Bluebird Care (Maidstone, Tonbridge & Royal Tunbridge Wells)

Bluebird Care (Maidstone) is a domiciliary care provider that was providing personal care to people in their own homes. Most of the people being supported were elderly. At the time of our inspection there were 113 people receiving support.

People’s experience of using this service:

¿ Some people told us that not all staff were skilled in carrying out their role. They said they thought newly recruited staff would benefit from some additional training. We have made a recommendation about this.

¿ We found people received safe care and support from staff. Staff knew what actions to take to ensure people were protected from abuse.

¿ The registered manager made sure there were enough staff before considering supporting new people. Those staff were recruited safely.

¿ Staff worked well together to ensure people received joined up care and support. People said they knew staff well, and felt staff knew them well.

¿ People received support from staff who had a caring nature.

¿ People were treated with kindness and respect, and their privacy and dignity was respected.

¿ People received personalised care which was responsive to their needs and preferences.

¿ The service had a registered manager who was dedicated to providing high-quality care which promoted an open and fair culture.

¿ Audits were in place to assess the performance of the service and to action any concerns as they arose.

¿ The service had developed strong links with the local community in innovative ways.

Rating at last inspection:

Good (report published 8 September 2016).

Why we inspected:

This was a planned inspection based on the rating at the last inspection. We found the service continued to meet the characteristics of Good.

Follow up:

We will continue to monitor the service through the information we receive. We will carry out another scheduled inspection to make sure the service continues to maintain Good.

Blue Bird Care Maidstone is a domiciliary care agency providing personal care to people living in their own homes in the community. They provide services to any people who need care and support. The agency provides care services mainly to people living in Maidstone and the surrounding area. There were approximately 136 people receiving support to meet their personal care needs on the days we inspected.

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.

The registered manager was also the registered manager for another service owned by the providers, so divided her time between the two services. The provider employed a care manager to support the registered manager and to manage the day to day operations in the Maidstone office.

People felt safe when receiving care from Bluebird Care Maidstone staff and they knew who to talk to if this changed. Staff had a sound knowledge of how to safeguard vulnerable adults from abuse. They understood their responsibility to report concerns and where to go to outside of the organisation should the need arise.

Risks to individual people and their circumstances had been identified, with actions put in place to reduce the risk and maintain people’s safety. People’s home environment had been checked for hazards before support commenced, helping to keep people and staff safe. Some people needed help to take their medicines. As well as attending training courses, regular competency checks were carried out on staff to ensure their continued capability to safely administer medicines to people.

The provider had robust recruitment processes in place to make sure new staff were suitable to work with vulnerable people in their own homes. Enough staff were available to be able to run an effective service, responsive to people’s needs. People told us that staff always stayed to support them for the time they were allocated. The personal development needs of staff were identified and supported within a supervision and annual appraisal system. The registered manager had a system in place to make sure staff one to one supervision sessions were not missed. Staff received the training they needed to be able to fulfil the requirements of their role well.

Although most people looked after their own healthcare needs or had a family member who helped with this, staff supported people who needed assistance when requiring health care appointments or advice.

People told us they made their own decisions and choices and staff were clear that people were in control of their care and support. Mental capacity assessments had been undertaken where appropriate following the principles of the Mental Capacity Act 2005. People’s families were often involved if their loved ones needed support to make decisions and this was clearly recorded.

A caring approach was shown by care staff and the staff supporting the delivery of care from the office. People made many positive comments about the staff and said they spent time listening to what they had to say. Most people had regular staff providing their care and support, creating confidence. People were given information about the service they could expect within a service user guide at the commencement of care and support.

One of the senior staff undertook a thorough initial assessment of people’s personal care needs to make sure they had the resources available to support people. People had a care plan that detailed all the individual support people required as a step by step guide for staff. People, and their families if appropriate, were involved in the process to ensure the support in the care plan expressed how they wanted their care and support to be undertaken.

How to make a complaint was included in the service user guide, and the people we spoke to knew how to make a complaint if they needed to. The provider asked people for their views of the service by sending out a questionnaire every six months. The registered manager acted on responses, resolving issues and feeding back to people.

