Archived: Starbrook

A registered manager was 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.’

There were minor inconsistencies with documenting checks that had been undertaken and some rewording was needed to clarify the actions staff must take to maintain a consistent approach when supporting people.

Relatives told us the staff were good and their family members received the care and treatment needed in their preferred manner. However, the constant theme with their responses was that there had been staff changes. These relatives told us senior manager had reassured them that steps were being taken to provide consistent care to people from regular staff.

The people we observed were relaxed and comfortable with the staff supporting them. We did not observe signs of distress from people when staff were offering support or attention. The staff we spoke with were able to explain the safeguarding of vulnerable adults from abuse procedure. These staff knew the types of abuse and the expectations for them to report alleged abuse.

Risks to keep people safe from potential harm were assessed. Where risks were identified action plans were developed to minimise the risks. For example, where people were at risk of choking, food was served in bite size pieces. Members of staff were knowledgeable about supporting people to undertake risks safely. For example, assessing venues for people experiencing activities for the first time.

Accidents and incidents were reported. We saw some reports had been analysed for trends and patterns and action had been taken to ensure staff were following guidance and to assess if care plans had to be reviewed.. A member of staff said the analysis had provided them with feedback about inconsistencies with staff following strategies.

Staff said there had been staff vacancies but this had improved. They said there were opportunities to discuss personal development with their line manager. Their performance was monitored and the training provided helped them deliver care and treatment.

People were able to make some daily living decisions and followed set routines which they preferred. Where people refused to undertake their routines staff discussed the suitability of the routines. We saw staff communicated well with people. We saw staff reinforce to people using their preferred method of communication “what was happening now” and “later”.

Care plans were in place on how staff were to meet people’s needs. The regional manager told us new care plan templates were to be introduced which were to reduce duplication of information. Positive Behaviour Management (PBM) strategies were in place which gave staff guidance on managing behaviours that challenge. . Service Support Team (SST) staff said their role was to support staff with developing PBM strategies which helped people maintain their usual behaviour.

People participated in household tasks and in activities both in house and in the local community. Social stories were developed by staff to help people understand events and prepare them for appointments such as healthcare.

Menus were prepared and the stocks of fresh, frozen and tinned foods showed people were supported to eat a well-balanced diet.

The provider regularly assessed and monitored the quality of care provided at Starbrook. The service encouraged feedback their relatives, which they used to make improvements.

The people who lived at the home were not able to express their views about the care and treatment they received from the staff. We used SOFI to observe the way staff interacted with people and we sought the views of the relatives of people who lived at the home.

One relative told us 'in general we are happy with the quality of care provided to XX.'

We saw staff supported people on a one to one basis. We saw staff followed care plans by the use of distraction techniques to consistently manage specific behaviours.

Staff copied/mirrored people's behaviours for example swaying, gestures and vocal noises. This intensive interaction was used to build empathy with the person. We heard staff encourage people to express their wishes using their preferred mode of communication. We saw two people person use assistive technology, one to request a drink and another to watch a film. One person used makaton (a type of sign language) to tell us about the people who were important to them.

Medicines were administered by the staff and we saw there were safe systems in place.

The provider has an effective quality assurance system.