Bluebird Care (Westminster, Kensington & Chelsea)

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has changed to outstanding.

This meant people’s outcomes were consistently better than expected compared to similar services. People’s feedback described it as exceptional and distinctive.

This service scored 88 (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 promoted a culture where everyone involved in people’s care had a deep understanding of their individual needs and preferences. The provider ensured people were central to the assessment process. Their views were always considered, and care was developed to reflect these. An external professional explained, “It is clear [the provider] demonstrates values regarding patient care and promoting independence.” The provider developed assessments and care plans that focussed on individual goals and aspirations. They supported people to rebuild routines and confidence. They constantly reassessed needs to ensure care was safe, provided in the least restrictive way and promoted people’s independence. People and their relatives gave feedback that people had achieved things they did not previously think were possible because of this.

The provider included innovative ways to assess people’s needs. Managers always visited people before they started using the service, in hospital and/or at home. They also arranged to meet people in places that were important to them, such as cafes and places in the community, so they could get to know what the person liked. This helped people feel the provider valued their wellbeing. This also helped managers to assess people in different environments to better understand their needs. The provider arranged for assessments to take place during different times of day and days of the week to suit the person.

The provider’s ethos was that assessments evolved to reflect how staff gained a better understanding of people’s needs. People and their relatives told us they had excellent relationships with the management team who regularly visited or called them to discuss their needs. People told us this made them feel their individual wishes and views were always considered as important and central to how care was delivered. In addition, they developed strong bonds with their regular care staff. These care staff contributed their views to help improve assessments and care plans. For example, a care worker supporting 1 person who lived in a communal setting. The person was finding it hard to engage with others and was declining meals. The care worker identified the person’s meals did not always meet their individual preferences and the person was strugglingly physically to manage independently. The care worker raised this with the provider so that their care plan could be adapted to meet these needs. The person’s nutritional intake and emotional wellbeing improved.

People and their relatives told us assessments and care plans were regularly reviewed and they always felt involved. Their comments included, “We have regular meetings”, “The staffing levels are adapted depending on what [person] needs at the time” and “Bluebird staff all understand [person] well. They communicate clearly.”

The provider used an electronic care planning system which was accessible to people and their relatives. They could view and interact with these records, adding their own comments or asking for revisions.

The provider demonstrated a culture where staff adopted innovative and evidence-based approaches to providing care so that people had good outcomes. The provider had strong partnerships with external professionals, including hospital discharge teams. Through these partnerships they ensured clinical recommendations were incorporated into care plans and staff followed these. An external professional commented, “I find staff knowledgeable and helpful. They are willing to engage and participate in extra training sessions to meet people’s individual needs.”

Staff worked closely alongside physiotherapists supporting people with their mobility. A professional told us how the staff gave clear and detailed information about people’s needs and support. They commented that this “greatly assists in ensuring continuity of care and clinical decision making”.

The provider ensured people experienced good outcomes and found ways to overcome barriers. For example, the provider cared for 1 person who was recovering from a mental health crisis and stay in hospital. Whilst other professionals initially wanted the person to go into residential care, the person wanted to return home. The provider worked with a multidisciplinary team to set up a personalised care package for them to safely live at home. Familiar staff received guidance and information to understand how to mitigate risks for the person. They provided emotional and practical support to enhance the person’s recovery. The person was able to regain independence and told the provider staff had “moved mountains” to help them achieve their personal goals.

The provider ensured people’s wishes and needs were central to care planning. They helped explain different terms to people and their relatives to ensure they understood about the support from the agency and input from others. They found ways to overcome barriers with communication. For example, ensuring all staff supporting individuals, including the management team coordinating their care, could speak people’s first language.

The provider employed nurses who offered clinical guidance and oversight. They trained staff to undertake delegated tasks which meant people could receive consistent care from familiar workers. Staff undertook a range of training to understand best practice. Staff completed training to understand how to care for people with a learning disability. Comments from staff included, “This training has helped me understand people’s needs better and to communicate more clearly” and “Training has ensured everyone is better supported in a person-centred way.”

Managers and staff undertook training and followed best practice for supporting people living with dementia. The provider supported relatives to understand the condition and discussed individual challenges with people and their relatives. People received personalised care which reflected best practice focussing on maintaining their dignity, independence and wellbeing. Comments from external professionals included, “I have found [the management team] and staff very professional and knowledgeable” and “The carers consistently demonstrate competent and safe clinical skills.”

The provider ensured there was a collaborative approach to planning and coordinating people’s care. Staff worked extremely closely with external professionals. Comments from external professionals included, “Communication with the agency is exemplary. They maintain open, transparent and regular contact. This has contributed to cohesive, well-coordinated care” and “I have found their communication to be detailed, timely and reliable.” Professionals told us staff were approachable, friendly and easy to engage with. They also explained how staff shared information and sought guidance from others to improve care delivery.

There were many examples of how the provider’s collaborative work with hospital discharge teams and therapists had led to improved care for people using the service. Managers ensured they sought early intervention when they identified a need and made timely referrals for additional support. For example, they had supported 1 person with complex needs to return home from hospital. They arranged for specialist equipment to be provided and worked with the rehabilitation and physiotherapy teams involved in the person’s care. This coordinated approach helped ensure a safe transfer from hospital and managed risks the person was exposed to once at home. In another example, the provider worked collaboratively with others to support a person recovering from poor mental health. This holistic approach led to life-enhancing outcomes, including a reduction in the person’s medicines.

Staff worked with other professionals to ensure everyone involved in people’s care considered their individual circumstances and preferences. For example, working with a physiotherapist to plan personalised exercises that helped to improve people’s mobility and confidence. The outcome of this work for 1 person meant they regained skills to manage some of their care independently, leading to reduced falls and better health.

Managers regularly met with staff and shared guidance and information. They held workshops and specialist meetings for groups of staff working with individual people. This helped staff to discuss what worked well and if any changes to care were needed.

The provider supported people to live healthier lives. The manager was a nurse, and the provider employed other nurses. This included a clinical lead whose role was to help develop care plans, train staff and oversee clinical governance at the service. Nurses trained staff to undertake specific roles with people they cared for and to understand about their health needs.

The provider ensured there was clear information about health conditions within people’s care plans. Staff liaised with external healthcare professionals to monitor and meet people’s healthcare needs. People and their relatives told us staff were good at monitoring people’s health and responding when they identified changes in this. People told us staff supported them with exercises and eating well.

Staff monitored people’s wellbeing. They kept records of the care they had provided and any concerns. They shared concerns with the person, their relatives and managers. For example, a member of staff identified changes in the condition of a person’s skin. They supported the person to access healthcare support for this. The changes were the symptom of a potentially serious disease. The early interventions resulting from the staff member’s observations enabled the person to receive treatment and make a full recovery.

Managers carried out regular reviews of care. They asked people and their relatives for feedback. They made changes to care when needed. Staff supported people to work towards planned objectives. These included developing skills and independence.

People consented to their care and treatment. During the initial assessment of their needs, managers assessed people’s mental capacity to make decisions. They consulted with the person and their representatives. When people were able to, they had signed agreement to their care plans. For people who lacked the mental capacity to understand and decide about their care, the provider liaised with their legal representatives and relatives to make decisions in their best interests. Relatives told us people were asked to consent to their care. They explained staff offered choices.