Bluebird Care (Calderdale & Bradford South) Also known as Hanson Lane Enterprise Centre

About the service

Bluebird Care (Calderdale and Bradford South) is a domiciliary care service. It provides personal care to people living in their own homes in the community. The service supports people with a range of needs including people with dementia. At the time of this inspection there were 140 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

Some people told us they experienced late and missed calls where the care worker did not arrive at all. They said they were happy with the care workers, but some people were not happy with the way the service was organised and managed.

People liked their care workers and said the quality of care was generally good. They received good support with their personal care, taking their medicines and with their meals. People and their relatives told us staff were kind and caring and did a good job.

Some relatives told us they were not happy with the communication from the service. They said it was at times hard to get through to the office on the telephone. The management team explained this was because office-based staff were having to go out to cover staff who were off sick so were not available to respond to phone calls.

The provider’s systems for monitoring that care calls were taking place were not always effective. The monitoring system produced alerts for office- based staff when a care worker had not arrived at a customer’s house to provide their care. However some alerts were missed due to the responsible person being out providing care and this had a negative impact on a few people who told us they had missed a meal and/or were upset by the missed call.

For several months the service had not been carrying out assessment visits to people before they started providing their care. This meant there were no environmental risk assessments for some people and other people had assessments and care plans which had not been updated for some time. The service relied on care workers to tell office based staff the risks they observed in a customer’s home. The provider told us that this was improving at the time of the inspection.

Staff were happy working for this service. They said the registered manager and nominated individual (the person who represents the company) were responsive and helpful. The training was of a good standard but the service was not up to date with the monitoring of care workers to ensure they were doing a good job.

The service had a comprehensive action plan in place to improve standards and the registered manager and nominated individual were very committed to improvement.

Rating at last inspection

The last rating for this service was good (published 01 May 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service. The inspection was prompted in part due to concerns received about staffing shortages having an impact on care. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of safe, responsive 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.

We have found evidence that the provider needs to make improvements. Please see the well led key question section of this full report.

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

Enforcement and recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified a breach of regulation in relation to the monitoring of care calls to ensure all required care is provided safely.

The provider has taken some action to address immediate concerns and also has a comprehensive action plan in place to improve the service.

We have made on recommendation to personalise emergency protocols for people who have diabetes.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an 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 continue to monitor information we receive about the service, which will help inform when we next inspect.

At our previous inspection in October and November 2016 we rated the service as ‘Requires Improvement’ and identified one breach which related to safe care and treatment. Following the previous inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions in Safe and Well Led to at least Good.

Bluebird Care (Calderdale and Bradford South) is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to people over the age of 18 years. Not everyone using the agency receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of our inspection 71 people were receiving personal care.

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.

The majority of people and relatives we spoke with were happy with the care and support provided by staff. They said staff usually arrived on time and stayed the full length of the call. However, three people/relatives told us the timing of calls was a problem and staff did not always stay the full length of the call. The provider agreed to look into these concerns.

People and relatives told us staff were kind and caring. People’s privacy and dignity was respected. Medicines management was safe, although further guidance was needed in relation to ‘as required’ medicines. Safeguarding procedures were in place to protect people from abuse. People were aware of the complaints procedure and knew how to raise concerns.

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 told us they had been involved in the care planning process. Care records were personalised and showed the support the person required from staff at each call. Risk assessments showed any identified risks had been assessed and mitigated. People’s nutritional needs were met and they were supported to access healthcare support as and when needed.

Staff received the induction, training and support they required to meet people’s needs. Staff told us communication was good. Recruitment checks were completed before staff started working in the service.

The company directors and registered manager provided consistent leadership and management. Action had been taken to strengthen and develop the governance systems to improve the overall quality of service delivery. This process was in the early stages and the company directors recognised these systems needed to be fully embedded to ensure all issues were fully identified and addressed.

Bluebird Care Calderdale and Bradford South is registered as a domiciliary care agency and provides a range of services including personal care in the Halifax, Brighouse, Elland and South Bradford area of West Yorkshire. At the time of inspection the agency was providing care and support to approximately one hundred and twenty people.

There was a registered manager in post. 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.

We found staff received training to protect people from harm and they were knowledgeable about reporting any suspected harm. There were a sufficient number of staff employed for operational purposes although the recruitment procedures designed to ensure only people suitable to work in the caring profession were not always being followed.

Where risks to people’s health, safety and welfare had been identified appropriate risk assessments were in place with actions taken to mitigate these. However, we found some shortfalls in the medication recording systems.

The people we spoke with and their relatives told us the service was generally reliable and staff usually arrived at the same time each day and stayed for the correct amount of time. However, some people felt the service could be improved by office based staff communicating more effectively as phone calls were not always returned in a timely manner.

Some people also raised concerns about the electronic system used by the agency to record visits, care documentation and daily records as they had difficulty accessing information at times. We therefore asked the provider to review the systems in place to ensure everyone who used the service had easy access to all their care records.

The staff we spoke with were able to describe how individual people preferred their care and support delivered and the importance of treating people with respect in their own homes. Staff told us the training provided by the agency was very good and they received the training and support required to carry out their roles effectively.

The registered manager demonstrated a good understanding of their responsibilities under the Mental Capacity Act 2005 (MCA) and staff demonstrated good knowledge of the people they supported and their capacity to make decisions.

There was a complaints procedure available which enabled people to raise any concerns or complaints about the care or support they received.

There was a quality assurance monitoring system in place that was designed to continually monitor and identify shortfalls in service provision. However, we found the shortfalls in the service highlighted in the body of this report had not always been identified through the quality assurance process.

We found one breach 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 end of this report.

One person we spoke with said; 'I'm very happy with the girls that come. I've never had any problems and they help me in any way they can.' Another person told us; 'They go above and beyond. I love them like family and they do all they can to make sure I'm happy.'

All of the people we spoke with who used the service told us they knew their support workers and said they were always 'very caring' and they 'helped out wherever they could'.

The five support workers we spoke with told us Bluebird Care was a good organisation to work for, where they knew a good service was provided and where they felt they were supported by their managers. Three of the five support workers we spoke with told us they feel Bluebird Care would benefit from employing more staff as they sometimes feel 'like there isn't enough time to do everything' or to 'get from one call to another'.

There were procedures in place to protect people from abuse.

There were effective systems in place to ensure people who used the service had given consent to their care and treatment. We saw that each person using the service had been required to sign and date a 'Consent Form'.

We found that records were maintained and kept up to date, including any changes following care plan reviews.

People who use the service or their relative told us they had received information from the agency prior to care being delivered and it included information on how to raise a complaint.

People were happy that on most occasions they had a regular set of care workers; they liked the continuity of care. They also told us all the care tasks were carried out and they felt safe.

Most of the care workers told us they felt supported by the manager and other colleagues from the agency. They told us they could raise concerns and they would be dealt with. However, nearly all care staff told us they would like more information in the care plan which provided details about how the person would like to receive their care.