Bluebird Care

Bluebird Care is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to both older adults and younger adults. The service works in conjunction with the local authority to provide a Discharge to Assess service. This service has been created to help people who do not require an acute hospital bed but may still require support from care services get home more quickly.

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. At the time of the inspection they were providing care and support to 130 people.

People’s experience of using this service and what we found

At the last inspection, systems to monitor the quality and safety of the service were not always effective and there was a lack of oversight by the management team. Improvements were seen at this inspection. The provider and registered manager implemented new systems and processes to assess and monitor the quality and safety of the service.

People were happy with the standard of care and support provided to them. Comments included,

“They (staff) really understood what I needed. It has been very reassuring having their visits” and “They take time to worry about you, it’s not just a job, you can tell they are about the people as well”.

An area for improvement identified by people was the timing of their visits. These were described as “erratic” at times. An improvement plan had been developed to address these issues. This included, contacting people to understand their expectations; a review of the specific geographical areas to reduce travel time for staff, and on-going recruitment of staff.

People said the service was safe. Comments included, “I feel nice and safe, they don’t rush me…” and “Yes I feel safe. The care is excellent really and the staff are lovely”. Staff ensured people were safe from harm. Risks to people were assessed and procedures were in place to help keep people safe.

The provider's systems protected people from the risk of abuse. Staff were aware of their responsibilities with regards to safeguarding people. Medicines were managed safely, and people were protected from the risks associated with the spread of infection. Infection prevention and control policies and practice kept people safe.

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 said staff were kind and considerate and encouraged them to maintain their independence in a professional way. Staff respected people's right to privacy and dignity. Comments included, “They’re very kind, very considerate, understand me and mostly my needs” and “I haven’t had any problems and there’s a couple (of staff) that are exceptional”.

People had care plans which reflected how they wanted to receive their care. Care plans were reviewed regularly. People and relatives were involved in the planning of care. People knew how to raise concerns.

Incidents and accidents were monitored by the registered manager. Where accidents and incidents occurred, the registered manager ensured appropriate action was taken for people to reduce the likelihood of injury or reoccurrence.

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 07 January 2021) and there were breaches of regulation. 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: This inspection was carried out to follow up on action we told the provider to take at the last inspection

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Blue Bird 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 is a domiciliary care agency. It provides personal care to people living in

their own homes. It provides a service to both older adults and younger adults. 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. At the time of the inspection they were providing care and support to 200 people.

People’s experience of using this service and what we found

The provider had failed to ensure robust recruitment practices had been followed, which put people at risk of receiving care from unsuitable staff. There were enough staff to ensure the scheduled visits could be met. However, several people said they would like more regular times for their visits and a more consistent team of staff supporting them. Staff recruitment was on-going and the registered manager and provider were confident this would help to address the issue of visit times.

In the weeks prior to the inspection we received six safeguarding alerts. Concerns related to staff approach and attitude, and allegations of theft. One concern had not been recognised as a safeguarding issue. This meant the report had not been dealt with in a timely way by managers at the service. This resulted is avoidable distress to the person involved. We have made a recommendation that the registered manager work with the local authority safeguarding team to ensure any safeguarding concerns are recognised and dealt with in a timely way.

Systems to monitor the quality and safety of the service were in place but had not always been effective. A lack of oversight relating to staff recruitment and safeguarding reports meant people had not been fully protected. This had been recognised by the registered manager and steps had been taken to improve oversight at the service. We have made a recommendation to ensure the new systems in place to monitor the quality and safety of the service are fully embedded to ensure improvements continue and are sustained. The provider and registered manager were open and transparent about the shortfalls found at this inspection. They had taken action to address most of the issues.

People said they were very happy with the regular care workers, who understood their needs and made them feel comfortable. People praised the staff for their kindness and most expressed confidence in staff’s knowledge and skills. Comments included,” They are lovely…” and “I don’t think we would ever get to the stage when we felt unsafe, the staff are very cautious”.

Risks to people’s health, safety and well-being were assessed, and measures put in place to reduce the risks. People’s medicines were managed safely.

People reported staff used personal protective equipment (PPE), such as face masks, gloves and aprons when delivering care. They confirmed they felt safe with staff practice during the pandemic. Comments included, “We’ve felt safe during Covid 19…” and “During Covid it’s brilliant with the carers. I can’t fault the carers at the moment”.

People were asked to share their views about the service through care review meetings, regular phone calls and the use of satisfaction surveys.

Some professionals described positive working relationships and good communication with the service. Others offered opportunities to build stronger professional relationships and improve communication.

Why we inspected

The inspection was prompted in part due to concerns received in relation to safeguarding issues. A decision was made for us to inspect and examine those risks.

We undertook this focused inspection on 12 November 2020 and inspection activity ended on 30 November 2020. We have identified a breach in relation to Regulation 19 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Recruitment practices had been followed, which put people at risk of receiving care from unsuitable staff.

This report only covers our findings in relation to the Key Questions in Safe, and Well-led.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

You can see what action we have asked the provider to take at the end of this full report.

Follow up

We will request an action plan for 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.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Bluebird Care on our website at www.cqc.org.uk.

People’s experience of using this service:

People did not always receive care and support from staff who understood their roles and responsibilities. This meant some staff had acted outside of their remit, which resulted in some care and support not being provided in a well-planned and directed way.

We recommended the provider looked at ways to improve staff knowledge of their roles and responsibility within the service.

