm or abuse.” Managers told us they were confident staff knew when and how to raise any safeguarding concerns.

Records showed when incidents had been referred to the local safeguarding team, and any actions taken.

People told us staff supported them to manage risks. For example, one person said, “The afternoon carers sometimes take me for a little walk to get some fresh air and now I can drive again one of them came with me to give me some support the first time I drove.” One person’s relative said, “The carer will help with food and drinks but [person] has variable swallowing and the carers are aware of this and will liquidise food when required and assist with eating.” Another relative said “Invictus have a good robust process for identifying needs and risk.”

Staff said that when risks were identified, these were shared with them and the care plan was updated. One staff member said, “We learnt about choking risks on our induction. I cut the food up small for one client.” Managers told us risks were identified at the point of assessment and reviewed.

People were assessed for the risk of pressure sores. Other risks were assessed and reviewed when required. For example, if the person’s needs had changed. At the time of our assessment, there was nobody using the service who was assessed as being a high risk of skin damage, choking or malnutrition.

People told us staff were trained to use any equipment in the home. Although not all staff were familiar with some of the cooking utensils people had in their homes, people told us they had shown staff how to use them. Some people told us staff would tidy up for them and put shopping away or sort their recycling.

Staff said they had been trained to use moving and handling equipment. One staff member said, “We had face to face training about all the equipment. We were able to practise using it.” Managers confirmed staff were aware and trained in manual handling techniques. Staff would be made aware of any hazards in the home environment and who to contact if there were concerns.

Environmental risk assessments were carried out. Assessments included, checking the internal safety of people’s homes. Assessments also included checking for adequate lighting and space for staff to park their cars.

People and their relatives spoke highly of the staff. People told us visits were never missed and that generally staff turned up on time. If staff were running late, people told us they were informed. One person said, “They have always turned up. Even when one girl got stuck and was two hours late, they still turned up.” People told us staff always stayed the scheduled length of visit and sometimes stayed later. People told us staff always completed all care tasks that were scheduled. People told us they had regular staff support them and spoke of them by name. Comments about staff included, “I really think the girls are brilliant”, “The staff are always calm. Their manners, their behaviour and respect has been outstanding” and, “I have been at [relative’s] house when the carer has been there and watched the interaction between them and my relative. The carer is very good and tries to encourage [person].”

One staff member said, “We have too many staff and not enough hours of work for all of us.” Another staff member said, “Since the end of a contract, my hours have dropped.” The scheduling system for visits allowed for preferences to be recorded, such as specific times, and male or female staff. Staff said, “We accommodate people's preferences for timings; so, if people want to change times because they’re going out for the day, we will do that.” Managers were concerned about providing sufficient hours of support for their staff team. However, they had taken steps to secure new contracts in other areas.

The service was reviewing staffing levels. Safe recruitment procedures were followed. During the assessment, records of interviews were not held in all the staff files we looked at. This was acted upon by the management team following feedback. All the recruitment files we looked at contained evidence of staff’s right to work in the UK. There were records of induction, competency assessments and probationary reviews with new staff. We saw training files for staff with care certificate training dates, induction dates and shadowing dates. Staff told us they shadowed other staff and were ‘signed off’ before working unsupervised. There were records of supervision sessions and wellbeing checks.

People told us staff wore personal protective equipment (PPE) when providing care. People and their relatives told us the staff put PPE on when they arrived at someone’s house and removed and disposed of it appropriately before leaving.

Staff told us they were provided with PPE. Staff had completed infection prevention and control training. Comments from staff included, “We change our gloves between each task” and, “I had my training. I put gloves and an apron on when I get there in front of the client so they are sure I am wearing clean PPE. When I finish personal care, I change the gloves and apron, and after every task. At the end, I take off the PPE, wash my hands and leave.” Managers told us there were regular monitoring checks on staff use of PPE.

Audits showed compliance with infection prevention and control procedures was monitored through spot checks.

People told us staff supported them with their medicines. One person said, “They helped me sort out my medication. The carer phoned the office and said that I needed to have a dossette box and the office sorted this out for me.” One person’s relative said, “The carer prompts [person] to take [their] tablets.” Another person’s relative said, “If I have to go out the carer will help with any tablets.”

Staff had completed medicines training. Staff knew when and where to apply any prescribed creams and lotions. One staff member said, “The care plan tells us where to apply creams. If we have run out, I would prompt the client to order some more or if the office order medicines for the client, I would report it. Or I could call the pharmacy or the next of kin.” One staff member said, “We try to encourage the GP to keep us updated of any medication changes.” Another staff member said, “We are encouraged to speak up if we make a mistake, even if we drop a tablet, we must tell the office.” Managers told us there was shared learning if any medicines errors occur. This was documented and additional training arranged for staff.

Medicine administration records showed medicines were administered as prescribed. Regular medicine audits were carried out. Stock balance checks were carried out. Medicines incidents were reported and investigated