Archived: A Star Support Services

Updated 9 January 2019

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 on 27 and 28 September 2018 and was announced. The onsite element of the inspection was completed by one adult social care inspector from the Care Quality Commission (CQC). Follow-up telephone calls to relatives and staff were carried out by a second inspector, also from the CQC.

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. We also reviewed information we held in the form of statutory notifications received from the service.

As part of this inspection we also liaised with service commissioners from the local authority.

We spoke with six members of staff including the provider/registered manager, house managers, and support workers.

We looked in detail at six support plans and associated documentation; four staff files including recruitment and selection records; training and development records; health and safety records; and documentation related to governance and management of the service.

Updated 9 January 2019

This inspection was carried out on 27 and 28 September 2018. This was an announced inspection, which meant we gave the provider 48 hours’ notice of our visit. This was because the service supports people living in the community and we wanted to be certain there would be someone available to facilitate our inspection.

A Star Support Services provides care and support to people living in a ‘supported living’ setting, so that they can live in their own home as independently as possible. People’s care and housing are provided under separate contractual agreements. The Care Quality Commission (CQC) does not regulate premises used for supported living; this inspection looked at people’s personal care and support.

At the time of this inspection there was 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.

We last inspected A Star Support Services in July 2017. At that inspection we found breaches of legal requirement regarding safe care and treatment; need for consent; good governance; and fit and proper persons employed. The service was rated ‘Required Improvement’ and we required the registered manager to send us an action plan with timescales for improvement.

This follow-up comprehensive inspection was planned to check on progress. We found improvements had been made in the key question of ‘Safe’ which meant the service was no longer in breach of legal requirements for safe care and treatment and fit and proper persons employed; but insufficient progress had been made overall. At this inspection we found two continued breaches of legal requirement regarding the need for consent and good governance. You can see what action we have taken at the back of the full report.

Improvements had been made in respect of emergency procedures and the availability of Personal Emergency Evacuation Plans (PEEP). Recruitment and selection procedures had also been strengthen to ensure consistently safe recruitment practices.

We found continued issues related to record keeping and documentation around 'consent' and the decision-making process that led individuals to be placed with the service. We also found issues related to the signing of tenancy agreements for those people who lacked mental capacity and could not provide consent.

Systems for audit, quality assurance and questioning of practice were not operated effectively. In particular, quality assurance systems were not sufficiently robust to demonstrate remedial actions, outcomes and lessons learnt.

We found there was a variation in the layout, format, quality and content of support records across the service. However, we saw that work was already underway in developing a new style and format of support plans and we were shown a draft example of this.

Appropriate systems were in place for both safeguarding and whistleblowing which sought to protect people from abuse. Staff understood their role in helping to keep people safe and gave us examples of how they would do this. Safeguarding training was also provided to staff.

People were enabled to live active and fulfilled lives. Positive risk taking with people's individual risk assessments aligned with support plans. A variety of risk assessments were also in place related to accessing the wider community. For example, going to the swimming pool, gym, road safety and accessing public transport.

People's medicines were ordered, stored, administered and disposed of safely.

People who used the service were supported by staff who were skilled and competent to fulfil their roles. Training provided to staff was a combination of face-to-face and e-learning. Topic areas included medication, challenging behaviours, autism, moving and handling, safeguarding and positive interventions. Staff were also provided with opportunities for continuous development.

People who used the service were supported to maintain healthy balanced diets. Whilst we saw that menus were planned in advanced, this was done in consultation with people and individual preferences were catered for.

People's ongoing healthcare needs were met. Support planning documentation contained details of the healthcare professionals involved in a persons care and records demonstrated that people who used the service were supported to attend a variety of health related appointments and to maintain good health.

Relatives were consistent in their praise of staff. People who used the service and their relatives were positively engaged on a regular basis and were actively encouraged to contribute and participate as much as possible. Regular house meetings took place and people were encouraged and supported to share their views.

Staff had sufficient time to provide one-to-one support to people who used the service. We noted the positive impact of this with regards to emotional wellbeing and managing behaviours that might challenge the service.

The service had a complaints policy and procedure and information was readily available with regards to how to make a complaint. Relatives of people who used the service told us they knew how to raise a concern and they felt assured these would be taken seriously.

Relatives of people who used the service were complimentary about the registered manager and house managers. We were told managers were supportive, caring and helpful.