East Sussex STAR Service

We rated East Sussex STAR as good because:

• The areas where clients were seen were safe and clean. The service provided safe care. Staff assessed and managed risk well and followed good practice with respect to safeguarding.
• The service provided a range of treatments suitable to the needs of the clients and in line with national guidance about best practice. Staff engaged in clinical audit to evaluate the quality of care they provided.
• The teams included or had access to the full range of specialists required to meet the needs of clients under their care. Managers ensured that these staff received training, supervision and appraisal. Staff worked well together as a multidisciplinary team and relevant services outside the organisation.
• Staff treated clients with compassion and kindness and understood the individual needs of clients. They actively involved clients in decisions and care planning.
• The service was easy to access. Staff planned and managed discharge well and had alternative pathways for people whose needs it could not meet.

However:

• Staff did not always submit notifications to the Care Quality Commission about incidents that were reported to the police.

• Caseloads were high. The average caseload for staff was approximately 70 clients. Staff said that the high caseloads meant that they could not always give clients the time they needed.

• Vacancies and high sickness absence in Hastings meant the service was often short staffed. The number of changes to service delivery and management during the previous 12 months had affected staff morale. Staff said they were stressed and under pressure because of the staffing levels.
• Staff were unable to locate the cleaning logs to demonstrate that medical equipment was cleaned regularly.
• The boilers in both services did not work properly and some areas of the environment were tired and in need of repair.
• Care plans were mixed across Eastbourne and Hastings. In Hastings, staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment. Care plans were less personalised in Eastbourne.
• There were no recognised scales to measure opiate withdrawal in any of the 14 care records reviewed.