We carried out a review of the data available to us about Bluebird Care (Bradford North) on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Bluebird Care (Bradford North), you can give feedback on this service.
Bluebird Care (Bradford North) is a domiciliary care service providing personal care to people in their own houses and flats in the community. At the time of our inspection there were 45 people using the service.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided
People’s experience of using this service and what we found
People were kept safe from risk and harm and staff had a good understanding of safeguarding processes. Risk assessments were robust and relevant. Staffing levels were safe and reviewed regularly by managers. Medicines were managed safely. Infection prevention and control (IPC) systems were in place to reduce people's risk of infection.
People's needs were assessed and reviewed regularly. Peoples' health and nutrition needs were supported, and staff were aware of their responsibility to promote peoples' rights. People had access to healthcare professionals.
People and family members knew how to make a complaint and they were confident their complaint would be listened to and acted upon quickly. Staff approaches promoted dignity & respect.
The provider was open and honest in its approach to supporting people and was in regular contact with people receiving support to ensure they received regular feedback on the quality of support provided. Staff knew how to support people to ensure end of life needs were met.
Managers ensured systems were in place to monitor the running of the service. Staff worked well in partnership with other agencies to deliver effective support. Managers audited support records, including accidents and incidents to assure themselves of quality. Lessons were learned when concerns were raised, and these outcomes were communicated to staff.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk.
Rating at last inspection and update
The last rating for this service was requires improvement (published 10 January 2020) and there were breaches of regulations. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We carried out an announced comprehensive inspection of this service on 5 November 2019. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve safe care and treatment, and governance.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions safe, effective, responsive, and well-led which contain those requirements.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Bluebird Care (Bradford North) on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
Bluebird Care (Bradford North) is a domiciliary care service providing personal care to people in their home. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided. The provider told us at the time of the inspection 51 people received personal care.
People’s experience of using this service and what we found
People were not always safe. Risks to individuals were not assessed and appropriately managed, and lessons were not learned when things went wrong. Medicines were not managed safely. Staff sometimes arrived at times that were not always suitable to the person. Recruitment practices were robust and ensured staff were suitable to work at Bluebird Care (Bradford North).
Staff felt supported in their role. Staff completed induction and annual refresher training although some was overdue. People received assistance with meal preparation and to live healthier lives as required. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People told us staff were kind, caring and treated them with respect. They said the same staff usually visited and knew them well which meant they received personalised care.
People’s care plans had very limited information about how care should be delivered although there was a list of tasks that staff should complete during their visit. There was no information in people’s care records to show how the service has explored people’s preferences and choices in relation to end of life care. The provider had identified care plans were generic and needed more information about people’s individual needs. Systems were in place to deal with concerns and complaints.
Management systems were not implemented consistently and effectively. Some members of the management team and staff did not fully understand how to operate the electronic care system. People had opportunities to share their views about the service but these were not always acted upon. The nominated individual was knowledgeable and had a clear vision around how they wanted to develop the service. They had been involved with the service since September 2019. They were responsive to the inspection findings; an action plan was received and when we completed day two of the site visit some positive changes had been introduced.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 19 April 2017).
Why we inspected
This was a planned inspection based on the previous rating.
We have found evidence that the provider needs to make improvements. Please see the safe, effective, responsive and well-led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.
Follow up
We will request another action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Bluebird Care (Bradford North) provides a wide range of home care services and support to older people who live across the Bradford local authority area. Their headquarters are located within the town centre of Shipley. On the day of our inspection 57 people were receiving the regulated activity of personal care.
A registered manager was in place. 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.
People we spoke with told us they felt safe with the care and support provided by the service. Staff had received safeguarding training and understood how to keep people safe. Risk assessments were in place and appropriate to people's needs. Accidents and incidents were monitored and appropriate actions taken as a result.
Medicines were safely managed and any issues dealt with promptly.
Most people we spoke with were positive about the service and told us staff generally arrived when they should and stayed for the correct amount of time. People particularly commented on the accessibility and responsiveness of the management team.
Sufficient staff were employed to ensure people received a reliable and consistent service. Robust recruitment procedures were in place and staff received appropriate training to allow them to provide effective care and support.
The service was acting within the legal framework of the Mental Capacity Act (MCA). People told us they were supported to make choices about their care and support and information about supporting people's choice was documented in people's care records.
People told us staff were kind and caring and supported them to maintain as much independence as possible. Staff knew people well and most staff told us they supported the same people which allowed them to build good relationships and maintain consistency. This was confirmed by people we spoke with.
Electronic care records contained information on people's likes, dislikes and preferences. However, further detail would enhance the personalisation of these.
Complaints were taken seriously by the service. Any complaints received were documented and investigated to provide people with an outcome. Complaints were analysed for lessons learned.
People's health care needs were met and we saw liaison took place with a variety of health care professionals such as GPs, district nurses and social workers.
Robust systems were in place to assess and monitor the quality of the service. A range of tools were used to drive improvements.
People and staff were mostly positive about the management of the service and told us they were approachable, responsive and caring. The management team was pro-active and open to ways of improving the service.
People were involved in the running of the service through meetings, reviews, surveys, social gatherings and a regular newsletter. Most people told us they listened to by the service. Staff attended regular meetings and completed an annual survey.
