Archived: Star Absolute Care

Updated 9 August 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

We gave the service 48 hours’ notice of the inspection visit because we needed to be sure the registered provider; who often provides direct care, staff and people we needed to speak to were available.

The inspection took place on the 21 June 2018. It included visiting the site office, and speaking to people and relatives by telephone prior to and after the site visit so that we could further understand their experiences. The inspection team consisted of one inspector and an expert-by-experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert-by-experience for this inspection was an expert in care for older people with dementia.

Prior to the inspection, we gathered and reviewed information we held about the service. This included notifications from the service and information shared with us by the commissioning local authority and health professionals. We used information the provider sent us in the Provider Information Return (PIR). 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.

During the site visit we spoke with two staff and the registered provider. We looked at four people’s care plans, two staff files, staff training records, policies and procedures, quality assurance documentation and information and policies in relation to people’s medicines. We spoke with four people using the service, two relatives, two health professionals, during the inspection process. We have included their feedback in the main body of the report.

Updated 9 August 2018

The inspection took place on the 21 June 2018 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service. We wanted to be sure that someone would be in to speak with us.

Star Absolute is a domiciliary care agency registered to provide personal care and rehabilitation services to adults with physical disabilities, sensory needs, learning disabilities and those living with mental health conditions. It provides a care to people living in their own houses and flats.

At the time of our inspection the service was supporting 12 people with a personal care service carrying out approximately 140 visits a week. Not everyone using Star Absolute Care receives a regulated activity; CQC only inspects the service being received by people provided with personal care; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

The service had a registered provider. A registered provider is a person who has registered with the Care Quality Commission to manage the service. Like registered managers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At our last inspection, in March 2017, we found two continued breaches of the regulations. The service was rated as ‘Requires Improvement’. This was because the provider had not fully ensured that staff had suitably up to date training, received regular formal supervision and that policies and systems supported them to carry out their duties. We wrote to the provider and asked them to tell us what they would do to ensure they met the legal requirements. The provider wrote to us to say what they had done and planned to do to meet the legal requirements. We undertook a comprehensive inspection on 21 June 2018 to check whether the required actions had been taken to address the breaches previously identified.

At this inspection improvements had been made and the breaches had been met. For example, the provider had established policies and procedures that specified the types of training staff would be required to complete and the timescales that these courses needed to be refreshed This ensured staff regularly updated the skills and knowledge required to provide safe effective care. The provider had also developed clear written, roles and responsibilities that they could measure their staff performance in relation to.

The provider had systems in place to ensure medicines were managed and administered safely and staff were trained and assessed as being competent to administer medicines safely. In relation to supporting people with ‘as required medicines’ the provider was not consistently providing suitable guidance for staff. We have recommended that they seek further guidance in relation to best practice in this area. Robust arrangements in relation to documentation was also not consistently achieved in relation to the management of recruitment processes.

People and relatives were very positive about the care given by the service. One person told us, “I feel very safe, the carers have never missed a visit in all the years I have had them.” Another told us, A relative told us, “They are absolutely excellent. They never let me down. I can go out knowing that my relative will be OK.” People and their relatives were involved in their care planning and their preferences and choices were respected. Relatives and health care professionals told us that staff were knowledgeable and encouraged choices and recognised that the needs of people living with dementia.

There were good systems and processes in place to keep people safe. Health and safety and environmental risks were monitored through audits. Risks and accidents were assessed and staff received guidance on what actions to take to mitigate risk and ensure people and staff’s wellbeing at the service site and in the community. Staff knew how to recognise the potential signs of abuse and what action to take to keep people safe.

The provider and staff considered people’s capacity and worked in line with the Mental Capacity Act (MCA) 2005. Staff recognised the importance of choice respecting people’s choice and self-determination. People’s right to privacy, to be different and to be treated with dignity was respected. People’s religious, cultural beliefs, chosen relationships and disability rights activities were promoted where this was an important part of a person’s life.

People were supported to maintain good health, maintain a healthy nutritious diet and had assistance to access health care services when they needed to. Where needed, people were supported to receive support from health care professionals and staff worked with these professionals to promoted people’s wellbeing and independence. On person told us, “They keep my life ticking over because I can’t do it on my own. They enable me to lead an independent life and go to university.”

People’s communication needs were met as staff had a good understanding of people’s methods of communication including their sensory needs. People and their relatives told us they could communicate with the service, and receive information in a way that met their needs. When required people had access to technology that promoted their independence.

There were clear management lines of responsibility and accountability. The service had an established leadership and the values discussed and demonstrated by the registered provider were reflected in their staff team’s actions and motivations. One staff member told us, “We provide a good standard of care and each person is an individual.” The provider was committed to supporting people of all ages to gain as much independence as they could achieve. The service had an open transparent culture, where feedback, complaints and surveys were encouraged and acted on.