Bluebird Care (Carlisle)

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 75 (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.

Staff were knowledgeable and reported incidents, accidents and safeguarding concerns appropriately, which were then investigated. A staff member said, “I reported a concern a few weeks ago, and got feedback and was kept up to date on progress and the outcome.” Discussions were held in team meetings and there was a shared approach to learning lessons.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. Staff made sure there was continuity of care, including when people’s support was shared with another provider.

People’s needs were assessed before care was provided and this information was used to develop care plans and risk assessments. Care was discussed and agreed with people. Were appropriate, relatives and healthcare partners were involved in discussions.

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 and conducted thorough investigations. A tracker was used to log concerns, record action taken and a summary of learning.

People, and their relatives told us they felt safe. Comments included, “I feel safe with them, they give you that bit of confidence,” and “I’ve never felt anything but safe.” A staff member said, “They are very hot on reporting straight away. I raised a report which was reported to the on call and taken forward straight away.”

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.

Risk assessments were in place. People and their relatives said they were involved in managing risks and could access records on the electronic system. Some risk assessments were specific to the person. Others included more general risks, hazards and control measures rather than having a focus on specific risks to the individual. For example, in relation to skin care some risk assessments included that people who were not able to maintain their own skin care could induce the risks of deterioration of skin integrity. The nominated individual was aware that some records needed to be more personalised and said, “We have the new care plan format which will hopefully help us resolve this.” We did not find any evidence that people were adversely impacted by this.

One person said, “I have a moving and handling plan, if there’s a new one (staff member) I tell them everything and they read the plan.”

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Environmental risk assessments were in place and regular inspections of equipment used in the delivery of care were completed.

Safe recruitment practices were followed, with robust induction, training and support. There were mixed views about staffing. Some people said they had regular staff who arrived on time (give or take 15 minutes) and stayed for the time allocated. Other people and relatives commented that staff didn’t stay for the required time and sometimes left early. One person said, “Some of the young ones are in a hurry to get away. I pay for half an hour, but after fifteen minutes they are ready for going.” The nominated individual said, “We are aware of this and it has been addressed with staff [in relation to leaving calls early].”

Most staff thought calls were planned to provide continuity for people but some did comment on the lack of travel time in between calls which impacted on the time they spent with people. Records also indicated some calls did not last for the expected time although all the required care was provided before staff left. We discussed this with the nominated individual and recruitment and training manager who said, “We are aware of the need to look at travel time. It was raised in questionnaires and in the suggestions box. We are looking at reconfiguring runs to incorporate travel time, but it is obviously taking time.”

If people needed additional support staff stayed longer to ensure people were safe and well cared for. This was reported to the office staff or on call if outside of normal office hours.

Appropriate and relevant training was provided for staff, including access to specialist training for some staff who supported people with more complex needs. A care mentor was in post whose role was to improve and develop the experience of new staff.

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.

Care plans included information on the prevention of infection. Spot checks were completed which included the use of PPE.

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.

Staff completed training, and regular observations of competency took place to make sure staff managed medicines safely. Medicine records were accurately completed, and regular audits took place. Any gaps or omissions were identified quickly and acted upon to minimise risk and prevent future occurrences. The nominated individual said, “We are introducing body maps to support with the application of prescribed creams.”

Information on the administration of ‘as and when required’ medicines was recorded on medicine administration records (MARs) rather than specific protocols. The nominated individual said they would look at implementing specific protocols.