Bluewood Healthcare

Bluewood Healthcare is a domiciliary care agency, providing personal care to people in their own homes. At the time of inspection, 152 people were receiving personal care. 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 and family members were highly complementary of the support and care they received and told us they would recommend the service to others. A family member told us, “I have nothing but praise for all the carers do, I can’t find fault with anything. I have the utmost confidence with everyone, from the manager to all the carers, brilliant service.”

Systems and processes were in place to support people's safety. People's needs, including their safety were assessed and monitored. People were supported by staff who had been recruited consistent with the provider’s policy. There were sufficient staff to meet people's needs. People and family members spoke of the reliability of the service, and the consistency of staff who provided their care. People received the support they required with their medicines. Staff worked consistently within the providers policy and procedure for infection prevention and control.

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 and family members spoke of the kind and caring approach of staff and of their involvement in decisions about their care. People and their family members were involved in the development and reviewing of their care and support package.

People received good quality care outcomes, supported by the commitment of all staff to deliver person centred care, giving consideration to equality characteristics, and the individual needs and preferences of people.

The provider's systems and processes monitored the quality of the service. People's views and that of family members and staff were sought through surveys, which were analysed and used to identify where improvements were needed. A range of audits were undertaken to monitor the quality of care provided. Staff were supported through ongoing monitoring and effective communication, which included regular staff meetings to support the delivery of good quality care.

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 requires improvement (published 29 September 2022).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

We undertook a focused inspection to review the key questions of safe, effective and well-led only.

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 based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Bluewood Healthcare 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.

People's experience of using this service and what we found.

The majority of people and relatives we spoke with were satisfied with the care that staff provided and with the management of the service, though four relatives and one person were dissatisfied with some aspects of the service. This included receiving a poor response from office staff to issues raised and not being able to get through to office and on call staff when they needed to contact them about issues. Verbal concerns received by the service had not gone through the complaints process which would have led to a swifter resolution of issues raised by people and relatives.

Everyone we spoke with, except two relatives, said safe care was provided and if they had any concerns, the registered manager would act on the issues raised and put measures in place to ensure safe care. When we raised the issues from the two relatives, the registered manager acted swiftly to deal with them.

People were protected against abuse, neglect and discrimination. People were protected against the risk of infection, though one relative reported staff not wearing a mask. Details of how to reduce risks to people's safety were included in people's care plans though one risk assessment lacked detail on encouraging a person to eat. Care plans reflected people’s individual needs.

Safe recruitment practices were in place to ensure only suitable staff worked at the service. Enough staff were employed to meet people's needs. Timely calls were mainly in place to provide personal care. Quality assurance systems were in place to try to ensure people were provided with a quality service.

The registered manager understood their responsibilities and worked in an open and transparent way.

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

Why we inspected

The inspection was prompted by concerns we received that safe care was not being provided to some people. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

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 good to requires improvement based on the findings of this inspection.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Bluewood Healthcare 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.

Bluewood Healthcare is a domiciliary care service. The service provides care and support to people living in their own homes. At the time of the inspection there were 137 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 told us they felt safe using the service. Staffing was usually consistent and on time.

Risk assessments were in place that were detailed and updated as required. Staff followed assessments to keep people safe.

Staff were recruited safely, and appropriate pre employment checks were carried out.

Staff wore personal protective equipment whilst providing care to people and followed infection prevention control guidelines.

Incidents were recorded, reported, and reviewed appropriately.

People using the service could contact management as they needed. People felt listened to and able to feedback formally and informally.

The management understood their roles and responsibilities and reported all necessary information to CQC an required.

Quality monitoring systems were in place which ensured any errors could be found and acted upon.

The service worked in partnership with other agencies to ensure care quality remained high.

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 9 October 2019)

Why we inspected

We received concerns in relation to staff timings and quality of care being carried out. As a result, we undertook a focused inspection to review the key questions of Safe and Well-led only.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

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

Follow up

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

Bluewood is a domiciliary care agency providing personal care to people living in their own homes. It currently provides a service to people with physical disabilities people with dementia and older adults. At the time of the inspection, 160 people were receiving support with personal care.

