Archived: The S.T.A.R. Foundation

On this page

• 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.At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 62 (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 did not consistently ensure people’s care and treatment was effective by thoroughly assessing and reviewing their health, care, wellbeing, and communication needs. While care plans were developed to be person-centred, they did not always accurately reflect some individuals’ needs. For example, two care plans contained incorrect information about known medical conditions, and another lacked sufficient detail. The management team took prompt action to update these records. Regular reviews were in place to monitor changes in needs, with people and their families involved in the process. People’s preferred methods of communication had been assessed, and appropriate aids were provided to support understanding, including dental and eye care.

People’s health needs and clinical observations were not always completed in line with current guidelines, increasing risks such as dehydration. Fluid and food intake records for one person contained conflicting information, and there was no clear evidence that agreed actions were taken when fluid targets were not met. Records did not consistently confirm that food and fluids were provided at the correct consistency. During lunch, one person’s request for more dessert was not acted upon. Kitchen staff relied on verbal information about dietary needs with no written records to guide them, increasing the risk of errors in food texture or dietary requirements. The registered manager took immediate action to address these issues.

Monthly weight monitoring was in place to manage nutritional risk. A variety of balanced meals were offered, with mixed feedback from people. One gave us examples of where their food had been specially prepared for them so they could enjoy a takeaway. A relative said, “Good food choices here. The carers know what [my relative] likes and will eat, we provide some drinks, and there are plenty of snacks and drinks available. My relative has a sweet tooth and will eat a main meal in the living room as its comfortable in there for them.” Other relatives said the more choices could be given to support a specific cultural diet and another relative said, “I have complained about the food.”

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. Staff and leaders worked well together to ensure they understood people's needs and wishes. Handover meetings took place between shifts to give staff the opportunity to share information and updates.

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 were supported to access a range of healthcare professionals. Staff monitored people's health and well-being daily. Healthcare professionals, including GPs and speech and language therapists visited the service regularly. People told us they were supported to access healthcare when needed. One person said, "Staff are working with me in physio/hydrotherapy, and I am confident that they will get me fit and strong again." The service had an on-site gym, swimming pool and sensory room, which were accessible to people and supported their health and wellbeing.

The provider did not consistently monitor people’s care and treatment to continuously improve it.

People’s care and health was monitored by the staff who knew when to escalate concerns, however records relating to people food and fluid intake and skin monitoring records were not consistently completed or accurate. This had no impact on people and the registered manager took immediate action once we made them aware.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. Where people lacked capacity, systems were in place to ensure decisions were made in people’s best interests. People and relatives told us staff were always considerate and involved them in decisions about their care. Staff and leaders were knowledgeable about the Mental Capacity Act 2005 and worked in line with guidelines. Systems were in place to ensure decisions were made in people’s best interests where they lacked capacity.