The Royal Star & Garter Homes - Solihull

Updated 4 March 2020

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team

Inspection visits took place on 8 and 9 January 2020. Our first visit was undertaken by two inspectors, one assistant inspector, an Expert by Experience and a specialist advisor. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of service. A specialist advisor is a qualified health professional. Our specialist advisor was a registered nurse who had expertise in supporting people living with dementia. One inspector returned to complete our second visit.

Service and service type

The Royal Star & Garter is a care home. People in care homes receive accommodation and nursing or personal care. CQC regulates both the premises and the care provided and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

The first of our visits was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and three professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection

During the inspection

We spoke with 15 people who used the service and eight people’s relatives about their experiences of the care provided. Due to their needs some people could not tell us about the care they received, or quality of service provided. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We spoke with 23 members of staff including the registered manager, two lead nurses, three nurses, the hospitality services manager, the activities manager, two activity assistants, one administrator, the lead housekeeper, four senior care workers, five care workers, the dietician and one physiotherapist. We also spoke with one visiting health professionals and two volunteers.

We reviewed a range of records. These included nine people’s care records and multiple medication records. We looked at three staff files in relation to recruitment and supervision. A variety of records relating to the management of the service, including staff training data, compliments, complaints and quality audits were looked at.

After the inspection

We received further information from the registered manager to validate the evidence we found. We also gathered feedback from eight health care professionals and five other people including two volunteers who often spent time at the service.

Updated 4 March 2020

The Royal Star & Garter is a care home providing personal and nursing care to a maximum of 60 people aged 65 and over. Some of those people lived with dementia. The home is purpose built and divided into four 'houses' called Linley, Roundel, Whiteley and Croucher. It is part of The Royal Star and Garter Homes which was established in 1916 to provide care to military veterans. At the time of our inspection 59 people lived at the service and some people from the local community attended a day club hosted by the service.

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

The service continued to exceed people’s expectations. People continued to have opportunities to live their lives to the full and they received exceptionally personalised and responsive care. The strong person-centred and inclusive culture demonstrated staff were dedicated to ensuring people received high quality care in line with the provider’s aims and strong values.

The attention to people’s individual wishes and needs showed how exceptional staff were at going above and beyond what was expected of them. The service had won several awards and had been recognised for their outstanding commitment to making a positive difference to people’s lives since our last inspection.

The service was an excellent role model for others and was led by a passionate management team which had been strengthened since our last inspection to further improve outcomes. Excellent governance systems were embedded and had been further improved since our last inspection.

There was a coordinated and personalised approach to support people to move into the service. People’s needs were under constant review to ensure they continued to be met. The service was extremely committed to working in partnership with health professionals to maintain people’s health and wellbeing.

People and relatives continued to feel involved in care planning and people were involved in important decisions. People mattered and promoting people’s dignity was at the heart of everything staff did. People’s independence was promoted and people’s right to privacy was respected.

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.

Staff knew what was important to people and care records contained very personalised and up to date information including people’s life histories which helped staff to provide excellent person-centred care. People continued to receive excellent, coordinated end of life care and people continued to be treated with respect after their death.

People’s needs were consistently met by a highly skilled and dedicated staff team. People, relatives and health professionals without exception were all extremely complimentary about the staff and a culture of continuous staff learning was embedded.

People eating and drinking enough to maintain their health was of paramount importance and people told us they thoroughly enjoyed the food and mealtime experiences. There was a creative approach to encourage people to try food from different cultures.

The service had a very proactive approach to managing risk and staff had an excellent understanding of how to manage and reduce risk. People felt very safe and the inclusive culture meant people’s views were well captured and people felt comfortable to speak openly about their feelings.

The provider’s safeguarding procedures and personalised approach protected people from harm. Staff knew what to do and who to tell if they had concerns about the well-being of anyone using the service.

Staff were recruited safely. During our visits enough staff were on duty to respond to people's needs to maintain their safety. Medicines management continued to be safe. People’s medicines were administered by registered nurses and trained care staff. Their competency to do so was regularly checked by managers.

The service was exceptionally clean and well maintained. People had been involved in initiatives to minimise the risk of infections spreading.

Strong emphasis was placed upon continuous improvement and learning lessons based on research and reflective practice. The whole staff team understood their responsibility to be open and honest when things went wrong. Lessons had been learnt and had been shared throughout the organisation to benefit people and staff. People told us they had no need to complain and they felt confident if they did raise concern it would be investigated and resolved.

The service played an important role in their local community that enhanced people’s lives. People were supported to maintain links with people who were important to them. Strong and meaningful links were established with local and national organisations.

Rating at last inspection

The last rating for this service was Outstanding. (Published 19 September 2017)

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

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 reinspection programme. If we receive any concerning information we may inspect sooner.