A registered manager was in place. 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.
People and their relatives all spoke positively about the service. They said Bluebird Care (Bradford North) provided them with effective and responsive care that met their needs. They said that generally the service was reliable and staff arrived at the same time each day and stayed for the correct amount of time.
All the people we spoke with told us they felt safe from abuse whilst using the service. They said staff treated them well and managed risks to their health and safety appropriately. Staff demonstrated a good awareness of safeguarding and how to act to keep people safe.
Although people who used the service provided good positive feedback about the service, we found a number of issues with care records and medication documentation. This meant that we could not evidence a consistent and high quality service in these areas. The provider was transitioning from paper based records to computerised record keeping. During this transition period we found a number of people did not have up-to-date care records or risk assessments.
The service had recently reduced the number of care packages it provided, to ensure it could continue to meet people’s needs. At the time of the inspection we found there were sufficient staff employed to ensure people received a reliable and consistent service. Safe recruitment practices were in place.
Medicines were not consistently managed in a safe way. We found a number of gaps on Medication Administration Records (MAR) where we could not confirm people had received their medicines as prescribed and care records did not always reflect the medicines people were taking.
Staff received a range of face to face training and support from a recognised training provider to help ensure they had the correct skills and knowledge to care for people. People told us that staff undertook tasks carefully and competently. Most people told us they received care from a consistent group of staff, although a number of people said this wasn’t always the case and they would prefer a smaller group of staff to visit their homes.
The service was acting within the legal framework of the Mental Capacity Act (MCA). People told us they were supported to make choices about their care and support.
People told us that staff were consistently kind and caring and always treated them well. People said they felt listened to by staff and management. Wherever possible the service promoted people’s independence to help them do more for themselves.
Care records contained information on people’s likes, dislikes and preferences for example with regards to mealtime choices. This demonstrated staff had taken the time to understand the people they were caring for.
We saw evidence the service liaised with external health professionals such as GP’s, and district nurses to help ensure people’s healthcare needs were met by the service. Feedback from health professionals about the service was positive.
People told us complaints were appropriately managed by the service.
People and staff all spoke positively about the way the service was managed. They said the management were responsive in answering the phone or getting back to them regarding any queries or concerns.
Some systems were in place to assess and monitor the quality of the service. However this was not consistently so. We found records of daily care and medication records were not routinely audited as part of a system to check staff were providing appropriate care and support. We found a number of discrepancies within documentation which should have been identified and investigated by checks of this paperwork.
We saw the provider was committed to further improvement of the service. Plans were in place to ensure the electronic care recording system provided a system to robustly monitor that staff arrived on time, stayed for the correct amount of time and completed all required tasks. The registered manager told us their plan was to ensure the system was fully implemented by March 2016.
We found two breaches of the health and Social Care Act 2008 (Regulated Activities) Regulations 2014.You can see what action we asked the provider to take at the back of this report.
Bluebird Care (Bradford North) is a home care service which provides personal care in people’s own homes. This includes help with washing and dressing, mobilising around their homes and supporting people to access the local community. At the time of the inspection, the service provided care to 102 adults. The service had a registered manager in post.
The overall feedback about the quality of the service was positive from people who used the service and their relatives. For example, people told us that staff delivered effective care, were friendly and treated them well. People said they felt safe when staff were in their home.
There were two areas where people felt improvements were required. Firstly, they said that they would like more continuity of care staff, so that they could build up good relationships with familiar carers who understood their needs. Secondly, although people told us staff were usually on time, and never missed calls, they told us that when they were late, they were not contacted by the service. We saw the provider had identified these problems and was working through an action plan to address them.
Staff understood how to keep people safe and how to identify and act on allegations of abuse. Staff understood how the Mental Capacity Act (MCA) was applied to ensure decisions made for people without capacity were made in their best interest.
People’s needs were assessed when they started using the service and this was used to produce clear support plans to allow staff to deliver effective care. People’s likes and preferences had been recorded and there was evidence people were involved in their care planning and review.
Staff had received a range of training to allow them to do their role effectively. This included induction training based on national standards as well as regular training updates in areas such as manual handling and safeguarding.
People said staff were kind and considerate. People said that all the care staff were of a satisfactory standard but some were better than others. People said that it was difficult to develop strong relationships with staff due to the lack of continuity of carers.
People and their relatives were involved in the planning and review of care through regular care plan reviews.
Management had identified the key challenges which faced the organisation. We found these had been identified through quality assurance systems such as spot checks and surveys. An action plan was in place to address these challenges which were consistent with what we found during the inspection.
There were currently only limited systems in place to monitor the timeliness of care calls. There was no analysis of late calls to look for themes and trends, and late calls were not identified if staff failed to ring the office.
We found the staff we spoke with had a good understanding of how to maintain people's privacy, dignity and promote their independence.
We found the provider had assessed people's needs and there was evidence care plans had been amended to reflect people's changing needs.
We found the provider had enough staff to ensure the safety and welfare of people who used the service.
However we found staff had not received timely induction training which put people who used the service at risk of receiving care that was not to an appropriate standard.
We found the provider had systems in place to monitor the feedback of people who used the service and its staff.