Star Road Respite Service

About the service

Star Road Respite Service is a residential care home providing short stay accommodation for adults with a learning disability and autistic people living in the London Borough of Hounslow. Up to seven people can stay at the service at any time and around 62 different people use the service. On the day of the inspection 3 people were staying at the service.

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

Right Culture

The provider had systems in place to monitor the quality and safety of the service. However, the process for ensuring infection prevention and control arrangements were always in line DHSC guidance had not been implemented consistently at the time of our visit.

People and those important to them were involved in their care. The provider had a clear vision for the service based on improving people's quality of life and staff worked to make this happen.

Right Support

Staff worked to help people spend meaningful time when they came to stay by supporting them to take part in activities at home and in the community.

Staff communicated with people in ways that met their needs and supported people with their medicines safely.

Staff supported people to meet their health needs and worked with other agencies to do so. 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.

Right Care

People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to their individual needs.

The service had enough appropriately skilled staff to meet people’s needs and keep them safe. Staff had training on how to recognise and report abuse and they knew how to apply it. The service worked with other agencies to respond to safeguarding concerns.

Staff received an induction, training and supervision to help them support people. They worked with other agencies to meet people’s care and health needs.

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 18 October 2019). The provider completed an action plan after the last inspection to show what they would do and by when to improve. Whilst we found improvements had been made at this inspection, some improvement was still required.

Why we inspected

This inspection was prompted by a review of the information we held about this service and to follow up on action we told the provider to take at the last inspection. We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Star Road Respite Service is a care home providing short stay accommodation for adults with learning disabilities in the London Borough of Hounslow. Up to seven people can stay at the service at any time, and around 75 different people use the service. On the day of the inspection five people were staying at the service.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

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

People were generally happy using the service. Most relatives and professionals felt that people received a good service. Although some commented that people did not always have support to take part in a range of stimulating activities. Relatives felt people's care needs were met and some felt the service provided an invaluable support for the person and their family.

However, a number of relatives and professionals told us that communication within the service was problematic. They had experienced problems which had a detrimental effect, for example people missing out on activities. Some also told us they felt staff needed more training to support people who had sensory or communication needs. There was a diverse range of needs because the group of people using the service was so large.

The staff were kind and caring towards people. They told us they were supported and they had the information and training they needed to care for people. However, the staff had not received specific training regarding autism, sensory needs and learning disabilities. People using the service had these needs and, whilst the staff were familiar with the individuals they were supporting, they did not have the information about best practice guidance which might help them improve the way people were supported.

People were safely cared for and the staff had assessed the risks to their safety and wellbeing. They had enough to eat and were able to make choices about their care whilst staying at the service. They received their medicines in a safe way and their care was planned for according to their individual interests and needs.

The provider had systems for monitoring the quality of the service and making improvements. They investigated complaints, accidents and incidents. There were planned improvements to the service and some of these were based on feedback from relatives and other stakeholders. Relatives were able to attend regular meetings and share their experiences.

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.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.

The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement.

As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.

The service used some restrictive intervention practices as a last resort, in a person-centred way, in line with positive behaviour support principles.

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 Good (published 22 March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

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.

There was a registered manager at the service at the time of our inspection. 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.

Star Road Respite Services provides short-term accommodation and personal care for up to seven adults with physical and learning disabilities in order to give their carers a break from their caring responsibilities. There were six people using the service at the time of our inspection. People were able to use the service for tea visits, day and overnight stays which also included weekends.

The service followed correct procedures with regards to administration and recording of regular medicines.

The service protected people from harm and abuse. Staff had good understanding of safeguarding procedures and family members told us they thought their relatives were safe at the service.

The service regularly assessed and reviewed risks to people’s health, wellbeing and welfare and had procedures in place to identify and manage these risks.

The service had various systems in place to ensure people lived in a safe environment.

The service had recruitment procedures to ensure only suitable staff were appointed to work with people who used the service. The service had sufficient staffing levels to meet people’s needs.

Staff had the knowledge and skills they needed to carry out their roles and responsibilities. Staff undertook regular training to be able to understand and respond to the complex needs of people using the respite service. Staff received effective support in the form of regular one to one supervision, and yearly appraisals of their practice.

The service was working within the principles of the Mental Capacity Act 2005 (MCA), and conditions on authorisations to deprive a person of their liberty were being met.

People received care that was person centred and reflected their care needs and individual preferences.

Staff supported people to maintain a balanced diet that reflected their nutrition needs as well as cultural and religious preferences.

People were supported to maintain good health and they had access to healthcare services. The service worked closely with other healthcare professionals involved in each individual person’s care to ensure their needs were being met.

People received care that was compassionate and caring. Family members told us they were happy with how the service supported their relatives.

Staff promoted people’s independence and encouraged the promotion of people’s individulaity . People were encouraged to engage in daily tasks and experience new activities outside the service.

Staff respected people’s dignity and privacy when providing personal care.

People using the service had access to a variety of activities at the service and in the local community.

The provider had a complaints procedure which was available in a pictorial format. Family members were encouraged to give their feedback about the care provided by the service via compliments and complaints cards and in three-monthly coffee mornings.

The service promoted a culture of ongoing and transparent communication about different aspects of service delivery. The registered manager promptly addressed any gaps in staff knowledge and performance.

The service had internal auditing and monitoring processes in place to assess and monitor the quality of service provided.

The service worked closely with a range of external healthcare professionals to ensure high quality care provision and promote a multi-disciplinary approach to supporting people they cared for.

We have made one recommendation about the management of medicines in care homes.

People looked happy and relaxed at the service and staff interactions were positive and respectful. Relatives comments included 'my family member is so happy when he is going to Star Road, you can tell by his facial expression that he is happy' and 'the service really does give us a break, the manager and staff are very approachable and flexible'.

All relatives we spoke with gave us positive feedback about the standard of care people received at Star Road.

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan.

Relatives told us they felt their family members were 'safe' at the service and that staff were skilled, competent and knowledgeable in supporting people with their specific needs.

People who use the service benefitted from the appropriate management of medicines.

Staff received training which equipped them with the skills and knowledge to care for people. Staff told us they were well supported.

The provider had systems in place to monitor the quality of services provided.

People told us they enjoyed their stay at the service. One person said 'I like it here, it gets me out'. Feedback from relatives showed that people were treated with respect and the staff were professional, polite and caring towards them. One relative said 'they look after my family member very well, 100% I could not fault them'.

People received care and support that met their assessed needs in the way they preferred.

Equipment was available to meet people's needs, regularly risk assessed and appropriately maintained to make sure it was safe for people to use.

People said they liked the staff and relatives told us they felt there were enough staff on duty to meet people's needs. One relative said 'anything that I ask them to do for my family member they always try it out'.

People told us they could speak with staff if they had any concerns or worries. A relative commented 'They always put things right, even if it is a trivial thing'.