Bluebird Care (Nottingham)

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. This is the first assessment for this newly registered service. This key question has been rated Good.

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 had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

People had access to a complaint policy which was shared with people using the service and relatives in a handbook at the point of care commencing.

People felt confident to raise concerns and that they would be treated with kindness and understanding. Leaders completed a governance report once a month to review any risks and areas of improvement which explained how safety incidents were recorded, analysed and reported.

Care staff told us that lessons were learnt from feedback and from when things went wrong and the information and outcomes were passed down. Staff demonstrated a clear relationship of trust and transparency with leaders.

Safety concerns such as safeguarding incidents, other incidents and accidents were recorded, investigated and reported appropriately. Risks were dealt with, and outcomes of investigations were shared with all relevant parties.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

People told us what they would do and who they would contact if they were concerned about any risks or if their health condition was worsening. People told us staff were aware when their needs changed. One person said, “Staff ask how I am as soon as they come in to see me, they ask me if I’m feeling my usual self and will always ask if I need anything more other than my usual support.”

Leaders were confident in their systems of care, where safety of people was managed and monitored. This included a safe admission pathway, appropriate risk assessments and effective partnership working with other health professionals.

Care staff told us risks to people health and well-being were well documented in people’s care plans and risk assessments.
 

The provider had clear systems and processes to ensure safe admissions to the service and made additional referrals when required. We saw examples of how the service effectively worked with other health and social care professionals to achieve better outcomes for people. For example, carer’s immediately raising concerns when noticing signs of a urinary tract infection and contacting the GP for an appointment.
 

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

People told us they felt safe and supported by staff and knew how to raise any safety concerns. People told us the staff provided them with contact details of who they can contact if they did not feel safe.

Leaders gave us examples of how they dealt with safeguarding incidents. Safeguarding was frequently discussed in team meetings and support sessions with staff. Care staff confirmed they received safeguarding training and knew how to apply it in practice. Staff had good understanding of what abuse and neglect was and how to report it.

The provider had effective systems and processes to make sure people were protected from abuse and neglect. There was a safeguarding policy, and all staff completed safeguarding training and refreshed it annually. There were clear procedures about how to deal with safeguarding concerns. We saw examples of how safeguarding concerns were identified, investigated and reported appropriately.
 

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Leaders told us they involved people and their relatives in assessing risks. Risks were recorded and reviewed regularly. Care staff told us that risks to people were clearly recorded in people’s care plans and risks assessments and were easy for staff to understand.

Risks to people were recorded and staff had clear guidance of how to manage and mitigate known risks. Some aspects of the risk assessments required personalising; we shared this feedback with the provider who immediately made the required changes.

A person using the service told us, “I trust the care staff listen to me and share information with the office about any changes in need or things I am worried about.” People confirmed changes in their care were made in line with what they had expressed.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The provider carried out environmental risk assessments prior to care commencing. This included clear guidance for staff to support people to maintain a safe home environment, such as what to do in the event of a fire or a power cut. Staff understood their duty and responsibility to maintain safety in people’s homes. A staff member explained to us, “I always make sure the environment is safe and comfortable for everyone involved in the care at that moment in time.”

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

People told us staff were well trained and knew what they were doing. Comments included, "I have no concerns they [staff] all seem well-trained and seem to know what they are doing,"; "They [staff] are very nice and know what they are doing."

People said that staff mainly attended to them on time, as per their contracts and if staff were late it did not have significant impact on the care and support. Feedback included, "They [staff] have never been exceptionally late"; "They [staff] more or less arrive on time." Care staff also told us they were usually able to complete their care calls on time, and confirmed that they are provided with sufficient travel time in between their calls.

Staff completed induction prior to commencing employment, this included shadowing more experienced members of staff. Staff performance was managed through regular support sessions, spot checks and appraisals. Care staff told us the induction process was thorough and they felt prepared and supported to carry out their role. Most staff told us that ongoing training was of good quality.

Staff told us they had ongoing opportunity to learn through regular training courses and continuous professional development. For example, all staff were required to complete a Care Certificate. The Care Certificate is an agreed set of standards that define the knowledge, skills and behaviours expected of specific job roles in the health and social care sectors.

The provider’s recruitment processes were safe and robust. Staff had all necessary checks completed prior to commencing employment at Blue Bird Care (Nottingham), for example Disclosure and Barring Service (DBS) background checks, (a background check to see if someone has a criminal record or is barred from working with vulnerable groups in the UK), and references.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

People said staff always wore appropriate personal protective equipment (PPE). They shared no concerns about staff infection prevention and control practice (IPC). People who required support with food preparation told us staff were conscious of good food hygiene practice.

Leaders told us that they ensured staff were familiar with the relevant IPC policies and had sufficient PPE and staff confirmed this. Staff were aware how to protect people and reduce the risk of infection. Staff confirmed they received IPC and food hygiene training.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Not everyone using the service received support with medicines, however people raised no concerns about the way staff supported them with medicines. They told us staff were aware if there were any changes to the prescribed medicines.

Leaders told us they ensured all staff received medicine administration training as part of their induction and it was refreshed annually. Staff told us they felt competent when administering medicines and knew what to do if a person refuse to take their medicine or if they made a medicine error.

The provider had systems in place to ensure that people were safely supported with medicines. A medicine policy was in place which staff had access to. People had medicine care plans and risk assessments that documented what support was required. Leader’s completed monthly medicine audits.

People who did not have capacity to make decisions around medicines had their needs assessed in line with the Mental Capacity Act 2005.

Medicine Administration Records’ (MARs) evidenced that people received their medication as prescribed. When medicine errors occurred, they were addressed and reported promptly. The provider had an effective governance system in place to ensure that medicines were administered safely.