Bluebird Care (Reigate)

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Assessments were holistic and person-centred, taking account of people’s health, wellbeing, communication needs, and preferred daily routines. People were actively involved in the assessment process, with families or advocates included where appropriate. Care plans were subject to regular review to ensure they remained suitable, with outcomes clearly recorded alongside any required actions. Documentation was clear, reflected people’s views, and feedback from most people indicated they were satisfied with the care provided. The registered manager said, “We take into account people's backgrounds. On assessment they might have a preference of gender, age etc. All those preferences are taken [on board] and put into the care plan. [After the first couple of weeks of the care plan] we see [people’s] preferences and adapt [their care plan] to ensure continuity of care. I call new customers after 2 weeks and the supervisor will call them after week 3 to check [in and make sure they are happy we are meeting their needs]”.

The service took early action when changes in needs were identified, and reviews reflected changes in people’s circumstances, with risks considered and outcomes recorded. One person told us, “Every six months someone comes round and asks lots of questions”. A relative said, “[The care plan] was reviewed earlier this year. We changed from two visits a day to four and then back again when [my relatives] health got better”.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Evidence-based tools were used to identify and assess any risks related to pressure ulcers and nutrition and hydration. From the assessment, a personalised care plan was developed, tailored to meet each person’s individual needs, and was regularly reviewed and updated to reflect any changes in those needs.

Staff received training relevant to their roles, which supported them to provide care in line with current best practice. The management team monitored practice through regular audits and spot checks to ensure standards were maintained and any areas for improvement were identified.

Policies and procedures reflected relevant national guidance, and staff demonstrated an understanding of how this informed their practice.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff had access to the information they needed to assess, plan and deliver care effectively. Care records were clear and up to date, helping ensure continuity of care. Information was shared appropriately between teams and services, including when needs changed or when people were referred to other professionals. A staff member told us, “All information is provided on the [app with] the [persons] information…If I have any questions, I will phone the office to confirm details. If there is any important information the office will put that on the [app], update [us] in team meetings, or ring us if we are going into that particular person…We are also sent text messages when important information has changed”.

Staff made referrals in a timely way to help ensure people received the right support. Effective communication with external professionals and relatives was evidenced through records and tracking systems, which supported oversight and coordination of care. A relative told us, “[Staff] call me if there is anything of concern – I get good feedback. They will also put it on their records and call the office”. Another staff member said, “I think the [service] really cares for [people], they work hard to retain them and work closely with other local services to ensure the care they receive meets their needs. And most importantly, stay at home like they wish!”

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

The service supported people to access health services when needed. Care staff were trained to report any changes in people’s needs, allowing the provider to respond appropriately to identified risks. A staff member told us, “I understand people’s healthcare concerns by reading their care plan, observing changes during visits, and listening to what the person or their family tells me. If I notice deterioration, I would record it and report it to the office or on call person…These would need to be reported quickly so that advice or medical support can be arranged.”

Staff encouraged people to remain as independent as possible while supporting healthy routines, such as preparing meals of choice, promoting fluid intake and encouraging engagement in meaningful activities that supported physical and emotional wellbeing. We saw an example where a staff member noted upcoming hot weather and so supported a person to locate and set up their fan in preparation. We also saw examples where staff had supported and encouraged people to move and take walks, which had impacted positively on their wellbeing.

The provider used newsletters to share information about different partnerships and schemes to support healthy living. For example, in a recent newsletter they signposted people to how they could access NHS-funded eye tests at home.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured outcomes were positive and consistent, and they met both clinical expectations and the expectations of people themselves.

Incidents had been effectively reviewed to check outcomes were appropriate and if actions were needed to improve the care individuals received. People’s health was monitored. Staff understood the importance of reporting changes in people’s needs and escalating concerns to relevant healthcare professionals. For example, a staff member told us, “If a pressure sore is reported we will go through the [process] of…[making a] referral to the district nurses…We also can make referrals to the occupational therapist…whilst notifying the GP of any changes.”

Quality assurance systems were in place to monitor people’s outcomes and support. Care plans, risk assessments were consistently reviewed and updated to reflect people’s changing needs and to ensure that safe and effective support continued. Training, effective communication and information sharing to and between staff meant they were clear on the standard of care expected from the provider.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

The Mental Capacity Act 2005 (MCA) provides a legal framework for making decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to make decisions, any made on their behalf must be in their best interests and as least restrictive as possible.

Staff worked in accordance with an up-to-date customer consent policy which clearly set out any person who might not have the mental capacity to give valid informed consent about any care and treatment proposed, was properly assessed in line with the requirements of the MCA.