Archived: InVent Health Limited

Updated 5 June 2019

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. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team: The inspection team consisted of one adult social care inspector, one inspection manager and an expert by experience. The expert by experience had experience of supporting someone with complex needs.

Service and service type: 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 older adults, younger disabled adults and children.

The service had a manager registered with the Care Quality Commission. This means that they 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 visit because it is small and the registered manager could have been out of the office supporting staff or providing care. We needed to be sure someone would be in to support the inspection.

Inspection site visit activity started on 19 February and ended on 20 February 2019. We visited the office location on 19 February to see the manager and office staff; and to review care records and policies and procedures. We visited two people and their families in their homes on the 20 February and later that day returned to the office to give feedback on the inspection.

What we did: Prior to the inspection we reviewed the available information we held about the service. We used information the provider sent us in the Provider Information Return. This is information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the Provider Information return (PIR) and used this along with information gathered from professionals to develop the plan for the inspection.

During the inspection we looked at available documents to support the management of the service. We spoke with staff during the inspection and had email contact with staff shortly after. We emailed staff with questions about the service and how they were supported to help us gather as many staff views as possible

We:

•Reviewed four care plans in the office and looked at two care plans in people’s homes.

•Spoke and had contact with 20 staff including, the registered manager, regional lead nurses, clinical coordinators, nurses and support workers.

•Spoke with 12 families of people being supported by the service and two people being supported directly.

•Reviewed accident and incident records, medicine records and other records to support the delivery of the service.

•Looked at available audits and quality assurance information ascertaining the service delivered was that which was required by people being supported.

After the inspection we requested some additional information on the structure of the service which was received when expected.

Updated 5 June 2019

• About the service: InVent Healthcare Ltd is a domiciliary care agency supporting adults and children with very complex and life limiting conditions. At the time of the inspection the service was supporting 47 people across the East and South of England.

People’s experience of using this service:

•The registered manager was based in a Norfolk office. The service was managed from three locations across the South and East of England. Governance systems had not been developed to allow the registered manager to have oversight of the whole service provided.

•Quality audits and monitoring records were not used effectively to drive improvement and identify where change was required. A system of effective quality assurance was yet to be developed.

•Medicine management was not as robust as required, specifically around the management of controlled drugs. Audits identified some issues but not all and they did not serve to drive improvement in this area.

•People’s care records and monitoring information were not contemporaneous records of the service provided. Some care plans were missing from people’s files and reviews that resulted in changes to support provided, whilst implemented were not routinely recorded on people’s care plans and assessments. When we looked at files in people’s homes we found additional information was available. We have made two recommendations about this.

•Team meetings did not happen as frequently as the service’s policy required. The provider had identified this but appropriate action had not been taken. We have made a recommendation about this.

•Staff told us key information was shared at team meetings for the team supporting specific individuals and we saw daily records contained comprehensive information on how to support people. Staff told us the daily records kept them updated of any changes to people’s needs and staff were available on the phone for support if required.

• 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 service supported this practice. Consent was acquired as appropriate.

•Family and people, we spoke with being supported by the service told us it was excellent and they had confidence in the staff to keep them or their family member safe.

•The service included the relevant people and professionals in reviews of people’s care. The service worked well with other specialist services ensuring the care delivered was safe and effective in meeting people’s needs.

•Safeguarding procedures were available at the service and had been developed and agreed for each person.

•Staff were safely recruited and received specialist training for the people they supported.

•Support people received was clinically complex and life sustaining treatment was provided routinely to the people supported.

Rating at last inspection: Good (report published 6 March 2016).

Why we inspected: This inspection was completed as part of our planned programme of comprehensive inspections.

Enforcement: Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up: Any action we agree is required will be monitored to ensure it is taken.

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