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Archived: Starlight Care Ltd Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

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

Inspection areas

Safe

Requires improvement

Updated 30 September 2017

The service was not consistently safe.

Risk assessments were not completed and this meant staff could not always support people in a safe and consistent manner.

Safe recruitment processes were not followed. The provider did not complete adequate pre-employment checks of staff they employed.

Medication administration records did not contain sufficient details.

Staff understood how to keep people safe from abuse and how to report any concerns.

Effective

Requires improvement

Updated 30 September 2017

The service was not always effective.

New staff completed an induction when they joined the service. However, this 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.

Staff consulted verbally with people about their consent to care and treatment. However, this was not consistently recorded.

People were provided with support to ensure their dietary needs were met.

Caring

Good

Updated 30 September 2017

The service was caring.

People told us the staff who supported them were kind, caring and treated them with compassion.

People told us they were treated with dignity and respect and staff promoted their independence.

Rotas were organised to ensure that people were supported by familiar staff wherever possible.

People who were at the end of their life had appropriate support and equipment in place.

Responsive

Requires improvement

Updated 30 September 2017

The service was not always responsive.

Care plans contained some person centred information but this was not consistently recorded.

People told us they were actively involved in reviews of their care. However, this was not recorded.

There was a discipline and grievance policy and procedure in place, which explained the process of how to raise a complaint.

Well-led

Requires improvement

Updated 30 September 2017

The service was not always well-led.

Quality assurance systems and audits that were in place were not effective and the manager did not consistently monitor the safety and quality of the service.

Notifications such as safeguarding and expected deaths of people who used the service had not consistently been submitted to CQC as required.

People who used the service and the staff said that the management were caring and supportive.