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L & N Services Ltd t/a Bluebird Care (York) Good

This service was previously registered at a different address - see old profile

Reports


Review carried out on 4 November 2021

During a monthly review of our data

We carried out a review of the data available to us about L & N Services Ltd t/a Bluebird Care (York) on 4 November 2021. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.

This could change at any time if we receive new information. We will continue to monitor data about this service.

If you have concerns about L & N Services Ltd t/a Bluebird Care (York), you can give feedback on this service.

Inspection carried out on 12 August 2019

During a routine inspection

About the service

L & N Services Ltd t/a Bluebird Care (York) York is a domiciliary care service that was providing personal care to 39 people.

People's experience of using this service

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People received safe care and support because systems and processes in place ensured any risks were safely managed by staff, and their needs met with minimal restrictions in place. Staff had received training and clear guidance was followed to help people to understand how to remain safe from avoidable harm and abuse.

People and their relatives told us they were happy with the service provided. Staff understood the importance of providing person-centred care and had developed positive relationships with people.

Medicines were managed and administered safely. Records confirmed people had received their medicines as prescribed.

People were involved in their care planning. Records were person-centred and evaluated consistently. Where agreed outcomes were not achieved, amendments were made with people's input.

Staff received appropriate induction, training, and support and applied learning effectively in line with best practice. This led to good outcomes for people and supported a good quality of life.

Staff were friendly and polite. Staff took time to get to know people. They had a clear understanding of, and how to support, people's individual and diverse needs.

People and their relatives told us they were confident if they had any complaints the registered manager would address them appropriately.

People knew the manager and told us they trusted them. Staff told us the registered manager was supportive and approachable.

The provider completed oversight and the nominated individual told us they were setting up associated records to ensure quality assurance remained a priority and was effective in maintaining standards and driving improvements.

For more details, please see the full report which is on CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good, (published 25 July 2018).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 27 June 2018

During an inspection looking at part of the service

We carried out an announced comprehensive inspection of this service on 19 October and 3 November 2016. A breach of legal requirements was found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 Well led.

We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for L & N Services Ltd t/a Bluebird Care (York) on our website at www.cqc.org.uk.

This service is a domiciliary care agency. It provides personal care to people who live in their own homes in and around the city of York. At the time of the inspection there were 62, predominantly older people receiving care and support services.

Not everyone using L & N Services Ltd t/a Bluebird Care (York) receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

There was a registered manager in place who was registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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 provider had made improvements to the recording of people’s information. They had fully implemented an electronic system to record information about people’s care and support and information was accessible to everybody who required access.

The systems and processes in place enabled the provider to monitor and mitigate risks relating to people's health and safety. Staff used the information to provide people with safe care and support.

The provider had implemented a new system and process that ensured policies and procedures were available as a point of reference for staff and these were kept up to date with the latest regulatory requirements and best practice.

There was positive feedback about the leadership and management of the service from everybody we spoke with.

The registered provider had systems and processes in place to obtain feedback on the service and this was evaluated with resulting actions implemented.

Inspection carried out on 19 October 2016

During a routine inspection

This inspection took place on 19 October and 03 November 2016 and was announced. The provider was given 48 hours' notice because the location provides a domiciliary care service and we needed to be sure that someone would be available to speak with us.

At our previous inspection in October and November 2015, we identified a breach of Regulation 12 Safe Care and Treatment under the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. The registered provider had submitted an action plan with information on how they intended to meet the breach. During this inspection, we checked and found the actions implemented meant the registered provider was not in breach of this regulation.

The service provides personal care to people who live in their own homes in and around the city of York. At the time of the inspection there were 75, predominantly older people receiving care and support services from Bluebird Care York.

There was a registered manager in place who was registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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 provider had implemented a new system and process that electronically managed records for the care and support people received and we saw this was in place in conjunction with paper records for people. We found information in these records was not consistently recorded, accurate, complete or reflective of people’s current needs.

The registered provider completed medication audits that were designed to ensure people received their medication in line with their prescription and that information was available that ensured this was done safely. We found that people received their medication safely but medication records for people were not detailed, accurate and consistent. Audits completed were ineffective, as they had not addressed the lack of complete and accurate records that we found.

The registered provider had measures in place to keep people safe from avoidable harm. Care plans included risk assessments for people and their environment but we found there was ineffective monitoring that ensured this information was up to date, accurate and complete. We also found the information did not guide staff on how to mitigate the identified risks.

