Stellar Healthcare Solutions received an overall rating of Requires Improvement at its first rated inspection, with breaches of Regulations 12 and 17 identified due to inadequate risk assessments and ineffective governance systems. People and relatives were satisfied with kind, consistent care, but incomplete risk mitigation plans posed avoidable harm risks and monitoring processes lacked evidenced oversight.
Concerns (7)
critical
Care planning
: “one person who was cared for in bed, did not have a skin integrity risk assessment to assess the risk of the person developing pressure sores or a risk mitigation plan”
criticalCare planning: “there was not a risk mitigation plan or care plan to provide clear guidelines to staff. Information was spread across different records.”
criticalSafeguarding: “We saw in the risk assessment that the person should only have pureed food, but one entry in the daily notes recorded the person had a sandwich.”
moderateGovernance: “quality monitoring processes in place, but these were not always effective as they had not enabled the provider to identify and address the issues we found”
moderateSupervision / appraisal: “The registered manager told us staff supervision was undertaken but we did not see written evidence of this.”
moderateRecord keeping: “The provider did not always record their monitoring processes such as spot checks and supervisions which meant there was not always evidence of learning and service improvement.”
minorConsent / capacity: “The provider did not get written consent from people, but agreed they would in future.”
Strengths
· People felt safe and were satisfied with care; staff were described as kind, excellent and respectful.
· Consistent staffing provided continuity of care and helped build meaningful relationships with people.
· Safe recruitment procedures in place including DBS checks, references and identity verification.
· Staff received appropriate mandatory training including safeguarding, medicines and infection control.
· Care plans were person-centred, recorded individual preferences, social history and communication needs.
Quality-Statement breakdown (24)
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Ensuring consent to care and treatment in line with law and guidanceRequires improvement
effective: Staff support: induction, training, skills and experienceRequires improvement
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies to provide consistent, effective, timely careGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: Meeting people's communication needsGood
responsive: Supporting people to develop and maintain relationships to avoid social isolationGood
responsive: Improving care quality in response to complaints or concernsGood
well-led: Continuous learning and improving careRequires improvement
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Managers and staff being clear about their roles and understanding quality performance, risks and regulatory requirementsGood
well-led: Engaging and involving people using the service, the public and staffGood