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

The provider had systems and procedures in place to safeguard people from abuse. A small number of people had experienced missed visits and calls. Some people who required two staff to complete their personal care had not had the two care workers arrive at the same time, which caused disruption to peoples’ and relatives’ lives.

People were mostly supported by care workers who had the right skills and knowledge to provide care that met people’s assessed needs. However, a small number were not trained to meet people’s specific health needs and other staff were unhappy with the thoroughness of the training. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People consistently told us that care workers were kind and caring and treated them with dignity and respect. A common concern that people shared with us was that they were not always informed when home care visits were running late. Some people experienced home care visits that were either too early or late which they found to be disruptive. People told us it was sometimes difficult to speak to staff in the office because calls were not answered. People’s diversity was recognised by many carers speaking the same language as the people being supported.

Most people experienced continuity of care because they were supported by a core team of care workers who understood their needs. Some people were yet to experience that continuity, though the service’s performance in relation to that was improving.

People have care planned to meet their needs and preferences and ensure choice and control over their own lives. People were provided with a means to complain if they were unsatisfied with aspects of the service.

The provider had improved procedures for monitoring the quality of the service, however, this did not include seeking people’s feedback about their experience of the care and support. Few of the people we spoke with recalled receiving a questionnaire from the provider. People told us that most of their concerns were about a lack of communication from the office.

Rating at last inspection

At the last inspection the service was rated as Good (December 2017).

Why we inspected

This inspection was brought forward in the visit schedule due to concerns from the local authority. There has been a significant input from the Local Authority which has impacted positively on the inspection outcome.

Follow up

We will continue to review information we receive about the service until the next scheduled inspection. If we receive any information of concern we may inspect sooner than scheduled.

At our last inspection in September 2015 we rated the service overall as ‘Good’.

At this inspection we rated the service overall as ‘Good’.

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 continued to receive safe care. Staff recruitment processes were followed and ensured that people were protected from being cared for by unsuitable staff. There were enough staff to provide care and support to people to meet their needs safely. Staff were trained in procedures to support and to protect people from abuse.

People continued to be protected from avoidable risks. A range of risks assessments were completed and preventative action was taken to reduce the risk of harm to people. Where people required support with their medicines, staff had been trained in the safe handling of medicine, which was supported by a policy and procedure. People were supported to maintain good health and nutrition.

People continued to receive effective care and support. Staff received induction and ongoing training for their role and understood their responsibilities to work effectively.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice. People continued to receive good care. They had developed positive relationship with the staff who understood their needs. Staff were kind, caring and treated people with dignity and respect.

People continued to receive care and support that was responsive to their individual needs. Care plans were personalised and provided staff with clear guidance as to how people wished to be supported. Following our inspection visit care plans were updated to include people’s diverse, cultural and lifestyles choices and support required to access the wider community. Care plans and relevant information was made available in accessible formats to help people understand the care and support agreed. Staff worked in a flexible way which promoted continuity of care so that they could meet people's needs in a person centred way.

People knew how to raise a concern or to make a complaint. The provider had a complaint policy and procedure and complaints received were investigated.

The provider and registered manager had not consistently met the regulatory responsibilities. They had not provided us with the key information about the service when required, which we took into account when making judgement about the service. The registered manager had not fully understood and met all the legal requirements with regards to their registration. This included accessing relevant support to maintain their knowledge as to changes in legislation and best practice. Following our inspection visit the registered manager took the necessary steps to ensure the service was registered correctly and assured us they would access training.

The registered manager ensured the management team provided people and staff with the support they needed. Effective systems were in place to monitor and improve the quality of the service provided through a range of audits and views sought from people and their relatives. We have made a recommendation as to staff’s involvement to influence the development of the service.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask. This is a summary of what we found:

Is the service safe?

People told us that they felt safe with the care workers who supported them and that they were treated well. One person explained: 'I feel as safe as houses with them.' A family member told us: 'I know that she [their relative] is in safe hands.'

