Bluebird Care Exeter & Teignbridge

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 service. This key question has been rated Outstanding.

This meant people were protected by a strong and distinctive approach to safeguarding, including positive risk-taking to maximise their control over their lives. People were fully involved, and the provider was open and transparent when things went wrong.

This service scored 91 (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 strong proactive and positive culture of safety, based on openness and complete honesty. Staff actively listened to concerns about safety and thoroughly investigated and reported safety events. Lessons were always learnt to continually identify and embed good practice.

The provider had effective electronic systems and processes which ensured comprehensive monitoring so when things went wrong, they were thoroughly investigated and used as opportunities for learning and improvement. The registered manager completed a monthly analysis of safety events and responded to any themes. For example, creative ways had been explored to ensure a person had their prescribed medication and staff had involved people and relatives in learning about good hand washing to minimise infection cross contamination.

The provider ensured learning was effectively embedded across the service. Staff received regular feedback through organisational communications, including shared learning from incidents, and highlighted changes made as a result. For example, staff were updated about the signs of sepsis following an event. All policies were checked to ensure each staff member had read them.

Leaders had a clear understanding of their responsibilities under the duty of candour, acting with openness and integrity. Investigations were comprehensive and person centred, involving people and their families to ensure transparency and shared understanding. People and their families were provided with timely, honest explanations when things went wrong, reinforcing trust and confidence in the service. People were then offered face to face follow up with the registered manager as an opportunity for discussion. The recent customer survey included safety and reported that ‘100% of customers said they felt safe with Bluebird care’.

Staff knew what incidents to report and how to report them. Staff raised concerns and reported incidents and near misses in line with the provider’s policy. Staff told us how they were actively encouraged and rewarded for raising concerns about safety and ideas to improve. A reflective culture was supported by incident debriefs and support planning documents to ensure learning and prevention. These were very detailed looking at family involvement and showed creative methods for future actions, in one case to safely vent frustration for example. The regular Leadership Compliance meeting shared recognition of good practice and compliments to boost morale and reinforce positive behaviours.

The Clinical Lead oversaw falls management. Staff reported falls of any type with each person having an individual falls register to monitor patterns. Plans were proceeding to establish a Bluebird Falls Team to visit and advise. Staff had a post falls handout showing the process to follow to keep people safe.

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

From the moment people first contacted the service, robust arrangements through the customer on-boarding team were in place so that care was discussed and planned with the involvement of people, their relatives and professionals. Records demonstrated the provider’s consistent approach which ensured people had excellent continuity of care using the customer enquiry process. A customer screening tool ensured there was consistent information and included discussion about realistic expectations for people. People received written follow up explaining the process before an assessment with a courtesy call asking how the first visit went. Managers then monitored people and staff compatibility to ensure people received care in an environment they were comfortable with.

Feedback shared people’s positive experiences right from the beginning of contact with Bluebird. One relative said, “They go above and beyond, they take time to call and find out how [person’s name] is after every hospital visit. They re-assess after every hospital stay; it’s their process. We sit down and go through the care plan.”

The provider prioritised safety and continuity of care throughout people’s care journeys. For example, when people had been admitted into hospital, the provider collaborated effectively with various clinical teams to ensure people had effective continuity of care. This included taking photos of how equipment worked or how people liked things to be laid out. This had a significant positive impact on the support people received. It ensured they had safe and appropriate care which met their needs and preferences to an extremely high standard.

A ‘Roving Responder’ team had been set up working with the local hospital to address delayed discharges and admissions. Staff had been trained by the hospital to deliver clinical care so people could go home early from hospital or avoid delays getting to hospital.

Staff and leaders knew people exceptionally well and recognised when their health and wellbeing needs changed. They were highly responsive in seeking advice and support from healthcare professionals which reduced hospital admissions for people. This had been further enhanced by having an in-house paramedic clinical lead whose quickly accessible advice could reduce waiting for external health professional responses. For example, quick communication with hospital doctors meant one person was prevented from waiting in the emergency department.

Professionals spoke highly of the provider. Comments included, “I have observed that care staff demonstrate a good understanding of service users’ functional needs, including mobility, safety, whilst promoting independence, and they are proactive in raising concerns or seeking advice where appropriate. This collaborative approach has contributed positively to achieving outcomes for individuals, supporting them to remain safe and as independent as possible within their own homes. I would also highlight the willingness of your team to engage with recommendations from occupational therapy, implementing guidance effectively and providing feedback where needed.”

