Background to this inspection
Updated
15 December 2020
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. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was carried out by two inspectors and three Experts 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.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
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 a short period notice of the inspection. Due to the impact of the COVID-19 pandemic we were mindful of the amount of time inspectors were on site. Therefore, records and documentation were requested before and following the site visit and were reviewed remotely. Inspection activity began on 11 November and ended on 27 November 2020.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
Due to the risks of Covid-19, we did not make home visits to people who used the service. Instead we sought feedback from people, their relatives and members of staff by telephone. We spoke with 25 people who used the service and 18 relatives about their experience of the care provided. We also spoke with ten members of staff, the nominated individual and registered manager. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We reviewed a range of records including multiple care and medicine records. We looked at three staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
We continued to seek information from the provider to validate evidence found.
Updated
15 December 2020
About the service
Starcare Limited is a domiciliary care service. At the time of the inspection 262 people received support from the service, with 261 of those receiving personal care. The CQC only inspects where people receive personal care. This is to help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.
People’s experience of using this service and what we found
Some people told us they did not always know which staff would be attending, if the call was going to be late and said they did not have a regular carer. The registered manager explained that factors such as the impact of the COVID-19 pandemic had, at times, impacted on staff absence which in turn had affected call times on occassion. We have made a recommendation that the registered provider reviews systems in place, to ensure there is a consistent approach and that audit systems include assessment of consistency of staff.
Quality assurance systems had been improved since the last inspection and were, overall, effective. However, medicines audits had not always identified issues noted within the inspection. The registered manager took immediate action to address this.
People received their medicines from trained and competent staff. Procedures were in place to protect people from abuse and people told us they felt safe with the staff who supported them. Staff were aware of the procedures to follow to prevent and control the spread of infection and received specific guidance about the COVID-19 pandemic. Risks associated with individual’s needs were assessed and regularly reviewed with measures in place to mitigate these. Recruitment procedures were safe.
People were treated with dignity and respect. People told us that staff were “kind” and “polite.”
Each person had a personalised care plan which was detailed, person-centred and included assessment of people’s specific communication needs. We saw that people had been involved in planning their support. People were aware of who to contact if they had any concerns.
People and relatives were positive about the culture of the service and staff. Staff felt supported in their roles. There were opportunities for people to provide their views of the service they received.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was requires improvement (published 7 June 2019) and there were multiple breaches of regulation. At this inspection we found sufficient improvement had been made and the provider was no longer in breach of regulations.
Why we inspected
We carried out an announced comprehensive inspection of this service on 7 June 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve staffing, person-centred care, governance and informing CQC about significant events as required.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Caring, Responsive and Well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed to Good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Starcare Limited on our website at www.cqc.org.uk.