Bluebird Care (Bristol, Bath & N E Somerset)

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.

At our last assessment we rated this key question good. At this assessment the rating has remained good.

This meant people were safe and protected from avoidable harm.

This service scored 72 (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. For example, where concerns had been raised about the live-in service, the provider took immediate action to understand what went wrong and adapted their working practices to ensure learning was taken to prevent reoccurrence.

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 they had received good support to transition into the service. The service completed assessments of people’s needs before they started support and regular reviews were completed of people’s care provision during the first 13 weeks to ensure people’s needs were being met by the service.

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 if they had any concerns, they would raise them with the provider and felt confident they would be dealt with. Staff knew how to identify abuse and followed the processes to report abuse. Staff received face to face safeguarding training annually and completed additional safeguarding e-learning as required by the provider. The manager kept a log of safeguarding incidents to ensure all required actions had been completed. The provider had a safeguarding policy which staff had access to. There were opportunities to discuss safeguarding during team meetings and supervisions.

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. People told us they had been involved in setting up their care plans and risk assessments. One person told us, “[Staff] would tell me if they thought there was any risks and help me move things in case I trip over them.” Staff told us they had electronic access to care plans and risk assessments via their work phone. One staff member told us “Care plans incorporate tasks that are designed to help us support people.” People’s care plans and risk assessments were regularly reviewed and updated when their care needs changed.

The service detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care. One person told us, “Staff seem very risk aware and act preventively and promptly to help me avoid risks in my home.” Risk assessments were being completed on people’s homes before support commenced. Staff told us about the checks they completed for equipment and what they would do if they had any concerns. Leaders explained the process of the checks they completed to ensure people’s equipment was safe for people and staff to use. Staff had received training in manual handling. There was evidence of staff liaising with professionals to ensure people had access to the equipment they needed. Equipment being used by people was documented in care plans with guidance for staff on how it should be used including a link to video guidance. There was a business continuity plan in place which highlighted what to do in an emergency.

The service 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 they felt staff had the right skills and knowledge to meet their needs and were complimentary about the staff. Where people had raised concerns about staff, people told us this had been dealt with by the provider, and they were satisfied with the response. Staff had regular opportunities to attend training and were encouraged to complete role-related qualifications such as National Vocational Qualifications (NVQ’s).

However, recruitment processes required some improvement to align with the provider’s policy. For example, although references were received to check the suitability of staff to work with vulnerable people, we found 1 staff member lacked recruitment references in line with the provider’s policy. We also found 1 staff member’s Disclosure Barring Service Certificate (DBS) had not been reviewed since 2017 and gaps in employment for the same staff member had not been explored. The provider acted straight away to address this for existing staff, and to strengthen the processes going forward, they had added additional checks to their recruitment process.

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 told us staff regularly used personal protective equipment (PPE) and was aware of hygiene and infection control. One person told us, “When I go in the shower and when I get in and out of bed, they have apron and gloves on, they will take these off at different times and put new ones on. I’ve seen them do this regularly.” Staff had a good understanding of infection prevention and control (IPC) and knew when to use PPE and how to dispose of it appropriately. Staff told us they were able to obtain PPE from the provider. The provider had an IPC policy and procedure in place and staff had received training which was completed annually in line with the provider’s policy.

The provider made sure 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 families supported by the service told us they were happy with the way staff supported them with their medicines. One person told us, “Staff are excellent in supporting [person] with medication from their dosset box and in applying creams, as required.” Staff received regular medicines training and competencies were assessed on a regular basis. Body maps were in place to document the application of topical medicines and records showed medicines were given safely and as prescribed.Where medicine errors had occurred, these were clearly recorded and reported with reflective practice taking place and further training provided for staff.

However, we found 1 person did not have a risk assessment in place for a blood thinning medicine, although no harm to the person had been found. The provider took steps to resolve this immediately during the on-site visit.