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.

The provider’s clear safeguarding systems supported staff to recognise and respond to potential risks of abuse or harm. These risks were overseen by the Operations Manager who had completed training as a designated Safeguarding Lead Level 3. Staff worked closely with individuals to understand their wishes and what helped them feel safe. People and relatives told us they felt safe with staff in their homes, and feedback reflected confidence, reassurance and trust in the care they received.

Safeguarding processes were embedded into day‑to‑day practice, and incidents were investigated in line with policy. Actions were taken in a timely manner, and learning from events was shared to support safe practice across the team. This helped ensure safeguarding remained a consistent priority and risks were understood and managed appropriately. One example showed how concerns were acted on promptly with Bluebird acting decisively to keep people safe. Regular checks had uncovered poor care from an agency worker brought in to cover a live-in carer break. This resulted in the service working with the local safeguarding team to improve the workers practice and ensuring the person received prompt treatment.

Overall, the provider had effective safeguarding arrangements that protected people from the risk of harm. Staff understood their responsibilities, acted quickly when concerns arose and worked with other professionals to help keep people safe.

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

Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them. BluebirdCare Exeter and Teignbridge were members of the Restraint Reduction Network which meant they had pledged to highlight and inform staff restrictive interventions must always be lawful, proportionate and least restrictive and genuinely a last resort. Staff were trained in positive behaviour management to support this pledge.

Care plans had personalised guidance for staff on how best to support people to minimise risks to their safety and emotional wellbeing. One person was supported to make their way independently to a local club. The staff member had clear instructions to discreetly ensure the person was safe, going with the person a few times to learn and document the route and liaising with the club. The person was able to be more independent and reach their goals because of a positive risk taking approach. People consistently told us staff knew them exceptionally well. They were regularly involved in reviews of their care and had confidence in staff’ skills to support them safely.

Staff understood their responsibilities to keep people safe and told us how they involved people in their care. Staff received clear, up to date information about people’s risks and any safeguarding needs including taking photographs of potential risks in the home environment and detailing ways to minimise these. We saw clear documents and photographs showing staff how to use equipment, access homes and manage pets. Care plans ensured staff felt informed, equipped and able to deliver safe care consistently.

The provider was fully aware of all potential risks in the care environment and controlled them well. They made sure equipment, facilities and technology supported the delivery of safe care.

The provider took appropriate steps to identify, assess and manage risks within and around people’s homes. The customer on-boarding team and managers ensured care plans contained environmental and fire risk assessments. They included vital information such as where to shut off gas, electric or water in the event of an emergency. Care plans had photographs showing staff exactly where risks could be. There were also details of who people lived with and relationship dynamics. This meant staff knew what tasks family member did and their level of involvement as well as any tensions as well as creating close relationships.

People were supported to keep their environment safe. Staff had worked with one family to ensure a person was living in a less hazardous environment. Documentation showed staff being mindful of how they introduced change to ensure the person’s wellbeing. For example, staff were respectful and communicated in an open and positive way.

The provider demonstrated a proactive and innovative approach to environmental safety. Technology enabled care improved early intervention and pinpointed unusual activity using monitored sensors and smart devices. Bluebird Care Exeter and Teignbridge supported people and families with technology enabled care, which had been used as an introduction to care to support people reluctant to accept assistance. Use of sensors provided data showing times where people may require more support. This meant for some people, they could continue living at home rather than in a residential setting.

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

The provider had created accessible staff teams and deployed them where their skills were needed. For example, there was a separate night care team provided consistent care and specific support related to night-time needs. The recent customer satisfaction survey analysis highlighted the importance of consistency and continuity of care. The provider said this remained a high priority for Bluebird Care Exeter and Teignbridge. Staff were trained in refining tasks. Details were provided around personalised bed making and item placement; for example, where people liked their items to be left. Staff were also trained in palliative care and had supported families overnight, organising practical tasks, preparing the person for families to spend time with, and offering comfort.

The service was set up in a unique way so that staff could be deployed effectively to anticipate changing needs in the local system. The Roving Responder team had been set up, with staff trained in clinical care by the hospital, to expedite hospital admissions and discharges. BluebirdCare Exeter and Teignbridge worked closely with the hospital in looking at sustainable ways to manage these issues. A registered paramedic managed the new Specialist Complex Care team to ensure accessible access to clinical skills and the ability to meet complex care needs further. The manager was developing clear delegated task policies and working closely with community health professionals to enable people to receive a skilled and safe service.

