We carried out a review of the data available to us about Silverstars Care on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Silverstars Care, you can give feedback on this service.
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 the inspection the service was supporting 20 people who required support with personal care. This figure can change daily as people's needs change and new clients are accepted.
People’s experience of using this service and what we found
People and their relatives told us the service was well led. Since our last inspection additional senior staff had been appointed and new quality systems had been implemented to monitor and improve the service for people.
No one using the service was being deprived of their liberty under the Court of Protection. Mental capacity assessments were carried out to determine whether the person had capacity to make decisions related to their care. However, the service had not always assessed people’s mental capacity in a way that met legal requirements. Following the inspection the provider reviewed all assessments relating to capacity.
We have made a recommendation in regard additional training in regards assessing capacity.
People and relatives said the service was safe. Formal and informal methods were in place to share information around risk. Arrangement were in place to monitor and record risks. However, the risk assessments were not always reflective of the person’s risk and information about people’s risks were not always comprehensive.
We have made a recommendation about the review and recording of risks.
People were supported by staff who were kind and caring. Feedback about the caring
approach of staff was positive. People who used the service, and their relatives, described a service they could rely on. They confirmed visits were not missed and staff arrived when expected. They said they felt safe with the staff. There were sufficient staff employed to ensure all planned visits were undertaken.
People’s medicines were managed safely. Staff had received training in medicines administration and had their competency assessed to ensure the safe administration of medicines.
Staff received supervision and competency observations to help ensure they had the knowledge to
perform their roles effectively. Staff and people told us senior staff and the registered manager completed spot checks where they observed staff supporting people.
The service had an effective out of hours system in place over 24hours. A contingency plan was in place to ensure the service kept running through adverse weather conditions or during staff sickness.
People said the service was well managed. There were effective systems in place to monitor the safety and quality of the service. Regular feedback about the quality of the service people received had been sought. The management team continually looked for ways to improve the service. People were encouraged to raise any concerns they had or make suggestions to improve the service they received.
Why we inspected
This was a planned inspection based on the previous rating.
Rating at last inspection:
At the last inspection the service was rated Requires Improvement. (published 08 March 2019). We identified two breaches of the Health and Social Care Act (Regulated Activities) Regulations 2014 relating to safe care and treatment and good governance.
The provider completed an action plan after the last inspection to show what they would do and by when to improve.
At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
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.
Silverstars Care provides personal care to people living in their own houses and flats in the community. It provides a service to older adults. This is the first time the service has been rated Requires Improvement.
Not everyone using Silverstars Care receives regulated activity. CQC only inspects the service being received by people provided with personal care, help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of our inspection the service was providing personal care support to 14 older adults.
The provider of the service was also the 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.’
Robust governance and quality monitoring systems were not established or embedded within the service. Improvements were required in how the service was managed and how arrangements for accountability and delegation of management tasks were recorded. Monthly audits which included reviewing people’s records, staff files and training were not established which would ensure the quality of the service and identify where improvements could be made.
People's safety was potentially put at risk from staff who had not been trained in all aspects of their roles. For example, medicine administration. Action was needed to improve medicine administration, recording and auditing. Where people required medicines with safe gaps in administration the guidance of health professionals and instruction on the medicine administration record were not always followed. Staff did not complete accident forms when medicines had been administered wrongly or inform the provider.
Risk assessments for people's individual care needs were not accurate, personalised and lacked detail of the identified risk. Although staff were aware of people risks, risks were not monitored adequately, or completed within care plans to ensure the effective monitoring and mitigation of the risk.
The quality of the assessment of people's care needs did not routinely take place before the service began. Although people confirmed they had discussions with the provider in regards their care, there were no formal recording of the pre assessments. Further work was needed to ensure a consistent approach to how people showed their agreement to their care by signing their care plans.
People's care plans and associated records did not detail their most current care needs and documents had not been reviewed. Care plans were generic and held no evidence of individualised or person centred care. The provider told us they were not currently supporting anyone who required end of life care.
Systems in place for the recruitment and selection of staff were in place. Recruitment checks were routinely carried out before staff started their employment to ensure they were suitable to work with people using the service. Staff completed an induction process, however there were no further supervisions or competency checks completed or recorded. People told us they felt well supported but the service needed more staff.
We have made a recommendation in regard training, supervision and appraisal.
Silverstars Care had a small group of staff, although people told us they were supported by staff who treated them with kindness, respect and compassion. Some raised concerns in regards time keeping. The provider told us they were investing in a new on line system which would ensure the service was monitored more closely.
Staff understood their safeguarding responsibilities. People were supported by staff who treated them with kindness, respect and compassion. Staff had a good understanding of the people they cared for and supported them in decisions about how they liked to live their lives. People were supported by staff who respected their privacy and dignity.
We checked whether the service was working within the principles of the Mental Capacity Act. People told us that staff sought their consent before providing care. One person told us, “The staff are helpful they always ask me first to check I am happy with the care they are giving me.”
Systems were in place for recording complaints within the service. People’s relatives told us they felt confident to raise complaints but had not needed to.
During our inspection we found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We asked the provider to send us an action plan detailing how they were going to improve.