Archived: Starcare Mid Cheshire Branch

Starcare Rural is a domiciliary care service providing personal care to 159 people at the time of the inspection. 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.

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

Systems to monitor the quality of care being delivered were effective in ensuring peoples care was safe and met people’s needs. However, some audits needed to explain what actions would be taken when errors in recording were identified. We have made a recommendation about the development and training of staff responsible for completing audits.

People were supported to take their medicines safely. Some documentation was updated during our inspection to ensure medicines records were clear and complete.

Risks to people were clearly identified and care plans explained to staff how to support the person. Care plans were person centred and staff told us they were accessible and easy to follow.

Staffing levels were sufficient and systems were in place to monitor the timeliness and consistency of staff during care visits. People spoke positively about the care they received and told us they felt safe. Staff were described as, “lovely,” and that staff, “couldn’t do enough” to support them.

Staff felt confident in the registered manager and also felt well supported in their roles. Staff had access to appropriate personal protective equipment (PPE).

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 requires improvement (published 25 September 2019).

Why we inspected

This focused inspection was a planned inspection based on the previous rating. This report only covers our findings in relation to the key questions safe and well-led.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

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

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.

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.

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.