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Archived: Star Absolute Care

Overall: Good read more about inspection ratings

Rivendell, Rowhook Hill, Rowhook, Horsham, West Sussex, RH12 3PU (01403) 791656

Provided and run by:
Mrs Linda Darkens

All Inspections

21 June 2018

During a routine inspection

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.

1 March 2017

During a routine inspection

The inspection took place on 1 March 2017 and was announced.

Star Absolute Care is domiciliary care service that provides support to people in Horsham and the immediate local area. At the time of our visit the service was supporting 11 people with personal care, carrying out 140-160 visits each week.

The service was run by the provider and there was no requirement to appoint a registered manager. The provider is a ‘registered person’. 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 January 2016, the provider was found in breach of three legal requirements. At this visit, we found that action had been taken regarding requirements in the areas of medicines management and the safe storage of records. Further action was needed, however, to ensure that staff received appropriate staff training, supervision and appraisal. This was a continued breach of regulation and we have asked the provider to take action.

The provider lacked clear systems and processes to ensure compliance with the regulations. The provider did not always have clear policies to set out how they would meet the requirements. The provider had not fulfilled their action plan sent to the Commission following our last inspection and remained in breach of the regulation concerning staff training and support. We are considering what regulatory action we will take to ensure this requirement is met and sustained by the provider.

Despite the above-mentioned issues, people and relatives were delighted with the service they received. One person said, “We are more than happy, they are absolutely lovely”. Another told us,

“I’ve been really lucky with the help I’ve been given and the people that come to me”. In response to the provider’s survey a third person had written, ‘This agency has not only helped my physical health but my mental health too’. People enjoyed good relationships with staff and everyone said they would recommend the service.

People were able to adjust their call times and duration to suit their lifestyles. They told us staff regularly went ‘over and above’ what was expected of them and that they were never rushed. People told us how the provider had attended appointments with them and returned for additional time following calls if further support was needed. Relatives felt supported by the provider, who would cover for them even at short-notice. People and relatives told us the service was reliable and they had never been left in the lurch.

The provider had an excellent understanding of the people she supported and was in regular contact. People and relatives felt able to raise any concerns or ideas and were confident they would be listened to. The provider operated in an open and transparent fashion and people felt fully involved in their care. Staff supported people to maintain their independence. They treated people respectfully and with dignity.

People were supported by a regular team of staff. The agency was small, with just the provider and three staff delivering care at the time of our inspection. Staff knew people well and were vigilant to changes in their needs. The provider was proactive in responding to changes and in seeking input from healthcare professionals when needed.

Staff understood local safeguarding procedures. Risks to people’s safety were assessed and reviewed. Where necessary staff had collaborated with people to find ways of minimising risks whilst maximising their independence.

People had confidence in the staff who supported them. Staff understood how consent should be considered in line with the Mental Capacity Act 2005. Staff supported people to prepare meals and to eat and drink if required. Staff spoke positively about their roles and the support they received from the provider.

We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we have told the provider to take at the back of the full version of the report.

11 and 14 January 2016

During a routine inspection

Star Absolute Care is registered to provide personal care for people in their own homes. On the day of our visit the service provided personal care to 10 people with a range of needs including older persons who were frail.

The service provider, Mrs Darkens, also worked as the manager. Registered providers have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People told us Star Absolute Care provided safe and reliable care, but we found the service was in need of improvement in a number of areas as procedures were often informal with a lack of recording to demonstrate the service was safe and effective.

Staff were trained in safeguarding procedures and knew what to do if they suspected someone had been abused. The service’s safeguarding procedure needed to be expanded to include details about the types of abuse people might experience and contact details about who they should contact to report any concern.

Staff supported people with shopping and the provider had policies and procedures about this, which staff confirmed they followed.

Staff supported people with their medicines and made a record when they did this, but this was not in sufficient detail to show the type and dosage of medicines administered. Whilst people said they were satisfied with the support they received with their medicines, staff training did not include any observations and competency assessments to ensure staff carried this out safely.

Staff training was provided but this needed to be expanded to ensure all staff had the required skills to effectively care for people.

Staff supervision and appraisal was in need of improvement. The provider said staff supervision and appraisals did not take place and that she checked staff performance by attending care calls with staff. However, staff told us they worked independently.

People’s records were not available even though notice of the inspection was given to the provider. Not all people’s records were securely maintained.

The CQC monitors the operation of the Mental Capacity Act (MCA) 2005 which applies to domiciliary care. Not all staff were trained in the Mental Capacity Act 2005. The service had no policies and procedures regarding the MCA and the provider was unsure of how the MCA applied to people who received care.

People received a reliable service from regular staff. There were sufficient numbers of staff to meet people’s needs. Checks were made on staff so only those staff suitable to work in a care setting were employed.

Each person had a care plan which gave guidance to staff on supporting people safely. Risks to people were assessed and recorded. These included environmental assessments for people’s homes so staff knew any risks and what they should do to keep people and themselves safe.

People were supported to eat and drink where this was appropriate or requested by people. The service supported people to access healthcare professionals when needed.

People were supported by staff who were kind and caring. People were able to express their views and said they were encouraged to be independent. People said they were treated with dignity and respect.

People said their needs were regularly reviewed and they were contacted on a regular basis to ensure that their current needs were being met.

People and their relatives concerns were listened to and acted on. People and their relatives were aware of the service’s complaints procedure and said they felt able to raise any issues which were resolved to their satisfaction.

We found three breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

31 January 2014

During a routine inspection

We were informed that, at the time of this inspection, 15 people received personal care in their own homes from the service. We spoke with three people and the relatives of two others. This was by telephone after we had visited the office.

People and relatives we spoke with confirmed they were happy with the care and support that had been provided. One person told us, "It is marvellous. The carer workers are so good and cheerful!" Another person commented, "The care workers are all very good and very helpful." A third person told us, 'I can't say anything but that they are excellent! The care workers are friendly; they will sit and chat with me if they are not busy. I can only speak very highly of them.' A relative we spoke with said, "I am absolutely delighted. It has meant we have been able to keep X at home. Life has been made easier for them and for the family.' Another relative told us, 'I am very happy with the care given to my relative.'

We also spoke with three care workers by telephone. They demonstrated that they had a good understanding of their roles and responsibilities. They were also knowledgeable about the individual needs of each person they visited to provide care.

We also gathered evidence of people's experiences of the service by looking at a selection of records. They included care records and care workers' training records. We found that the records we looked at were up to date and well maintained. They also ensured people received care that was safe, appropriate and in accordance with individual wishes and needs.

We asked about the agency's systems for monitoring the quality of the service provided. We were informed people had been consulted and included when the care provided had been reviewed. However, the provider was unable to demonstrate how adverse events, incidents, missed calls, comments and complaints had been audited and monitored.

5 March 2013

During a routine inspection

During the inspection we spoke with members of staff and with people who used the service and their family members. One relative told us " your help allowed our Aunt to stay in her own home and that meant so much to her, it was her last and greatest wish."

We made observations throughout the visit and saw that people were offered choices as to when they wished to be visited. We looked at peoples individual care plans and saw that the information recorded enabled staff to plan and deliver the required level of care and support on an individual basis.

We saw that regular audits of the service were completed by the provider ensuring that people who used the service benefit from a service that monitors the quality of care that people received.

Staff told us that they had received regular training and that they felt that they were supported to carry out their roles and meet the needs of people who used the service.

People that used the service told us "the service is exemplary" and "the carers are second to none."