Starbrook

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

We reviewed 8 quality statements for this key question.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and relatives did not share any concerns about this quality statement. One relative told us, “They [staff] do let me know of any incidents, they tell me what happens. The staff are good and tell me what they have done about things.”

Staff understood they had to complete incident forms following any type of incident and accident. Staff were able to attend meetings or have discussions with management about what had gone wrong and the potential causes. One member of staff told us they felt there was a supportive learning culture at the service. They said, “We will try and investigate the cause, whether it is as a whole team, or with a specific individual. We graze over it in team meetings, trying to reduce risk of happening in the future and try to get down to the route cause. We talk about this in team meetings, especially around medicines errors or incidents of challenging behaviour.”

The provider had an electronic data system for recording incidents and accidents. Staff completed the initial forms with details of what had happened and sent copies to the registered manager for review. However, we found some incident forms did not record all action taken to prevent recurrence. The regional manager told us this had been identified as learning for the registered manager who was new in post. Support was being provided to improve recording to capture all actions taken in response to all incidents.

People and relatives did not share any concerns about this quality statement. Relatives thought communication had been good which meant transitions had been safe.

The registered manager understood the importance of people being supported safely when transitioning between services. If a person needed to go to hospital staff knew what records to take with the person, for example, hospital passports and medicines records. The registered manager said, “The staff team will support the person, we will make sure the person is accompanied to the hospital. We know the importance of staffing with our staff in the hospital.”

Professionals we contacted did not share any concerns about this quality statement.

The provider had effective processes to make sure key information went with people to health appointments or hospital admissions. Hospital passports contained important information such as allergies and communication needs. This meant emergency staff understood how best to communicate with people. If people were returning home from a short stay in hospital, the registered manager would reassess their needs and obtain any discharge information to update care plans.

Relatives told us people were safe at the service. One relative said, “[Person] is safe, I would not keep them there if I did not think [person] would be safe.” Another relative told us, “[Person] is very happy. I would know if there was a concern, [person] is well looked after, it is the right place for [person].”

Staff told us they had completed safeguarding training. Staff were clear about how to report any alleged abuse, and they were aware of the whistleblowing policy and process. Staff were confident the registered manager would take action if they reported concerns.

We observed staff engaging with people appropriately using preferred communication methods. People appeared to be comfortable when staff were nearby, and we observed people approaching staff for assistance.

The provider had effective processes to make sure all safeguarding concerns were recorded and shared with the local authority safeguarding team. Concerns were also reviewed by the regional manager and the provider quality team to make sure actions were taken when needed. The provider also had a positive behaviour support team who were involved where appropriate to support people with any distress.

Relatives did not have any concerns about how the service managed risks. People and relatives had been involved in developing risk management plans particularly for distress or behaviour that challenged.

Staff demonstrated a good understanding of people’s risk management plans, and the support needed for people to stay safe. Staff said they felt risks were well managed in the service and prompt action taken when new risks were identified.

We observed staff supporting people to manage risks they faced in line with their support plans. Examples included support to manage the risk of ingesting dangerous items and clear communication so people understood when they would be doing specific activities. Staff levels matched details set out in people’s support plans.

People had risk assessments and risk management plans, which set out the support they needed to stay safe. Plans gave clear guidance on how to support people and what strategies to use to support any distressed reactions. The plans had been regularly reviewed with people and their relatives to ensure the measures in place were up to date.

Relatives had no concerns about staff working safely and thought the environment was safe. One relative said, “It is a very safe environment with a good door locking system to the house.”

Staff referred people to relevant professionals when needed for assessment and guidance. For example, if people needed any equipment, staff would involve an occupational therapist to seek specialist advice.

We observed the environment was well maintained. People had their own rooms as well as access to shared communal areas. The registered manager showed us an area that was being considered as a potential sensory room. Staff were working with people to get feedback on whether a sensory room would meet people’s needs.

When areas needed maintenance staff reported maintenance requests to the provider. Systems such as fire alarms and emergency lights were checked regularly by staff and serviced. Staff also monitored fridge and freezer temperatures, keeping records of results. Those seen were all within a safe range.

Relatives had no concerns about the staff skills and numbers. One relative said, “They [staff] are all really good, can’t fault them at all. I get to see [person] with staff, they are all really good with [person].”

Staff spoke positively about their induction when starting at the service and said they had the training they needed to work safely. New staff were able to shadow more experienced staff until they were confident about supporting people.

We observed there were sufficient staff to meet people's needs and to respond to requests for support. Staff demonstrated a good understanding of people's needs, including communication and how to support people to manage risks.

People had the support they needed from sufficient numbers of staff. Staffing numbers were dependent on people’s needs and funding agreements. Some people had 1-1 staffing hours during the day, and some had 2-1 staffing hours to access the community. Where there were gaps on the staff rota the provider used agency hours. The service tried to use the same agency staff to enable people to be supported by staff they knew. New staff were provided with an induction and opportunity to meet regularly with their line manager. Training was provided both face to face and via online learning. The provider monitored staff training and prompted managers to make sure all mandatory training was completed regularly.

Relatives told us the service was always clean. Staff encouraged people to be involved in keeping their home clean.

Staff confirmed they had access to personal protective equipment and could request more if needed. Staff had been provided with training on infection prevention and control and received regular updates.

The home was clean and well maintained. Personal protective equipment was available for staff to use when needed. We observed staff following safe food hygiene guidelines. For example, food in fridges was covered and labelled and staff regularly checked fridge temperatures to make sure they were within a safe range.

The provider had an infection prevention and control policy, which was regularly reviewed and updated to reflect current guidance. The management team completed regular audits, to ensure they were putting the procedures and their training into practice.

Relatives were happy with the staff approach regarding medicines management. One relative told us, “I have no concerns about [medicines] at all. I feel the staff are aware if medication is needed for pain relief as [person] would change their behaviour.”

Staff did not share any concerns regarding medicines management. Staff confirmed they had received medicines training and been assessed by senior staff for competence. Staff we spoke with told us they felt confident managing and administering people’s medicines.

The service made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. They involved people in planning, including when changes happened. Medicines were stored securely and safely at the service. We observed that medicines were given to residents in a person-centred and caring way. Staff completed mandatory medicines management training and annual assessments were completed to ensure they remained competent. Care plans reflected people’s individual needs in relation to their medicines. Care plans included appropriate medicines risk assessments.