There was not a registered manager in post. The new manager had applied to register with the Care Quality Commission (CQC). The registered manager and provider are legally responsible for how the service is run and for the quality and safety of the care provided.

People did not always receive care and support from a consistent team of staff. People also said staff were sometimes late and they were not always informed. The manager was working towards improving this experience for people.

People received care from staff who were kind and caring. Staff respected people’s privacy and dignity when providing personal care. However, some people said they sometimes received care and support from a male care worker when they had said they preferred not to. The manager was reinforcing the need for planners to be aware that some people did not want a male care worker to carry out personal care.

There were systems in place to monitor the quality of the service, ensure staff kept up to date with good practice and to seek people’s views. However, they had failed to identify the lack of consistency of care workers that some people had experienced. The manager had identified shortfalls and was working towards addressing the issues raised.

Some staff in a specific geographical area said they did not feel supported and involved in the running and development of the service. The provider was looking at ways to improve communication with staff in this area and support them to be more actively involved.

People told us they felt safe with the staff who supported them. Risk assessments were in place to identify any risk to people and staff. All staff understood how to ensure people were safe. There were enough staff to support people with their daily living.

Staff demonstrated a good understanding of people’s needs and received training relevant to the needs of the people they provided care and support for. Some people needed help to prepare and eat a healthy meal. Staff ensured peoples dietary preferences were followed, and a healthy meal provided.

Staff encouraged people to be involved in their care planning and reviews. People were supported to express an opinion about the care provided and any improvements that could be made.

Records showed the service responded to concerns and complaints and learnt from the issues raised.

The service continued to have strong links with the local community. They provided support and training in Dementia awareness to local businesses, schools and colleges.

Rating at last inspection: At our last inspection we rated the service Outstanding. The report was published June 2016.

Why we inspected: This was a planned inspection based on the rating at the last inspection. The service’s rating changed from Outstanding to Good overall.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Bluebird Care provides personal care to people living in the areas of Taunton, Mid Devon, Sedgemoor and West Somerset. At the time of this inspection they were providing personal care for 96 people. They also provided a domestic service to people living in their own homes.

This was the care provider’s first inspection since they re-registered at their new address. The inspection was carried out by one adult social care inspector.

People who received care and support from Bluebird Care said they were very happy with the service provided. Everybody said the staff went above and beyond what was expected of them. People told us they felt safe with all the staff who supported them. There were clear risk assessments which meant care was provided in a way that minimised risks. One person said, “I always feel safe they are all so nice.” Another person said, I really look forward to them coming and I have never felt unsafe.” Staff were aware of how to recognise and report any suspicions of abuse and all were confident that any concerns would be fully investigated.

The registered manager listened to what people said and made adjustments to their care and the organisation to reflect their comments. For example care workers worked in small geographical teams to ensure people received care and support from a regular team of staff whom they got to know well and trust.

People received care and support in line with their needs and wishes because adequate numbers of staff were employed. There were contingency plans in place if staff were unable to carry out their visits. Staff were well trained and had a good knowledge of the needs and preferences of people which enabled them to provide personalised care. One person said “They all know exactly how to look after me; they even know which TV channel I watch and make sure it is on before they leave.” A relative said, “They know how to look after [the person] and they make sure the exercises he needs are done every day.”

Care plans were personalised to each individual and contained information to assist staff to provide care in a manner that respected their wishes. For example the care provider provided support for one person who had an active life and interests such as shooting and boxing. The care provider had arranged for the person to have a male care worker with similar interests and had facilitated a weekend in London at a boxing match.

People said they received care and support from a consistent team of people they knew. One person said, “I have my team of girls and I have got to know them very well.” Staff said they had sufficient travel time between visits so they could spend extra time with people to have a chat and get to know them rather than just provide the care required.

The registered manager had a clear vision for the care provider which was to provide a service which was influenced by the needs and wishes of the people who used it. There was a commitment to providing high quality care which was tailored to people’s individual wishes. Their vision and values were communicated to staff through staff meetings, supervisions and a regular newsletter. People’s views were gathered by regular monitoring visits and phone calls and by satisfaction surveys.

The care provider worked within the local community to promote awareness of the effects of living with dementia. They took a key role in supporting organisations to develop dementia champions within their staff teams. Part of their role within the community was to provide training sessions in dementia awareness for groups, clubs, colleges and family members of people they provided support for.

The registered manager demonstrated an excellent understanding of the importance of effective quality monitoring. The systems in place enabled checks of the service provided to people and to ensure they were able to express their views so improvements could be made. There was a high level of satisfaction with the service. Staff were proud to work for the service and felt valued for their work. A positive culture was demonstrated by the attitudes of staff and management when we talked with them about how they supported people.

The care provider operated a rapid response team who were available at short notice to prevent a hospital admission. They also provided an emergency response system with some of the people who used the service. This was an emergency lifeline which people could use if they required urgent assistance. The system used a Global Positioning System (GPS) which enabled anyone responding to the call to know the exact location of the person in difficulty.

People knew how to make a complaint and people said they would be comfortable to do so. One person said, “They always ring to check everything is ok and the supervisors come out to check they are working properly. When they do that they also ask if I am happy with the care they provide.” Another person said, “I have never needed to complain but they are so approachable I know I could speak to them if I needed to.”

Several members of the Bluebird Care team had been nominated, for the Care Focus Care Awards. On the last day of our inspection the registered manager was informed she had been accepted as a finalist for outstanding care. These are annual awards open to all care providers in Somerset to recognise excellence in care. Following the inspection the registered manager informed us they had won the category for outstanding care.