Archived: Starlight Care Ltd

Updated 30 September 2017

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.

The inspection took place over three days, 17, 18 and 27 July 2017 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in the office when we visited.

The inspection team consisted of two adult social care inspectors 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 in this case, had experience in of caring for older people and people with dementia.

Before our inspection, we reviewed all the information we held about the service, which included notifications received by the Care Quality Commission. Notifications contain information about changes, events or incidents that the provider is legally required to send us. We contacted the local authority commissioning and safeguarding teams. We also contacted the local Healthwatch. Healthwatch are a consumer group who champion the rights of people using healthcare services.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. This document had been completed prior to our visit and we used this information to inform our inspection.

During the inspection, we reviewed a range of records. This included four people’s care records containing care planning documentation, medication administration records and daily visit reports. We looked at six staff files relating to recruitment, supervision, appraisal and training. We viewed a range of records relating to the management of the service and policies and procedures.

During the inspection, we spoke with three people and visited two people in their own homes. We spoke with five relatives of people who used the service.

We spoke with four care staff, the registered manager, and three senior staff. We asked for feedback from external professionals who were involved in supporting people who used the service, however none was received.

Updated 30 September 2017

Starlight Care is a domiciliary care service which provides personal care and support to people who live in their own homes. The service is owned and operated by Starlight Care Limited.

The provider was first registered in August 2016 and supports people with a wide range of conditions including dementia, old age and physical disability. The service supports people who live in and around the town of Scarborough, North Yorkshire.

This was our first inspection of Starlight Care. We carried out the inspection over three days, 16, 17 and 27 July 2017, all of which were announced to the provider. The provider was given notice because the location provides domiciliary care services and we needed to be sure that someone would be in the location's office when we visited. We visited people in their own homes on 17 July 2017 to gain their views. At the time of our inspection, there were 14 people using the service.

The service had a registered manager in post. 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.

Staff showed a good understanding of the processes required to safeguard adults who may be vulnerable from abuse and they were able to explain to us what they would do if they had concerns. However, during the inspection process we identified a number of areas which required improvement to ensure that people's safety was consistently maintained.

On the first day of inspection the provider did not have a business contingency plan in place. However following day three of the inspection, the manager completed and implemented this plan to ensure the smooth running of the service in an emergency situation

People who used the service did not always have risk assessments in place for areas such as moving and handling, skin integrity and the use of bed-rails. Staff were not provided with sufficient information to enable them to manage risks. There was a lack of monitoring documentation with regards to re-positioning of people who were at risk of pressure damage.

Medicines had not always been managed safely. We found gaps in recordings so we could not be sure people had received their medicines as prescribed.

Robust recruitment procedures were not in place. We found appropriate checks had not been completed before new staff commenced employment. Staff recruitment records did not always contain full employment histories and gaps in employment had not been explored. References had not been obtained and there was no recorded evidence of interviews taking place. Disclosure and barring checks had not always been received prior to employment commencing.

All new staff were required to complete an induction with the provider when employment commenced. They then shadowed a senior member of staff. However, we found the induction process was not sufficient to provide new staff with the information they required.

Staff had not always received training that they need to provide effective care and support to people. There were gaps in key elements of training such as basic first aid, fire safety, food hygiene, and safeguarding of vulnerable adults. Specialist training in areas such as stoma and catheter care had not been completed.

Staff received regular supervisions from senior staff or management. Supervisions were usually completed in the community

People were consulted about their care and treatment and verbal consent was given. People we spoke with confirmed they were always asked for consent from staff.

Effective support was provided to people with dietary needs and people said they were happy with the support in this area.

People told us the staff and the managers were very caring. We saw people's needs were met with dignity and compassion and it was evident that people who used the service had positive relationships with the staff who supported them.

People told us they had a regular team of care workers and they never had to worry about late or missed calls. They told us the care workers arrived on time most of the time.

Care plans did not sufficiently detail the complex needs that people who used the service presented with. For example, people who were at risk of skin breakdown and who required stoma and catheter care. Care plans which were in place were not subject to a formal review process.

The provider was responsive to people's needs and regularly sought their opinions, which helped them to provide good care. However, there was no recording of these discussions.

People we spoke to were complimentary about the management and the staff of the organisation. We found no evidence of complaints being made to the service.

Following the findings of the inspection and the feedback to the provider, we saw that the manager and their staff worked in a pro-active manner to address a number of issues identified during the inspection process. By the third day of the inspection, the manager had implemented a number of improvements to the service. For example, risk assessments had been completed where they were required and care plans had been updated to ensure they contained sufficient person-centred information.

We found the provider was in breach of four regulations relating to good governance, safe care and treatment, staffing and fit and proper persons employed. You can see what action we have told the provider to take at the back of the full version of the report.