Star Residential Home is registered to provide accommodation, nursing, treatment, disease, disorder and injury and personal care, for up to 30 people. At the time of our inspection there were 24 older adults and adults living with dementia at the service. There were a number of communal areas, including two lounges, a dining area, and gardens for people and their visitors to use. The service is situated over two floors. There are accessible bedrooms on both floors by either the stairs or a lift. There were communal toileting and wash facilities for people who used the service.

A previous inspection took place on 17 February 2015 and the service was rated overall as ‘good’. There were no breaches of the Health and Social Act 2008 (regulated Activities) Regulations 2014.

This unannounced inspection took place on 28 September 2016.

There was a registered manager in place during this 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.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and report on what we find. Applications had been made to the local authorising agencies to lawfully restrict people’s liberty where appropriate. Staff were able to demonstrate an understanding of the MCA and DoLS to reduce the risk that people would not have their freedom restricted in an unlawful manner.

Plans were in place to minimise people’s identified risks and to assist people to live as independent and safe a life as possible. We found detailed records were in place as guidance for staff to monitor people’s assessed risks and health conditions.

People were supported by staff in a respectful and kind way. We saw that there were lots of positive interactions between staff and the people they supported. However, there were also some missed opportunities for staff to fully engage with the people they were assisting.

Arrangements were in place to support people with their prescribed medicines. People’s medicines were stored and disposed of appropriately. However, accurate records to document people’s medicines were not always kept.

When required, people were referred to and assisted to access a range of external healthcare professionals. People were supported to maintain their health and well-being.

People’s support and care plans gave detailed and individual prompts and guidance to staff on any assistance a person may require. They included the person’s wishes on how they were to be supported and their likes and dislikes. An activities co-ordinator and staff assisted people with their interests and activities and promoted social inclusion. People’s family and friends were encouraged to visit the home and staff made them very welcome.

Staff were trained to provide care and support which met people’s individual needs. The quality of staff members’ work performance was reviewed during supervisions and appraisals. This was to make sure that staff were deemed confident and competent by the registered manager to deliver people’s support and care needs.

Staff understood their responsibility to report any suspicions of harm or poor care practice.

There were pre-employment safety checks in place to make sure that all new staff were deemed suitable to work with the people they supported. There was a sufficient number of staff to provide people with safe assistance and care.

The registered manager sought feedback from people and their relatives. People who used the service and their relatives were able to raise any concerns or suggestions that they had with the registered manager and staff and feel listened to.

Staff meetings took p

Star Residential Home is a care home registered to provide accommodation, personal care and nursing care for up to 30 people. There were 25 people living at the home at the time of our visit. The home had internal and external communal areas, including a lounge, a lounge/ dining area, and a garden for people and their visitors to use.

This unannounced inspection was carried out on 17 February 2015 and was completed by one inspector. At our previous inspection on 30 September 2013 the provider was meeting all of the regulations that we assessed.

There was a registered manager in place. They had been in post since March 2012. 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 Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and report on what we find. There were formal systems in place to assess people’s capacity for decision making and appropriate applications had been made to the authorising agencies for people who needed these safeguards.

People who lived in the home were supported by staff in a caring and respectful way that also maintained their safety. People had individualised health care and support plans in place which recorded their likes and dislikes, needs and wishes. These plans gave staff guidelines on any assistance a person may require as well as how to respect people’s choices and preferences.

Risks to people were identified by staff and plans put into place to minimise these risks and enable people to live as independent and safe life as possible.

There were arrangements in place for the safe storage, disposal, management and administration of people’s prescribed medication. Formal capacity assessments were in place for people given their medication disguised in their food and/or drink.

Staff cared for people in a patient way. Staff took time to comfort people who were becoming anxious in an understanding manner.

There were a sufficient number of staff on duty. Staff were trained to provide effective care which met people’s individual support and health care needs. Staff understood their role and responsibilities and were supported by the registered manager to maintain their skills through supervision, appraisals and training.

People and their relatives were able to raise any concerns or suggestions that they might have had with staff members or the registered manager.

There was an ‘open’ culture within the home and staff were supported by the registered manager.

People were encouraged to be included in the running of the home should they chose to do so.

The registered manager had in place an on-going quality monitoring process to identify areas of improvement required within the home. Where improvements had been identified there were actions plans in place which documented the action taken.

Improvements had been made to the standard of support and care provided. People were better supported because remedial action had been taken to meet their physical, mental and social care needs.

People who we spoke with said that they had noted the improvement to their lives as a result of these actions taken.

People told us that it was, “Really good” and, “Lovely” to be living at the Star Residential Home.

The majority of people’s health and wellbeing needs were maintained and promoted. However, improvements are required to ensure that all of the people’s wellbeing and health, including their physical and mental health needs, are safely and appropriately met.

People were provided with a sufficient amount of food and drink to meet their nutritional and hydration needs. People said that they had liked the food and were offered choices of what they would like to eat. We have made suggestions for improvements to be made regarding the quality in how people’s nutritional and hydration needs are met.

People told us that the home was always clean and smelled fresh. They also said that they were satisfied with the standard and quality of the cleaning. Effective infection control systems were in place to minimise the health risk associated with acquiring infections.

There were effective systems in place to ensure that people who used the service, members of staff and visitors, were protected from the use of unsafe equipment and premises. Equipment was provided to meet people’s health and comfort needs.

All of the people that we spoke with said that they knew who they would speak with if they were unhappy about something, but they had no cause to make a complaint. There was an effective system in place to respond to people’s concerns or complaints.

There were satisfactory systems in place to ensure that people gave valid consent to their support, care and treatment. Where people were assessed not to have the mental capacity to make such valid decisions, they were provided with support, care and treatment in their ‘best interest’.

All of the people that were spoken with, and who were able to verbally tell us, said that they liked living at the home and had no cause to complain. They liked the staff and had confidence in their ability to safely and appropriately meet people's individual support and care needs.

People were supported to maintain their health and their well being was promoted. Their individual support and care needs were provided by skilled and competent staff who had access to informative care records.

The home was a safe and well maintained place for people to live, work and visit.

People were safely cared for by adequately recruited staff who attended up-to-date training.

People were given opportunities to make suggestions to influence how the home was run and to improve the standard and quality of the service provision.

People spoken with during the inspection were complimentary about the friendly care and support they received and one person commented that "The staff were wonderful and very helpful". We noted that the care staff treated people with dignity, kindness and respect.

During our visit we spoke with some people who use the service. Overall people told us that they were happy with their care, that staff were very good and that they were treated with respect and dignity. One person told us that the food was good and another person told us that staff would accompany her on shopping trips which she enjoyed.