During our inspection, we found policies and procedures provided for staff were not always up to date. This meant they did not always have access to current guidance.

The above concerns meant that at the time of our inspection systems and processes implemented to assess, monitor and improve the quality and safety of the service had not been fully established and were not always effective. This was a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we asked the provider to take at the end of the full version of this report.

People receiving a service were protected from avoidable harm and abuse by staff who had received training in safeguarding. Staff had access to policies and procedures on safeguarding adults from abuse and understood how to raise any concerns.

Sufficient competent and skilled staff were employed and staff deployment was managed electronically. The registered manager told us they recognised the importance for people in receiving care and support from a regular group of caring people and we saw rotas were planned to ensure people had contact with familiar staff who had sufficient time to travel between calls. This ensured people received their care and support at the times they wanted.

The registered provider had completed pre-employment checks on care workers that helped to ensure they were of suitable character to work with vulnerable people. It was clear from staff records that these checks had been undertaken and that the registered provider had received this information prior to the new employees starting work.

Care workers told us they felt supported in their role and there were systems to monitor the quality of the care provided. There were regular spot checks and competency checks of care worker’s practice and they were supported to improve and develop in their roles.

Accidents and incidents were managed effectively with systems in place to record actions and outcomes that helped to improve the service and keep people safe.

We checked and found the registered provider was working under the Mental Capacity Act 2005 (MCA) legal framework. People using the service were supported to make decisions and signed consent was sought in line with relevant legislation and guidance. Care workers had completed training in the MCA and encouraged people to make decisions and have choice and control over the support they received.

People were supported to maintain a healthy diet. Care plans included records for people’s individual nutrition and hydration requirements. Where people had any food allergies, these were recorded along with information on food that people liked or disliked.

People were supported with their health and wellbeing. We saw care plans contained detailed information about people’s medical history as well as contact details of healthcare professionals involved in providing their care and support.

Care workers were observed to be caring and we found the people they supported mattered. People had their privacy and dignity respected by care workers who were considerate of people’s individual preferences.

Inspection carried out on 22 October and 4 November 2015

During a routine inspection

We inspected this service on the 22 October and 4 November 2015. The inspection was announced. The registered provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be in the location offices when we visited.

L & N Services Ltd t/a Bluebird Care (York) is a domiciliary care agency and is registered to provide personal care to people in their own homes. At the time of our inspection the service was supporting approximately 70 people in and around York, although not all of these people received support with personal care.

The service was registered at a new location in April 2015 and this was the first inspection of this service at this location.

The registered provider is required to have a registered manager in post and on the day of the inspection there was a manager registered with the Care Quality Commission (CQC). 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 people who used the service told us that they felt safe with care workers in their home. We saw that there was a system in place to assess risks and that proportionate risk assessments were put in place to manage these risks to keep people safe and prevent avoidable harm. Care workers we spoke with knew how to identify signs of abuse and what to do if they had concerns.

We found that the registered manager did not always sign off accident and incident forms to record what action had been taken to prevent future incidences of avoidable harm and there had been no analysis of accidents and injuries across the service. This meant that we could not be certain that wider patterns or trends would be identified. These issues could place people who used the service at risk of otherwise avoidable harm. We have made a recommendation about improving the management of accident and incidents in our report.

We found gaps in recording on Medication Administration Records increasing the risk of medication errors occurring. This was a breach of Regulation 12 (2) (g) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

There was an effective recruitment and induction programme and on-going training to make sure care workers had the necessary skills for their roles. Care workers told us they felt supported in their roles and there were system to monitor the quality of the care provided. There were regular spot checks and competency checks of care worker’s practice and they were supported through team meetings and supervisions to improve and develop in their roles.

People using the service were supported to make decisions and signed consent was sought in line with relevant legislation and guidance. Care workers encouraged people to make decisions and have choice and control over the support they received.

There was strong evidence of a person centred culture when planning care and support. People’s needs were assessed and care plans were very detailed, specific and person centred; this enabled care workers to provide effective care and support tailored to the individual needs of people using the service. Care workers understood the needs of the people they were supporting and provided compassionate care and support. People using the service felt that care workers took an interest in their lives and we could see that there were systems in place to enable people to develop positive caring relationships with their care workers.

People using the service and care workers told us it was well-led. We found that the registered manager kept up-to-date with changes in legislation and guidance on best practice and information was communicated to care workers. There was an open person centred culture, people using the service and care workers felt able to raise issues or concerns.