Care workers and members of the management team knew what to do if they suspected that someone had been abused. One care worker explained: 'I would report it immediately to the office.'

Risk assessments were in place. Those checked on the day of our visit showed us that the risks associated with people's care had been assessed and measures had been put into place to reduce that risk. This showed us that people's health and welfare was, wherever possible, protected.

Personal protective equipment was available for care workers to use including disposable aprons and gloves. This ensured that care and support was provided safely and in line with the services infection control policy.

There was an appropriate recruitment process in place and care workers were not allowed to work in the community, until all the appropriate checks had been carried out. This safeguarded the people who used the service and ensured that only suitable people worked for it.

Is the service effective?

We spoke with people who used the service and they told us that they were satisfied with the care and support they received. One person explained: 'They are very, very good, I couldn't wish for better.'

People told us that the management team where effective and approachable and ensured that the best possible service was provided. One person told us: 'The care coordinator is very good, she gives me a lot of confidence and If I have a problem, she does her best to sort it out.'

Care plans provided care workers with information about people's care and support needs. However, not all of those seen during this visit included all the tasks that care workers were carrying out.

On speaking with both care workers and the management team it was clear that they understood the needs of the people they supported. This ensured that people's needs were met.

Consent to the care and support that people received was obtained and weekly contact was made with everyone who used the service. This ensured that people remained happy and in agreement with the care and support they received.

Is the service caring?

People who used the service told us that they were very happy with the care and support they received. They told us that the care workers showed them respect at all times and they provided their care and support in a kind and dignified manner. One person told us: 'They are very nice very helpful and very caring. They are like my daughter.'

A family member told us: 'The carers are competent and caring. Very nice people.'

Is the service responsive?

The provider had an effective complaints procedure that ensured complaints were taken seriously and thoroughly investigated. Everyone using the service had been given a copy of the procedure so that they knew what to do if they were unhappy with the service they received. People who used the service told us that they knew what to do if they weren't happy. One person told us: I would phone Bluewood, I have a blue folder with their number in.'

A complaints policy was in place and a copy of this had been given to everyone who used the service. This ensured that they, or their advocate, were informed as to what to do if they were unhappy about the service they received.

Is the service well-led?

A quality assurance system was in place and the management team regularly assessed the service provided. Annual quality surveys had been used. This provided the people who used the service with the opportunity to share their thoughts on the support they received and enabled the management team to monitor the quality of service being provided.

People who used the service were provided with a copy of its Statement of Purpose and Service User Guide. These documents explained to the reader the aims and objectives of the service and what they could expect from the service themselves. This ensured that they were fully informed of the service and what it offered.

Care workers felt supported by the management team and told us that they felt able to talk to someone should they have a concern of any kind. One care worker explained: 'If I had any concerns I would talk to my supervisor, she is very nice.'

We saw that when a care plan was initiated or changes made the person was asked to sign to confirm agreement to the changes. One person we spoke with told us:' The quality of care is excellent. I could not wish for better care or care workers'.

All the people we spoke with told us they were very happy with their care. One person told us:' The provider seems to develop their staff. I have a care worker who is proactive and the company are supporting them to complete further training'. A carer also told us: 'The provider seems to have a good recruitment process. The staff we have are very competent'.

We found the records we reviewed were up to date and accurate. All had an initial assessment in place and a care plan had been developed from this. The daily records were monitored on a monthly basis and the care records reviewed on an annual basis and where changes in care needs had been identified.

We also found evidence of the provider failing to follow their own policies and guidance in relation to care staff having completed the mandatory induction programme. We found evidence of care staff being engaged in the delivery of care without having completed some key practical elements of their training.

Care support staff also told us they considered the heavy reliance on computer based training did not adequately prepre them for all aspects of their role.

People using the service told us that the provider always discussed changes to their care and respected their individual choices. The provider recorded peoples choices and ensured these were respected during the delivery of care.

We also found the provider regularly audited the service and took note of any themes or trends and adjusted the service delivery in order to continuously improve the standard of care.