Archived: Faster than a Cat t/a Bluebird Care (Trafford)

Bluebird Care (Trafford) is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults, younger disabled adults and children. At the time of this inspection, Bluebird Care (Trafford) that was supporting 62 people living in their own homes.

Not everyone using Bluebird Care (Trafford) 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 take into account any wider social care provided.

Following our inspection visit we received information of concern from a whistle-blower. The Greater Manchester Police were investigating these concerns. At the time of publication this outcome was not yet known. However, the provider and registered manager were dealing with the concern in an appropriate and professional manner.

People’s experience of using this service:

At this inspection we found the evidence continued to support the overall rating of good and at the time of our inspection visit there was no evidence or information that demonstrated serious risks or concerns.

The registered manager had completed audits to help ensure the quality of service provided. However, for some areas, these had not identified missing documentation relating to people’s care. The risks to people were low so we have made a recommendation that the provider reviews their audit processes around record keeping.

Medicine administration was managed safely. Protocols or detailed instructions for the administration of ‘as required’ medicines had been improved.

There was sufficient and adequately trained staff to support people safely. Recruitment processes were very robust. This helped to ensure staff were appropriate to work with vulnerable people. The provider had suitable systems in place to protect people from abuse including accidents and incidents.

People were safe because there were effective risk assessments in place, and systems to keep them safe from abuse or avoidable harm.

People’s needs were thoroughly assessed before starting with the service. People and their relatives, where appropriate, had been involved in the care planning process. Staff were aware that they needed people’s consent to share information.

Staff were competent and had adequate professional support to enable them to support people safely and effectively. Staff received the training and support they needed to carry out their roles effectively. They had regular supervisions and annual appraisals.

People were supported in a friendly and respectful way. People, relatives and staff got on well and staff were aware of people’s personalities and behaviours. People told us staff supported them in a patient and unhurried manner. People and relatives were complimentary about the staff and their caring attitude.

Care plans were detailed, person centred and reflected relevant information about people’s needs and protected characteristics. There was evidence that these were reviewed regularly or as people’s needs changed.

People knew how to make a complaint. There was an effective complaints process in place. Complaints were thoroughly investigated and action taken to address the complaint raised.

People and relatives told us they were very happy with the care provided. They said that there was good communication between themselves and the service.

Rating at last inspection:

At our last inspection in July 2016 we rated the service good in all areas and it was given a rating of good overall.

Why we inspected:

This was a planned inspection based on the previous rating.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit in line with our re-inspection programme. If any concerning information is received we may inspect sooner.

Bluebird Care (Trafford) is a domiciliary care agency. This means that care workers travel to people’s homes to support them according to their assessed needs. At the time of our inspection, 75 people in the Trafford area were being supported by the service in their homes with various aspects of their personal care.

The service had a registered manager. 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.

Overall the management of medicines by the service was good but we did find two issues. These were a medicine protocol that lacked detail and a medicine care plan that had not been updated when a person’s medicine had changed. The service took action during the inspection to correct the issues.

Risks to people had been assessed and control measures were in place. However, we identified one person who was being supported by staff to use a hot water bottle and there was no risk assessment in place. The service planned to put a risk assessment in place as soon as possible.

People told us that care workers used personal protective equipment when assisting them with their personal care. We saw records which showed a care worker had persistently flouted the infection control policy; the service had identified the problem via spot checks and was in the process of addressing the issue with the care worker at the time of our inspection.

The service recruited new care workers safely. Care workers could describe how to protect the people from abuse and said they would report any concerns appropriately.

We saw improvements had been made to the visit scheduling system so that care workers arrived on time for their visits. People told us that care workers were rarely late, and when they were, it was almost always due to traffic problems which could not have been avoided.

People told us that care workers were well trained. Care workers told us and records showed that they had access to regular mandatory training as well as specialist courses to help them support people with complex conditions. In addition, care workers received regular supervision, on the job spot checks and an annual appraisal.

The service was compliant with the Mental Capacity Act 2005 and staff could tell us how the legislation impacted upon the people they supported.

People received person-centred support to eat and drink when they needed it. The service also assisted people to maintain their holistic health according to each individual’s needs and mental capacity.

People told us they had developed friendly relationships with the care workers, and that care workers respected their privacy and dignity. People also described how care workers supported them to remain independent.

The service provided people with information on advocacy and referred people to advocacy services if they needed it. We saw detailed, person-centred care plans of people who had received end of life from the service and feedback from their relatives which was highly complimentary.

The service tried hard to ensure it employed care workers with the right caring values and that people were supported by a small team of regular care workers.

The service was transitioning from paper records to an electronic care planning system. We saw that care plans of each type were detailed, individualised and person-centred. There was a system in place to ensure care workers could provide support even if there were technical difficulties accessing the electronic system.

People’s care plans were flexible and reviewed with them regularly. Relatives and healthcare professionals could access the electronic system with the person’s permission. Existing ‘customers’ that did not like the new electronic system could revert to paper records if they chose.

We saw that complaints were investigated, recorded and resolved according to the complaints policy. People and their relatives felt able to raise any issues or concerns with the care workers or staff working in the office.

The service was extremely committed to continuous improvement and had gone to great lengths to involve its staff, the people using the service and their relatives.

The managing director and registered manager were forward thinking and used innovative new technology to improve the service’s responsiveness to the people using the service via audit, monitoring and quality assurance.

Care workers felt highly valued by the service. We saw the managers tried hard to involve care workers in developing and improving the service. Care provided was evidence-based and care workers were encouraged to celebrate and share their own good practice.

There was a refreshingly open culture at the service. Staff felt able to admit errors and received support to improve when they did. The managing director had developed a philosophy of care for the service and care workers could describe how the service’s vision and values underpinned the support they gave to the people.

All the relatives we spoke with were positive about the care and support people received, they told us: 'My X is happy, I have been there when staff have been with my X and they are looking after her well. I feel confident with them.' 'I ask my X when staff have been how it was and they tell me they have been extremely caring, done what I have asked, they have a really nice relationship with X.' 'I have absolute faith in them.' 'Carers have been brilliant.'

We saw care records contained personal information of people's likes and dislikes. Care records contained assessments of people's needs in relation to personal care, medication, nutrition and hydration and moving and handling.

We saw a copy of the medication policy which had been reviewed in June 2013. The policy contained clear guidance for staff.

The owner provided us with details of the comprehensive recruitment process which included application, interview and a psychometric test for all potential new staff to assess people's personality and attitude towards the job role.

Staff were positive about the support they received and told us they could talk with the manager or owner if they had any issues or concerns.

People were asked for their views on a quarterly basis when satisfaction surveys were sent out to people and their relatives. The feedback was overall positive.

Customers can request specific time slots and the service will try to adhere to these where possible.

Customers are given a welcome handbook containing relevant information when they first take up the service and a copy is left in the care file within the home.

The service had close working relationships with Age UK and the local authority to support their customers.

Bluebird care had recently been awarded The Dignity In Care award from Trafford Local Authority.

Customers told us; "I could pay less for a housekeeper but feel safe and content with Bluebird and you can't put a monetary value on that feeling'. 'I am very impressed with whole company they take my needs into consideration at all times. I have had different support from them depending on my needs but I have never been disappointed. The assistant who comes is great she has a passion for what she does and does it to the standard I expect and want'.

A relative told us; "We would not have our X at home now if it wasn't for Bluebird care". "I cant say anything else other than we are not dissapointed they are really good".