About the service 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.