Short Term Assessment and Re-ablement Service

such as meal preparation and advice and referrals to other services as needed. The local authority is the provider and the service is situated in Rochdale Infirmary. At the time of the inspection 75 people were using the service.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. Like registered providers, they are 'registered persons'. Registered persons have a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The service was last inspected in July 2016, and rated Requires Improvement. There were four breaches of the Health and Social Care Act 2008 (Regulated Activities) 2014. Some policies and procedures were out of date, there was no record of people giving their consent to care and treatment, support plans did not show how people had been consulted to develop their plans in an individual way and medicines administration was not always safe. The service were asked for and provided an action plan to make improvements. We saw that at this inspection the necessary improvements had been made.

The service used the local authority safeguarding procedures to report any safeguarding issues. Staff had been trained in safeguarding topics and were aware of their responsibilities to report any possible abuse.

The administration of medicines was safe. People were encouraged to manage their own medicines.

Staff were robustly recruited, received a suitable induction, had access to a lot of training and received support and supervision which helped them carry out their roles.

Staff were described as reliable and trustworthy. People felt safe with the staff who looked after them.

We observed staff had a professional and friendly attitude with people who used the service and we saw some good natured exchanges between them.

The office the service worked from was fit for purpose and provided staff with a place to meet.

People were supported to take a nutritious diet.

Staff understood their responsibilities under the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS). Staff had been trained in the MCA and DoLS and could recognise what a deprivation of liberty was or how they must protect people’s rights.

People who used the service were consulted about their care and signed their agreement to the plans of care they helped develop.

People who used the service were supported to be independent. Plans of care were developed around gaining independence and we saw how people were supported to achieve their goals.

People had access to a complaints procedure if they wished to raise any concerns.

People who used the service and staff thought management was approachable and supportive.

Policies and procedures were reviewed and gave staff the information to equip them to work in a care service.

Management conducted audits and gained feedback from people who used the service and staff to improve the quality of service provision.

The Short Term Assessment and Re-ablement Service (STARS) provides short-term support of up to six weeks to help people recover or cope after a decline in health, injury or an illness (such as a hospital admission or becoming unwell in the community to prevent admission to hospital). The service encourages people to achieve maximum independence, health and well-being. Services include supporting people to manage their personal care (washing and dressing), other daily tasks such as meal preparation and advice and referrals to other services as needed. The local authority is the provider and the service is situated in Rochdale Infirmary.

At the time of the inspection there was a registered manager. 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.

The service was last inspected under the Health and Social Care Act (Regulated Activities) Regulations 2010 on 2 December 2013, where the five outcomes we inspected were compliant.

On the day of our inspection the service was providing varying levels of support to 90 people. The service was flexible as the number of people that received personal care varied at any given time. This was due to referrals and pressure from local hospitals in order to optimise the use of acute hospital beds. During our inspection the registered manager told us they had received 32 referrals within one week. The service was split into two; STARS+ and STARS. STARS+ provided support for up to two weeks to prevent hospital admissions and STARS provided support for up to six weeks to re-able people in their own homes after a period in hospital.

The service worked in conjunction with an NHS Trust to ensure that rehabilitation was fully implemented into people’s care packages. This joint working enabled people to regain their independence as quickly as possible.

During this inspection we found a number of breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

The management of medicines was not always safe. We noted hand written medicine administration records (MARs) did not contain two signatures to evidence that the information on them was correct and had been checked. We also noted a medicines error had occurred in that Paracetamol had been administered incorrectly, resulting in the person receiving over the prescribed amount. The service raised a safeguarding concern in relation to this error. The medicines policy and procedure that was in place in the service contained incorrect and out of date information and therefore did not provide adequate guidance for staff to follow.

Staff members also told us that although no one was currently prescribed controlled drugs, they had administered controlled drugs to people in the past. The medicines policy did not make reference to controlled drugs and the procedure for staff to follow. We have made a recommendation that the service considers current best practice guidance in relation to controlled drugs.

Records we looked at showed that a Disclosure and Barring Service (DBS) check was carried out prior to staff commencing employment. However, we saw no other evidence that this was further checked at any point during their employment.

Support plans that were in place did not contain a signature or evidence that people had been involved in and consented to the level of support being given. Support plans were not person-centred, they were pre-populated forms completed by the staff members without evidence that the person was involved. They also did not direct staff on how to meet individual needs or the preferences of people.

Staff did not always have access to relevant information to guide them in their roles. Some policies and procedures contained out of date or incorrect information. The registered manager told us some of these policies were due to be reviewed and re-written.

We found adequate numbers of staff were deployed to meet the needs of people who used the service. All the people we spoke with told us staff spent the required amount of time supporting them.

We found staff participated in regular supervision sessions with their manager and annual goal setting and performance appraisals. Staff had completed all mandatory training and e-learning courses were available.

People who used the service told us they were supported by staff members who were kind and caring. All of the people we spoke with spoke very highly of the staff members.

Most people who used the service knew how to make a complaint, compliment or raise a concern. We saw that people were given leaflets detailing who to contact should they wish to.

Staff members and external professionals all felt the registered manager was approachable.

People who used the service were given the opportunity to feed back on their experience of the service. The registered manager used this information to make improvements.