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Starcare Rural Requires improvement

Reports


Inspection carried out on 21 August 2019

During a routine inspection

About the service

Starcare Rural is a domiciliary care agency providing personal care to 176 people across the geographical areas of Cheshire West, Knowsley and Sefton. Not everyone who used the service received personal care. The Care Quality Commission (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.

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

Staffing levels had improved since the last inspection, however people still consistently fedback that staff were not always punctual and often running late. There was increased communication from the office to inform people if staff would be arriving late.

People felt that they received good care and used words including ‘kind’, ‘caring’, ‘friendly’ and ‘respectful’ when describing staff. However, one person stated they had not built up a relationship with staff due to the number of different carers visiting.

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. People had been involved in developing their care plans and signed documentation to evidence this.

The provider had introduced new care plan documentation since the last inspection. We found these were person centred and very detailed. Staff spoke positively of the impact these have had.

Systems to ensure the safe administration of medicines had improved and risks to people’s health and care needs were appropriately assessed. The management team were responsive to any issues that arose during the inspection.

Governance had improved, and new systems were in place to monitor the quality of the service. The registered manager had left recently. Although a new manager had been appointed, they were not yet registered with the Care Quality Commission.

Recording of incidents had improved and records showed that these were reported in a timely manner to relevant authorities.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 11 March 2019) and there were numerous breaches of regulation. 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, however the service remains rated requires improvement.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 5 February 2019

During a routine inspection

About the service: Star Care Rural is a Domiciliary Care Agency providing personal care to adults with physical and mental health needs. At the time of the inspection they were supporting around 200 individuals.

People’s experience of using this service:

We identified four breaches of regulations. These were in relation to good governance, person centred care, staffing and notifications. Full information about CQC’s regulatory response to the more serious concerns found during inspection is added to reports after any representations and appeals have been concluded.

People were satisfied with the day to day support they received from the staff that visited them. However, their call times were not always planned in line with their wishes and so staff did not arrive on time. This impacted negatively upon the safety and wellbeing of people.

The overall governance of the service was not robust and had failed to ensure that people received a service that was in line with their wishes. It had failed to ensure that issues were not only dealt with but that subsequent improvements were sustained.

We have made a recommendation about the management of medication. People were supported with their medicines. However, there was a risk that this was not always done safely.

We have made a recommendation about the assessment and recording of mental capacity. People were supported to have maximum choice and control in how they wanted their support to be delivered. However, the polices and systems in place did not support this practice.

Staff received adequate training and support. People were confident in the ability of staff to provide the support that they needed.

Staff told us they felt very much supported by the organisation and they were valued as employees.

More information is in the detailed findings below.

Rating at last inspection: This was the first inspection of this service.

Why we inspected: This was the first inspection of this service since it was registered with the CQC on 1 March 2018.

Follow up:

We have requested an action plan from the registered provider as to how they plan to address breaches in regulation and make improvements to the service.

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