Innovations24 Limited

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• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

This is the first assessment for this newly registered service. This key question has been rated Good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 63 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

People’s individual care needs were discussed and planned for with them. This included important information in relation to their communication and health care needs.

People confirmed they had ongoing discussions about their care package. Some people felt reviews could be more formal, but communication about changes was good. A person said, “They (company) haven’t had to change my care, but they will check in with me every so often to see if the care that I'm receiving is the right thing; the manager usually comes in to do that.”

The management team confirmed that people received a monitoring call after 2 weeks of using the service, and then annually, or sooner if their needs changed. This helped ensure any emerging issues were identified and addressed in a timely way. We saw a sample review document that confirmed who was involved, what was reviewed, and any required actions were recorded and actioned. These confirmed reviews were effective.

Staff were overall positive they were provided with sufficient guidance. They told us what the procedures were for updating them on any changes and said this worked well.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. However, we identified the provider did not always follow their policies and procedures. For example, as reported in the Key Question Safe, medicines management did not follow best practice as described in the provider’s policy. Safeguarding procedures of reporting incidents to CQC had not occurred in line with the provider’s policy. Whilst no person had come to harm, this demonstrated management, oversight and leadership procedures needed strengthening.

Recognised assessment tools were used, such as the Malnutrition Universal Screening Tool (MUST), Waterlow and falls‑risk assessments, to identify people’s care needs, mitigate risks and monitor any changes.

Where support with eating and drinking was required, guidance for staff provided information about individuals' needs, preferences, and risks. Daily records confirmed staff supported people in line with their care plan.

People and relatives confirmed support with eating and drinking was good. Staff told us how they ensured preferences and choices of food and drinks were respected. Staff explained how they checked food use by dates to ensure they were safe to eat, and how they ensured people had easy access to snacks and drinks between care calls.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

The provider had a selection of communication procedures to share information with staff to facilitate joint working. This was important in ensuring people’s individual care needs were known and understood. Staff confirmed internal communication was good.

External professionals told us joint working was good. A professional said, “Communication with the management team was very prompt they made referrals for additional assessments when required in a timely manner.”

People’s care records, and discussions with the management team demonstrated how collaborative working had occurred to support people. This included joint review meetings, home visits and sharing of information as and when required with the agreement of the person.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People’s known health conditions and care needs had been assessed and were known and understood. From the sample of care records we reviewed, the registered manager had provided staff with information about the person’s health conditions and the impact this had on them and their care needs.

Care records and feedback from staff, confirmed how referrals were made to external health and social care professionals when people’s needs changed for further assessment or advice. When people had experienced an accident or were unwell, staff took action to make the person comfortable and contacted the person’s family and or sought medical or emergency support.

Staff were able to confidently tell us about how care needs in relation to specific health conditions, such as diabetes, catheter and dementia were met. Staff were knowledgeable about the signs to look for, the actions required to keep people safe, and when to escalate concerns to senior staff or healthcare professionals.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

People’s care plans were not outcome‑focused. This meant they did not clearly describe what the person wanted to achieve, how staff would support them to work towards those goals, or how progress would be reviewed.

Whilst the provider had systems and processes to monitor people’s care, the recording of discussions, decisions and actions was often not completed. The management team told us, and relatives confirmed, that there was more of an informal approach. This further demonstrated a lack of outcome‑focused actions and limited the provider’s ability to evidence how monitoring led to improvements in people’s care.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

The Mental Capacity Act (MCA) is a law in England and Wales that protects and empowers people aged 16+ who may lack the ability to make certain decisions for themselves. It sets out clear principles for assessing capacity, making decisions in someone’s best interests, and supporting people to be as involved as possible.

The registered manager was not fully meeting their responsibilities under the MCA. Whilst the provider’s policy and procedure stated that the registered manager was responsible for completing capacity assessments and best‑interest decisions in line with the key principles of the MCA, this had not been carried out appropriately.

The registered manager had completed an MCA assessment and concluded that the person lacked capacity in relation to an aspect of their care. However, there was no evidence to show how this conclusion had been reached or what information had been considered. Although the assessment recorded that a best‑interest decision was required, this had not been completed. This meant the provider could not demonstrate that decisions were being made lawfully or in the person’s best interests. We discussed this with the management team who agreed they required further upskilling to strengthen their knowledge and confidence in this area.

Guidance for staff about how to meet people’s care needs, included reference to seek consent before care was provided. Daily care records completed by staff confirmed consent was sought.