Sterling Standard Care Group

About the service

Sterling Standard Care Group is a domiciliary care service that provides care and support to people living with dementia, older people, people with a learning disability and autistic people, including children. At the time of our visit, the service was providing care and support to 80 people living predominantly in North London.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. At the time of our visit, around 30 people received personal care.

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

Right Support:

Risks in relation to people's care and welfare were not always thoroughly assessed. This meant staff did not always have the right guidance to support people safely. Systems were in place to manage people’s medicines. However, improvement was needed in the way information about people’s medicines was presented in their care plans and risk assessments.

Staff supported people to make decisions following best practice in decision-making.

Staff enabled people to access specialist health and social care support in the community.

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.

Right Care:

Staff were deployed effectively to meet people’s needs safely. However, we found shortfalls in recruitment processes, more specifically around staff documentation.

Staff understood how to protect people from poor care and abuse. People told us staff were kind and caring.

Staff promoted equality and diversity in their support for people.

Right Culture:

The service’s quality improvement processes needed to improve as they failed to identify the issues we found at this inspection.

People received support from a competent staff team. Managers ensured staff had appropriate support and training.

Managers worked towards improving care delivery by involving and gathering the views of people and their loved ones. Staff valued and acted upon people’s views.

There was a positive culture where people felt empowered and were pleased with their care.

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 (published 13 March 2019).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from good to requires improvement based on the findings of this inspection. You can see what action we have asked the provider to take at the end of this full report.

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

Enforcement and Recommendations

We have identified breaches in relation to safe care and treatment, and good governance.

We made a recommendation about the safe recruitment of staff.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

People’s experience of using this service:

The service first registered with the CQC in November 2016. This inspection on 20 February 2019 was the first inspection for the service.

People we spoke with told us that they were satisfied with the level of care they received. They told us they had been treated with respect and felt safe with the support they received from care workers. Relatives we spoke with told us they were confident people were safe when being cared for by care workers.

Arrangements were in place in respect of medicines management. Staff had received medicines training and policies and procedures were in place. We looked at a sample of Medicines Administration Records (MARs) and found that these were not always completed fully. Further, where medicines formed part of a blister pack, the medicines were not always detailed on the MARs and therefore it was not clear what medicines had been administered. We discussed this with management and they advised that they would ensure that medicines contained in a blister pack would be clearly recorded on the MAR in future. They confirmed that they would take immediate action in respect of this.

Systems were in place to help ensure people were protected from the risk of abuse. Staff records indicated that staff had received safeguarding training and staff confirmed this. Staff were aware of the process for identifying concerns and said that they would report their concerns to management.

Risks to people had been assessed, updated and regularly reviewed to ensure people were safe and risks to people in relation to treatment or care were minimised.

People were protected from the risks associated with poor infection control because the service had processes in place to reduce the risk of infection and cross contamination.

People received care and support from the same team of care workers. This maintained consistency and ensured that staff knew people and could build friendly professional relationships with people. People and relatives spoke positively about this aspect of the service.

People and relatives told us they were confident that care workers had the necessary knowledge and skills they needed to carry out their roles and responsibilities. Staff received a range of training, which they said was useful to their role and responsibilities.

Where people received support around their nutrition and hydration this had been documented clearly in the care plan.

Where possible people were involved in making their own decisions about their care and staff sought appropriate consent from people.

People received care that respected their privacy and dignity as well as promoted their independence wherever possible.

Care support plans were person centred and individualised. They addressed areas such as people’s personal care, what tasks needed to be done each day, time of visits, people’s needs and how these needs were to be met. They also included details of people’s preferences and details of their history and interests.

People and relatives spoke positively about the management of the service. There was a clear management structure in place with the registered manager, team of care workers and office staff.

The service had clear procedures for receiving, handling and responding to comments and complaints. People and relatives told us they did not have any complaints about the service but knew what to do if they needed to raise a complaint or concern.

Systems were in place to monitor and improve the quality of the service. We found the service had a comprehensive system in place to obtain feedback from people about the quality of the service they received through telephone monitoring and home visits. This enabled the service to continuously monitor this to ensure the effectiveness of the service.

The management team and office staff demonstrated compassion and commitment to the needs of the people who used the service as well as the staff who worked for them.

The registered manager promoted transparent communication, honesty and was approachable. This was confirmed by care workers we spoke with.

Rating at last inspection: The service was first registered with the CQC in November 2016. The service was originally located in Hackney and then moved to the new address in May 2018. This inspection on 20 February 2019 was the first inspection for the service.

Why we inspected: This was a planned comprehensive inspection that was scheduled to take place in line with Care Quality Commission scheduling guidelines for adult social care services.

Follow up: We will continue to monitor intelligence we received about the service until we return to visit as per our re-inspection programme. If any concerning information was received, we may inspect sooner.