This inspection took place on 5, 6, 13 and 19 October 2016. The provider was given 48 hours' notice to make sure someone would be in. The last inspection was carried out on 21 November 2013. The service met the regulations we inspected at that time.

Star House is a short break service for children and young people up to the age of 18 who have learning disabilities, physical disabilities and/or complex health needs who require nursing or personal care. It is a fully accessible single storey building with gardens and can accommodate seven children. There were six children using the service when we visited. Care is provided to around 45 children each year with each child receiving around 70 overnight stays per year.

The service is also registered with Ofsted. Ofsted last carried out a full inspection in October 2016 when the service was rated outstanding.

The service had 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.

Children and young people had access to a wonderful range of age appropriate activities, some of which they could not access at home. Facilities at the service included a soft play area, sensory/relaxation room, ball pool, toy room, computer and television room, sensory garden, allotment area, basketball court and trampoline. During our inspection each child was doing what they wanted with staff support. Staff did not view the complex needs of the children and young people as a barrier to them participating in similar activities to those of their peers.

Staff had an excellent understanding of the needs of the children and young people who used the service. Children and young people were supported to maintain their privacy and dignity by very compassionate staff. Children and young people were extremely comfortable with staff and there was a welcoming and homely atmosphere at the service.

There were very positive relationships between the families, children and staff that supported them. Staff had been creative in considering new ways to support families of children and young people.

Relatives we spoke with felt staff were very caring. One relative told us, “They are very caring and compassionate.” Another relative said, “The staff are lovely and so devoted and they really, really care about the role.”

Relatives spoke positively about the support they received from staff. One relative said, “They have given me emotional support when I needed it, they made time for me and were a friendly voice at the end of the phone.”

Relatives we spoke with felt the service was safe for children and young people. One relative commented, “As a parent I don’t have to worry a bit about them going there, I never have and it’s such a relaxed environment that I can ring every night. This allows me to switch off if I need to.” Another relative said, “I’m really happy with the service and so is my child.”

Relatives told us how the service had made a huge impact on their children by giving them the confidence to be themselves and allowing them to be children and young people.

Risks to young people's health and safety were recorded in care files. These included risk assessments about young people’s individual care needs such as using specialist equipment pressure damage and nutrition. The environment was clean and well maintained.

Medicines were managed safely. There was a clear system in place to book medicines into the service when a child or young person was admitted for a short break. There was clear guidance in place for ‘as and when required’ medicines, for example if a child or young person needed pain relief.

Children and young people who used the service were supported by staff that were trained and knowledgeab

We visited Star House, spoke with the managers and six staff. We saw one child during the inspection and spoke with three parents over the telephone following our visit.

We reviewed four children’s care records and saw these were detailed, up to date and highly person-centred, with the child’s needs at the focus of all information.

Parents told us they were extremely satisfied with the standards of care and they praised for the staff team and the quality of the service provision. One parent said about Star House: “They are family to us. I trust them with all my heart”. Another described Star House as “absolutely brilliant”.

Staff we spoke with were passionate about their work with the children. They emphasised each child was unique and had their own individual needs, which staff clearly understood well.

We saw plenty of documented evidence that Star House works in full co-operation with other providers to ensure children receive care that is tailored to their individual requirements.

We found staffing levels were appropriate to meet the complex needs of the children being cared for.

Records we looked at were stored confidentially and were up to date and organised efficiently.

We used a number of different methods to help us understand the experiences of children using the service including talking to children and observing the care provided. We spent some time with children and we observed staff friendly and warm towards children. We saw positive relationships between children and staff which was both kind and supportive and had lots of elements of fun. Children appeared relaxed and comfortable with their surroundings and with staff.

We spoke with four members of staff who were able to demonstrate a good understanding of the needs of children who stay at Star House. They told us that the staff team was supportive and worked well together and they were well supported by managers of the home.