This inspection was carried out by one inspector. We visited the offices of InVent Health, looked at care and staffing records and spoke with the manager and staff. Following the visit we spoke with three people who commissioned services for people from InVent Health, with one person who received care and with four parents of children who received care. We spoke to staff over the telephone and reviewed any information we held about InVent Health since this location was registered with us in February 2014.We considered the evidence we had gathered under the outcomes we inspected. We used this information to answer the questions we always ask:
' Is the service safe?
' Is the service effective?
' Is the service caring?
' Is the service responsive?
' Is the service well led?
This is a summary of what we found-
' Is the service safe?
People who commissioned care said the service provided by InVent was professional and safe. When we spoke with three parents of children who received care and support and with one adult who did, they were very positive about the quality and safety of care provided. they told us they felt safe with staff and were confident their best interests were always safeguarded.
We looked at three care plans. We saw assessments had been carried out to identify risks to the health, safety and welfare of people. Detailed plans were in place which showed how any identified risks were to be eliminated or managed.
The provider responded appropriately to any allegation of abuse. We were informed of one incident which had been reported to a local authority. The provider took appropriate action to address any issues raised and to ensure the safety and welfare of the child concerned. The local authority had closed the associated safeguarding process. All parties were satisfied with the outcome, additional training and support had been provided to the staff concerned and no evidence of abuse had been found.
Staff received safeguarding training which included how to recognise types of abuse and what action to take if it were seen or suspected. We saw staff handbook files included flow-charts for both adult and child safeguarding. These gave general contact guidance and informed staff who any report should be made to. We were told each team had the specific contact details for the relevant local safeguarding of adults/children boards. (InVent Health operate within a number of local authority areas, each with their own safeguarding teams and contacts.) We spoke with three members of staff on the telephone and spoke with other staff in person at the service's office. They confirmed they had received safeguarding training and told us they felt they knew what to do and who to inform in the event they saw or suspected abuse had taken place.
CQC Monitors the operation of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards. The service had policies and procedures in place and readily available in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. Relevant staff had been trained to understand when an application should be made, and how to submit one, although no applications had needed to be submitted. This ensured there were proper safeguards in place.
Systems were in place to make sure that managers and staff learnt from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continually improve.
' Is the service effective?
We looked at three care plans. We found people's needs had been assessed and were kept under regular review to ensure they remained effective, relevant and up to date.
Staff told us they received training to maintain their existing skills and to gain new ones. When we spoke with people who had commissioned services from InVent Health over many years, the said the service was effective and reliable. One commissioner summed up their experience of InVent Health by noting, "I find InVent to be professional, consistent and reliable. I communicate regularly with the regional lead nurse and I have always found her professional and competent, responding to my questions in a timely manner".
One person told us how concerned they were when they brought their child home from a high dependency hospital unit. The said they were nervous as to how their child's care could be sustained within a home environment. They told us they had now received care for five years from InVent Health and had gained full confidence over that time.
' Is the service caring?
The comments from parents and people who received care and support were exceptionally positive. One person said InVent Health were,"Perfect." Another said they were, "Absolutely fine."
People who dealt with InVent Health told us communication was not a problem, they said the care provided was respectful and reliable in most cases. One parent went through the process if new carers were required to join the team. They told us care staff were always introduced before coming to provide care and were,"A lovely team." The person who received support told us they treated them very well, listened to what they said and were patient as they had problems speaking due to their medical condition.
' Is the service responsive?
One commissioner told us InVent Health were "very responsive." They said one strength of InVent Health was the way they recruited staff and trained them in a bespoke' process, to meet the individual needs and wishes of the person concerned. They recognised this was inherently time consuming, however it meant people benefitted from a responsive and individualised service. They told us they found InVent Health were, "remarkably ready to change in order to suit the families."
We found there was a comprehensive complaints, incidents and accidents policy and procedure in place and included in the staff information pack and staff training. We had previously been informed by one parent about complaints they had in respect of the reliability and consistency of care being provided to them on behalf of their child. The service commissioner had been involved by them and CQC monitored the outcome of this complaint. We found InVent Health had co-operated fully in the complaints process and had worked with the family and commissioners in an effort to address the issues raised. They had acknowledged where the service had not been as consistent as they would have liked and had taken steps to try and address this. The matter was resolved by the commissioner and family with the support and co-operation of InVent Health.
When we talked with parents about the care they observed or experienced they told us care staff were sensitive and responsive to changes in needs or circumstances and always tried to accommodate any requests for temporary changes in care.
' Is the service well led?
People told us they did not have any particular problems with communication and could reach senior staff when they needed to.
The provider had a comprehensive series of audits in place to monitor the quality of service provided. We saw this included a detailed questionnaire for parents and people who received care. There was evidence the service responded to the findings of these audits. For example, in one case, additional male carers were recruited to meet one person's needs for male company.
Commissioners told us they found the service were open and co-operative when addressing any concerns or issues. We saw evidence of this in respect of one case notified to the CQC through our web-site.
Staff at all levels told us they felt very well supported by the provider and service managers.