The provider used an electronic scheduling system to plan and monitor care visits. This enabled real time oversight of when staff arrived and left people’s homes and supported effective rota management. Regular and familiar staff attended calls wherever possible and mapping tools were utilised to ensure realistic travel times, helping ensure calls were not rushed and care was delivered safely.

The provider ran an accredited training academy in house. New staff completed a comprehensive induction. This included a week of face-to-face teaching by a range of staff qualified in train the trainer courses as well as a welcome session by the provider. Records showed regular staff knowledge checks, direct observations and competency assessments. New staff also completed a trial period before working independently and were introduced to people with a senior staff member. This helped ensure they were prepared for their roles and understood the provider’s expectations around safe practice.

Live-in care workers received additional training relevant to their role. This included knowledge of personalised daily tasks for the person they would be supporting, how to give detailed handovers to other live-in staff at the person’s house and training in menu planning, food preparation and storage. Training was tracked on the Bluebird ‘My Learning Cloud’ system and was complete. All office staff were trained in a range of care topicsto enable them to assist in the community if needed, providing hands-on personal care.

Staff told us this comprehensive approach supported their learning and helped them feel confident in applying the skills they had developed. Competency assessments were refreshed when needed to ensure staff continued to work safely. New trainee care workers told us, “We learn in small segments which mean we learn well and take in what we hear” and they all said they were enjoying the training and the ‘goodie bag’ provided for new staff by the provider. All new staff were supported to achieve the Care Certificate; a nationally recognised qualification. Staff could choose to undertake further distance learning courses for free at a local college. Topics included Mental Health Awareness, Diabetes, Autism and Cancer Support. Staffhad taken this opportunity with some staff leading training sessions in the new care staff induction syllabus.

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.

The provider had effective systems in place to assess, monitor, and manage the risk of infection. Infection control and prevention was seen as everybody’s business, and people and families were shown how to perform good handwashing techniques by staff using leaflets and instruction. Staff support included checking people had enough cleaning products and soap to maximise cleanliness. Staff were proactive in identifying potential infection risks and took timely action to prevent the spread of infection. Any concerns were shared promptly with the appropriate external agencies to ensure coordinated responses.Infection control and prevention was overseen by the Bluebird Infection Prevention Lead.

People told us staff were respectful of their homes and surroundings and consistently supported them to maintain clean and hygienic environments. Staff received annual infection prevention and control (IPC) training, alongside individual discussions to identify and address any gaps in knowledge or skills.

Leaders carried out regular spot checks and audits to ensure staff demonstrated consistently safe and compliant IPC practices. Staff had access to appropriate personal protective equipment (PPE) and were also provided with company uniforms to support good hygiene standards. During their induction, new staff received information with photographs showing how the uniform should be worn, including their appearance, such as hair styles and nail length to maintain a good infection prevention standard. They could also request a fob watch to support better infection control.

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.

People and their relatives told us medicines were managed safely and effectively. Feedback included, “We don’t need medicines support yet but if we do it has to go through a thorough assessment with care planning in place. There is always so much thought given.”

Staff had received appropriate medicines management training, and leaders completed regular competency assessments to ensure staff were suitably skilled and confident in their roles. Monthly audits were completed. These had shown a rise in medicine refusals. Additional training in supporting people to take their medicine using education and kindness had resulted in less refusals. Staff used an electronic secure communication system where they could ask each other advice about medicines. For example, share a complicated prescription or discuss a new medicine. This was regularly monitored and also informed staff about any national medicine alerts.

Medicine records were electronic with office staff checking for any missed medicines twice a day. Records were personalised, clearly detailing how each person wished to be supported, any known allergies, and any requirements for medicines to be administered in a specific format. For example, advice was sought about how to time medicines safely for one person who had a weekly day centre appointment. Topical medicine records were robust. They showed where the medicine was stored, what the person thought it was for and confirmation all medicines had been confirmed as correct by Bluebird with the GP.

There were effective systems to ensure any changes to people’s prescribed medicines were communicated, documented, and implemented without delay. Staff worked closely with healthcare professionals to maintain safe and accurate medicines support. The provider used nationally recognised resources to benchmark policies and practice against sector guidance. The leadership team reviewed all policies annually as standard, and more frequently if incidents or updated regulatory information required earlier review and changes to practice were made promptly.