Bluebird Care (Westminster, Kensington & Chelsea)

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 78 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

There were systems to learn when things went wrong. Staff reported all accidents, incidents and complaints. Managers investigated these and took appropriate action to learn from these. For example, adapting people’s care plans, retraining staff and making referrals for people to receive additional support. The provider held regular meetings with staff to discuss lessons learnt. Managers analysed trends and arranged for additional staff training or provided information when they identified wider issues.

There was an exceptionally strong culture of collaborative working, which supported people to receive joined up care. The provider worked in partnership with local hospitals to help coordinate discharges. Managers attended hospital discharge meetings. They liaised with external partners to ensure the right equipment and support was in place for people when they went home. Managers supported people on the day of discharge, when this was their choice. They attended hospital and helped to coordinate transport home, often travelling with people. They ensured new care staff were introduced to people, either at hospital or when they arrived home.

Managers worked closely with hospital teams throughout people’s stays to ensure they understood any changes in their needs. Because of this, they were able to offer adapted care plans for people to return home and continue their recovery there. For example, offering increased hours of support. Relatives explained how this had helped people to feel safe, be comfortable at home and have improved nutritional intake.

The provider proactively planned and coordinated people’s transitions between services to ensure they received personalised and safe care. The provider worked in partnership with a local nursing home and physiotherapist service to care for people needing extra support when they left hospital. They held regular meetings and reviews to discuss and adjust people’s individual care to reflect changing needs as people regained their independence. For example, the provider coordinated the discharge for 1 person who had been admitted to hospital following a fall. They had multiple health conditions and were living with dementia. The provider liaised with the different teams involved in the person's care. They arranged for specialist equipment and retrained staff who the person was familiar with to ensure they could meet the person's changing needs. The specialist support and consistent care resulted in improvements in the person's health and wellbeing once they were back home and staffing levels were reduced to reflect these improvements.

External professionals working with the provider told us people received exceptionally person-centred care during transitions. A professional commented, “[The agency] is exceptionally organised and innovative, they always have their customer's best interests at heart. Together we have put together some genuinely unique hospital to home pathways.”

The provider coordinated transitions with people and their relatives to make sure their needs were central to all decisions.

Staff helped to remove barriers to people’s care and make sure they received continuity of support. For example, staff accompanied people on hospital visits, spoke with external professionals and advocated on behalf of people when needed. When 1 person became unwell and was taken to hospital in the middle of the night, staff accompanied them and stayed with them until they were admitted and settled several hours later. The staff visited people who were staying in hospital, taking them supplies when needed. Staff provided care such as helping people with hair, washing and make-up, as well as providing company and liaising with hospital staff to make sure they understood people’s needs and wishes. A relative commented, “[Person] recently had a small hospital procedure. The carer took [person] there and stayed with [them] for company. They always do the right thing.”

People and their relatives told us staff had supported them with personal transitions, including moving house. A person explained how their regular care worker had helped them when they moved and had recognised this was a challenging time for them. A relative told us, “The agency was extremely supportive and helpful when we moved house.”

There were systems to help safeguard people from abuse. The provider had appropriate procedures, and staff were familiar with these. Staff undertook training to understand how to recognise and report abuse. Staff were able to explain this to us. The provider worked with the local safeguarding authority to ensure allegations of abuse were reported and investigated. They took action to help protect people from avoidable harm.

People using the service and their relatives told us they felt safe. Their comments included, “I feel very safe and comfortable” and “When I spoke up, they believed me straight away. This reassured me.”

The provider had partnered with a cashless card system to help protect people from the risks of financial abuse. Staff who supported people with shopping used the card. This linked to a mobile application which could be monitored by the person, their relatives and managers.

The provider proactively involved people in making decisions about risk taking. They worked with the person, their relatives and other professionals to help develop personalised plans to manage risks. For example, a person who experienced anxiety and panic attacks was finding it difficult to leave their home. The provider involved the person in planning personalised care to help overcome these risks. They introduced regular care staff who supported the person to make small trips outside. Staff focussed on providing reassurance and managing safety. Overtime, they developed the support. The person started to take more regular and longer trips out, which had a positive impact on their mental wellbeing and mobility.

An external professional described how the provider placed an emphasis on supporting people to become independent and more mobile when possible. They explained risks were appropriately assessed and managed. They told us, “Carers are always willing to help [people] by supporting mobility and enabling safe walking. They are proactive in keeping us informed of any issues and whether additional support is needed.”

The provider regularly reviewed risk assessments and management plans to help make sure these were accurate. They shared information with people and their relatives. They had developed additional guidance to help people consider how to keep themselves safe. For example, preventing falls and tips for safety.

The provider helped to make sure people lived in safe environments. They carried out assessments of people’s home environments. When risks were identified, they discussed these with people and their relatives. They helped people to find ways to live safely and mitigate environmental risks. For example, supporting people to reposition belongings to help create more space to safely move around. The provider was able to demonstrate examples of how they had supported people in a sensitive and careful way, respecting what was important for the person.

There were enough staff to care for people and keep them safe. People were supported by the same familiar staff. During people’s initial assessments, they were asked about staffing needs, including personalities, gender, language and cultural needs. The provider tried to match staff who met people’s requirements. People and their relatives told us the agency was willing to change care staff if they requested this. People told us staff arrived on time. Their comments included, “They are always on time”, “We have 2 regular girls who are wonderful”, “Carers are trustworthy and on time” and “Bluebird is good at accommodating last minute requests for additional care visits. They make sure [person] is sent someone [they] are used to.”

There were systems to ensure staff were suitable. The provider carried out a range of checks during and after recruitment. They had asked people using the service to contribute ideas for interview questions. New staff undertook a range of training and a comprehensive induction. Staff received regular supervision and appraisals of their work. Staff took part in regular training updates. Comments from staff included, “I have completed a mix of mandatory and role-specific training” and “The training has helped me support the individuals we look after, with a deeper understanding of their needs.”

There were systems to help prevent and control infection. People using the service and their relatives told us staff kept their homes clean and followed good hygiene practices. A person commented, “They always keep everything spotlessly clean.” There were infection prevention and control procedures. Staff undertook training to understand these. Staff were provided with personal protective equipment (PPE). Managers carried out checks on staff to observe them providing care. These included checks on cleanliness and hygiene practices.

People received their medicines safely and as prescribed. The provider assessed people’s medicines needs. They planned care to meet individual needs, including supporting people to manage prescriptions, collect medicines and with administration. Staff undertook relevant training. Managers assessed their skills and competencies. Staff kept records to show when they had administered medicines. The provider carried out audits of medicines management. We saw they had acted when they identified concerns.

The provider supported people to remain independent with medicines when this was what they wanted and it was safe for them to do so. The provider developed person-centred ways to help people manage this. For example, 1 person was regularly forgetting to take their evening medicines, and no care visits were arranged for this time. A senior member of staff and the person developed a plan that on-call staff would call them each evening to remind them to take their medicines. They also developed this call into a social chat and check on the person’s wellbeing. This approached helped to ensure the person remained independent.

Staff were proactive in seeking support and guidance when they identified issues with people’s medicines, including when people were unwell.