Star House

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People’s experience of using this service and what we found

Star House was an exemplary model of person-centred care, driven by passionate management and staff who placed young people and their families at the heart of the service. There was a joyful, uplifting atmosphere in the home, which young people clearly loved. Young people were encouraged to achieve meaningful goals through use of best practice approaches and a desire to support them to experience the most out of life. Any barriers to participation in any aspect of life were removed, and young people were supported to overcome considerable challenges to achieve this aim. Respect for young people’s individual personalities and needs were central to the outstanding achievements at the service.

Young people received excellent support to express themselves and their wishes, even when they did not communicate verbally. Staff were highly trained, knowledgeable and passionate about the service giving young people the very best experience they could, and relatives told us they were highly appreciative of the support provided to them. The service had been well adapted for the needs of a diverse service user group, and had explored innovative ways to ensure young people had exemplary support to express their views and emotions.

The support provided to young people around death and dying was a powerful feature of this service. Where they needed it, young people had received the most sensitive, caring support to understand and overcome challenging emotions.

The management and culture at the service were outstanding. Young people’s rights, experiences and diverse needs were championed and celebrated, and staff at all levels used joyful language when talking about young people and the work they did. Staff turnover was low and we found their commitment to providing the highest standards of care were unwavering. Young people and their families were true partners in defining and running the service, and partnership work with health professionals and the local community was a strong foundation for providing excellent care and support.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was good. (Report published 10 January 2017).

Why we inspected

This was a planned inspection based on the previous rating.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Star House on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Star House is a short break service for children and young people up to the age of 18 who have learning disabilities, physical disabilities and/or complex health needs who require nursing or personal care. It is a fully accessible single storey building with gardens and can accommodate seven children. There were six children using the service when we visited. Care is provided to around 45 children each year with each child receiving around 70 overnight stays per year.

The service is also registered with Ofsted. Ofsted last carried out a full inspection in October 2016 when the service was rated outstanding.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, 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.

Children and young people had access to a wonderful range of age appropriate activities, some of which they could not access at home. Facilities at the service included a soft play area, sensory/relaxation room, ball pool, toy room, computer and television room, sensory garden, allotment area, basketball court and trampoline. During our inspection each child was doing what they wanted with staff support. Staff did not view the complex needs of the children and young people as a barrier to them participating in similar activities to those of their peers.

Staff had an excellent understanding of the needs of the children and young people who used the service. Children and young people were supported to maintain their privacy and dignity by very compassionate staff. Children and young people were extremely comfortable with staff and there was a welcoming and homely atmosphere at the service.

There were very positive relationships between the families, children and staff that supported them. Staff had been creative in considering new ways to support families of children and young people.

Relatives we spoke with felt staff were very caring. One relative told us, “They are very caring and compassionate.” Another relative said, “The staff are lovely and so devoted and they really, really care about the role.”

Relatives spoke positively about the support they received from staff. One relative said, “They have given me emotional support when I needed it, they made time for me and were a friendly voice at the end of the phone.”

Relatives we spoke with felt the service was safe for children and young people. One relative commented, “As a parent I don’t have to worry a bit about them going there, I never have and it’s such a relaxed environment that I can ring every night. This allows me to switch off if I need to.” Another relative said, “I’m really happy with the service and so is my child.”

Relatives told us how the service had made a huge impact on their children by giving them the confidence to be themselves and allowing them to be children and young people.

Risks to young people's health and safety were recorded in care files. These included risk assessments about young people’s individual care needs such as using specialist equipment pressure damage and nutrition. The environment was clean and well maintained.

Medicines were managed safely. There was a clear system in place to book medicines into the service when a child or young person was admitted for a short break. There was clear guidance in place for ‘as and when required’ medicines, for example if a child or young person needed pain relief.

Children and young people who used the service were supported by staff that were trained and knowledgeable. Relatives we spoke with described staff at Star House as competent and capable. One relative said, “Staff know what they are doing, they know the kids and interact well with them.”

A staff member told us, “The training we receive is excellent.

Care records contained detailed information and guidance about how to support young people based on their individual health needs, social needs and preferences. The support guidance in care records also included information about how much staff support young people required and how staff could promote young people's independence.

Staff at the service worked closely with other teams to enable a smooth transition from children's services to adult services. The service employed a dedicated transition worker which meant there was a single point of contact for families.

Relatives and staff spoke positively about the registered manager (clinical lead) and the management team as a whole. A relative told us, “[Registered manager] is really good. I know they’re always on the end of the phone.” Another relative said, “The management are very hands-on, definitely easy to talk to.”

The management team ensured the quality of the service was continually assessed and monitored by carrying out monthly audits of all aspects of the care provided.

There were systems in place to gather feedback from relatives and health and social care professionals. An annual survey had just been issued.

There was a positive culture and ethos at the service which was driven by the management team. They were clear that the aim of the service was the wellbeing of the children and young people. Staff took pride in telling us they treated each child or young person as an individual and we saw this put into practice.

We reviewed four children's care records and saw these were detailed, up to date and highly person-centred, with the child's needs at the focus of all information.

Parents told us they were extremely satisfied with the standards of care and they praised for the staff team and the quality of the service provision. One parent said about Star House: 'They are family to us. I trust them with all my heart'. Another described Star House as 'absolutely brilliant'.

Staff we spoke with were passionate about their work with the children. They emphasised each child was unique and had their own individual needs, which staff clearly understood well.

We saw plenty of documented evidence that Star House works in full co-operation with other providers to ensure children receive care that is tailored to their individual requirements.

We found staffing levels were appropriate to meet the complex needs of the children being cared for.

Records we looked at were stored confidentially and were up to date and organised efficiently.

We spoke with four members of staff who were able to demonstrate a good understanding of the needs of children who stay at Star House. They told us that the staff team was supportive and worked well together and they were well supported by managers of the home.