People and their families generally thought the service was well run and said the staff in the office were helpful.

During this inspection, the inspector focused on answering our five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people using the service and the staff told us. If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

We found that people who used the service were protected from the risk of abuse because all care staff were trained in the safeguarding of vulnerable adults and in the principles of the Mental Capacity Act 2005. All staff had been subject to Disclosure and Barring Services (DBS) checks before they started work. We found risk assessments with clear action plans were in place to ensure people remained safe. People's consent to care and treatment was sought appropriately. Staff monitored people's health and referred to health professionals or alerted emergency services when necessary. Staff undertook checks ensuring they were of good character and that they were entitled to work in the UK.

Is the service effective?

People and their relatives told us they were very satisfied with the quality of care that had been delivered. We looked at seven people's assessment of needs and support plans and we checked with people who used the service that the delivery of care was in line with their care plans and assessed needs. We found that people's needs were re-assessed when needed and that their care plans were adjusted to reflect changes in needs. People who used the service commented, "The care workers are really very efficient and do exactly what has been agreed" and "The staff often go the extra mile". We found that the staff had received the training they required to meet the needs of people who used the service and that additional training was available. There was a robust recruitment process that followed legal requirements.

Is the service caring?

We found that people who used the service were supported by kind and attentive staff. All the people who used the service that we spoke with were complimentary about the care workers' approach and attitude. One person who used the service told us, "The care workers are kind, cheerful and polite ". A relative of a person who used the service said, "My family member is very well cared for by the staff'.

Is the service responsive?

People's needs had been assessed before care and support began and their care plans were reviewed regularly to reflect any change of needs. We saw that people's care plans included their history, wishes and preferences. People and/or their representatives were involved with the reviews of their care plans. People's views were sought about the quality of care that they received and their views were taken into account. A relative of a person who used the service told us, "The communication is excellent, we are kept informed all the way". A member of staff told us, 'The staff can raise any concerns and it will be acted on straight away'.

Is the service well-led?

We found that the registered manager had a system of quality assurance in place to identify how to improve the service. People and their relatives or representatives were regularly consulted about their level of satisfaction and survey questionnaires were provided, collected and analysed. We saw the service operated an 'open door' policy where staff were encouraged to express their views. All the members of staff we spoke with confirmed they felt supported by the manager to carry out their roles and were able to discuss any concerns. One staff member told us, "I love this job. There is so much support and the manager and supervisor really care about the staff". Another said, "All the management staff in the office are very approachable, we are encouraged to discuss anything of concern'. Staff's practice was regularly observed and monitored to check good care practice was maintained and to identify whether additional training or refresher courses were needed.

People told us that staff from the agency had visited and assessed their care needs before the service to them commenced. They also told us that their care had been reviewed during visits from the manager or supervisors.

People we spoke with told us that they were happy with the service provided and that staff were generally reliable and punctual. People said that staff were respectful and caring. One person said, 'My husband is given a shower and they put cream on his back. He would say if he was not comfortable with them.' another says, 'I only get a strip wash but they are very considerate.'

Other comments made included; 'They are so nice and gentle and important to me that they are like friends,' 'I can assure you that if anything wasn't right I'd be on the phone telling them' and 'I have never had any hassles.'

We looked at six care files and found that care plans were reviewed on a regular basis with information clearly documented.

There was a policy and process in place for ensuring that staff were trained, supervised and appraised appropriately.

Comments and complaints people made were responded to appropriately.

Records were kept securely and could be located promptly when needed.

Care and support plans were detailed and highlighted any possible risks which through effective management could be minimised. People told us that the agency went through the plans with them at least twice a year to make sure they were happy with the support provided.

The staff had been trained to support people with their medication, and with the monitoring systems in place the staff were making sure people received the medication they were prescribed.

The agency had a safe and robust recruitment procedure in place to ensure the safety of the people they provide care to. The agency had a complaints procedure which they had followed. The information from recorded complaints had been used to improve the service they provide.