Archived: Bluebird Care (Guildford)

Bluebird Care (Guildford) is a domiciliary care service that was providing personal and nursing care to 66 people within their own homes at the time of the inspection. The service supported people with a variety of needs including dementia, mental health and physical disability. The service also provides live-in care 24 hours a day, seven days a week, respite care and ad hoc support to people.

The registered manager and the management team cover two locations which are Bluebird Care (Guildford) and Bluebird Care (Rushmoor & Surrey Heath). This report is for Bluebird Care (Guildford) location and contains the feedback obtained from people being supported by this location. The nominated individual is in the process of registering with the CQC for both locations to operate from the same office. We inspected both locations as the concerns raised crossed-over both locations. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

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

We found that risks to people had been assessed well by the service based on people’s individual needs. Medicines were being managed safely for people and people were supported to manage their own medicines where possible. People gave positive feedback about the care and support they received. However, there were some occasions when people’s care visits were late or re-arranged and people did not always receive the communication from the management team.

People told us on some occasions they had not received a response to their questions from the office team. The registered manager identified responding to people’s queries as an area for improvement and they recruited additional office staff to review and develop the communication process with people where required.

The service has been through a restructuring process and this involved a turnover of staff, both carers and management staff with the aim to set up a stable team. People told us they had seen improvements in communication from the management team since the changes were made.

Feedback had been sought from people and relatives prior to the Covid-19 pandemic. A new survey would have been due for completion but had been delayed due to these circumstances. The registered manager indicated that a new feedback survey was being developed to send out in November/December 2020.

People told us they were happy with the staff who attended for home visits or provided live-in care. People and their relatives said they felt staff were kind, caring and supportive and always respectful. Relatives told us they were happy with the level of contact from the registered manager and the staff.

The registered manager was receptive of feedback and demonstrated a desire to ensure any developments were actioned as part of the ongoing development of the service. Staff gave positive feedback about the registered manager.

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 07 October 2019).

Why we inspected

We undertook a targeted inspection to follow up on concerns which had been raised around staffing, management of medicines and management oversight of the service. This report only covers findings in relation to the Safe and Well-Led domains.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the Safe and Well-Led sections of this full report.

CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question

The overall rating for the service has not changed following this targeted inspection and remains good.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Bluebird Care (Guilford) 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.

Bluebird Care (Guildford) is a domiciliary care agency which provides support to people in their own homes. It operates in Woking, Guildford and Waverley. The service provides care and support to people with a variety of needs including dementia, mental health and physical disability. The service also provides live-in care 24 hours a day, seven days a week, respite care and ad hoc support to people.

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

Bluebird provided training to families and the local business community to help them to understand how to support people well. This helped families to be confident to support people at home between care worker visits.

People were supported to access healthcare services, staff recognised changes in people's health, and sought professional advice appropriately.

The service had developed strong links with the community. They took short notice packages of care and worked closely with the local authority on the winter pressures discharge project, supporting people to leave hospital and return to their homes.

People reported the service to be flexible and that it enabled families to have a break. There were many examples of where people had been supported to become more independent following timely skilled intervention by the service.

Some people had been identified as being at risk due to their health or living situation. Missed time sensitive medicines, uneaten food, decreased mobility and increased falls were all effectively noticed, reported and action was taken. Timely interventions by Bluebird helped people remain well at home for as long as possible.

Food and drink intake was recorded and effectively shared with healthcare professionals when there were concern. This helped staff to access appropriate timely support when needed.

Bluebird made financial awards to community groups that supported older people in the local area to help combat loneliness.

The service aimed to support people to live full lives and maintain contact with the local community. Random acts of kindness were provided by staff to help people have an increased feeling of well-being.

There was a positive culture in the service and management and staff were committed to ensuring people received the best service possible. Staff told us they were well supported and had a good working relationship with each other and the management team.

The service was regularly audited and monitored to ensure the service provided was effective and met people’s needs.

Many compliments had been received by the service. For example, “"Have recommended Bluebird to many people," "Can’t fault anything with the service," "I find them responsive to my needs" and "Very impressed with Bluebird."

People using the service all told us they felt safe and staff treated them in a kind, caring and respectful manner. People told us they received consistently effective care from the care staff. Comments included, “It is important to (Person) to be with someone they know,” “We have similar interests so can discuss things,” “You can't beat it. The best one (agency) I've been with. Very good, I can't fault the staff,” “Staff are respectful, polite and sensitive. I am very happy.”

People told us they were given a list each week detailing the times of their visits and the names of the staff rostered. Care workers were matched with people's interests and needs.

People told us if the staff or times altered they were mostly informed of these changes, staff always stayed for the full time of the visit and were competent in their roles. We were told staff often stayed over their allocated time to ensure all planned outcomes had been met.

Visits were not missed or very late. People were highly complementary of the service provided and of the registered manager. Comments included, “They (staff and management) are all wonderful, we are very pleased” and “We have nothing but praise for the care we get, no problems at all.”

Care plans were in place for all people using the service. There was an electronic care planning system in place. Staff accessed this on mobile phones which were provided to them. The information generated by this system was accurate, timely and detailed. The provider monitored and reported on all aspects of the service provided to people.

There were enough staff employed to help ensure all planned visits were made. Staff were recruited safely. New staff were provided with a robust induction and shadowed experienced staff until they felt confident to work alone.

Bluebird provided exceptional support to staff which helped them feel valued. Staff had been offered permanent contracts and regular hours if they wished.

Rating at last inspection and update:

At the last inspection the service was rated as Good (report published 23 January 2017)

Why we inspected: This was a planned inspection based on the previous rating.

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

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 and associated Regulations about how the service is run. The registered manager was present for the duration of the inspection.

Care workers knew how to keep people safe. They understood their responsibilities under safeguarding procedures. Staff told us they would report anything that looked like abuse to the registered manager who they said would deal with issues immediately. They said they were required to attend safeguarding training every year which was compulsory.

Staff recruitment procedures were safe. The provider had undertaken appropriate safety checks to ensure that only suitable staff were employed to support people in their own home. Staff met with their line manager on a one to one basis to discuss their work. Staff said they felt supported to undertake their roles.

The agency had procedures in place to manage medicines safely and ensured only suitably qualified staff administered medicines to people.

Risks to people had been identified, assessed and well managed. Information was provided to staff on how to care for people in order to reduce any risks.

The registered manager logged any accidents and incidents that occurred and put measures in place for staff to follow to mitigate any further accidents or incidents.

People’s consent to care and treatment was considered. Staff understood the Mental Capacity Act (2005) and about people’s capacity to make decisions.

People told us staff were kind and caring and respected their privacy and dignity. They said staff were polite and professional at all times.

Staff received a good range of training specific to people’s needs. This allowed them to carry out their role in an effective and competent way.

The registered manager undertook quality assurance audits to ensure the care provided was of a standard people should expect. Any areas identified as needing improvement were addressed by the registered manager to drive improvement and provide better services for people.

If an emergency occurred for example adverse weather conditions or an outbreak of staff sickness people’s care would not be interrupted as there were procedures in place to manage this.

A complaints procedure was available for any concerns. This was included in the information pack people were given when they engaged the services of the agency. People knew how to make a complaint but said they never used the formal process. They said if they were unsatisfied with anything they would ring the office where a competent administration team would resolve any issues immediately.

We looked at records in the agency’s office relating to the care of people and the management of the service. These included care plans, risk assessments, medicine records, staff recruitment and training files and a range of policies and procedures. These were well maintained and regularly monitored by the registered manager to ensure the quality of record keeping was appropriate.