Bluebird Care Lincoln

Bluebird Care Lincoln is a domiciliary care agency. It was providing personal care to 64 people at the time of the inspection.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

People’s experience of using this service and what we found

People told us they received a good service and felt safe. Risks were well managed. The provider learned from previous accidents and incidents to reduce future risks. The registered manager understood their responsibilities about safeguarding and staff had been appropriately trained. Arrangements were in place for the safe administration of medicines.

There were enough staff on duty to meet the needs of people. The provider had an effective recruitment and selection procedure, and carried out relevant vetting checks when they employed staff. Staff were suitably trained and received regular supervisions and appraisals.

People’s needs were assessed before they started using the service. Staff treated people with dignity and respect. They helped to maintain people’s independence by encouraging them to care for themselves where possible.

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.

The provider had a complaints procedure and people were aware of how to make a complaint. Continuous learning and improving care was at the heart of the service. An effective quality assurance process was in place. People and staff were regularly consulted about the quality of the service.

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

Rating at last inspection

The last rating for this service was good (published 8 October 2016).

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.

This inspection took place on 7 and 8 September 2016. The inspection was announced. At the time of our inspection approximately 118 people were receiving a range of support from the service and 82 people were receiving care under the regulated activity the service is registered with us for.

The service had a registered manager in place at the time of our inspection. A registered manager is a person who has registered with 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.

Staff understood how to report concerns about potential abuse, and when it was needed, took action to make sure people were protected from harm. People’s needs were assessed and any potential risks to people and staff were identified before any new services commenced. Environmental risks were also assessed within people’s homes to help protect all parties. Support plans were in place which helped inform staff about any potential risks to people’s health and wellbeing and to keep them safe when it had been needed. Relevant health professionals were also contacted for help and advice to maintain people’s wellbeing, where necessary.

An ‘on call’ system was in place outside of office hours to enable people, their relatives or staff to gain help and advice when they needed it. Staffing levels were monitored by the registered provider and an on-going recruitment programme was in place to make sure there were enough skilled and experienced staff to meet people’s needs.

Staff were provided with regular supervision, including direct observation of their care practice. Senior staff demonstrated a supportive and non-hierarchical style of leadership which was appreciated by staff at all levels in the service.

Staff undertook training in a variety of subjects to maintain and develop their existing skills. Staff worked together in a friendly and supportive way and were provided with regular support through supervision, ‘spot check’ visits and appraisals. These processes were used to help the registered manager and staff to identify any further training needs and allow discussion and reflection on individual and team performance.

CQC is required by law to monitor how a provider applies the Mental Capacity Act 2005 (MCA) and to report on what we find. The registered manager and staff had received training in this area and if people lacked capacity to make their own decisions the principles of the Mental Capacity Act 2005 and codes of practice were followed in order to protect people’s rights.

People who needed staff assistance to take their medicines were supported to do this and staff assisted people to eat and drink enough to keep them healthy whenever this type of support was required.

The provider had a range of quality monitoring systems in place which included audits, reviews and surveys. The provider and registered manager listened to what people had to say and took action to resolve issues or concerns when they were raised with them. There were systems in place for handling and resolving concerns and more formal complaints. The provider and manager met regularly reviewed and reflected on the systems they had in place to manage the service. When action was needed they responded in ways which enabled them to keep developing and improving practices for the future.

At the time of our inspection there were 110 people who received a service in their own homes. A single inspector carried out this inspection.

The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well-led?

Below is a summary of what we found. The summary describes what we found, the records we looked at and what people who used the service, their relatives and staff told us.

If you want to see the evidence supporting the summary please read the full report.

Is the service safe?

People and their representatives told us they felt safe with the staff who provided their care and support. One person told us, “I feel very safe with the carers, they know what they’re doing.”

Individual risk assessments took account of the environment within people’s homes as well as their care and support needs.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

Is the service effective?

We found up to date and detailed care plans were in place to meet people’s needs. We saw people, their representatives and staff who worked with them were involved in developing the care plans. People and their representatives told us staff followed the care plans when they visited.

People were allocated a small team of staff to provide their care and support in order to help with a consistent approach for them.

We saw the manager made sure staff had enough travel time between visits and enough time to carry out the care and support that people needed.

Staff were provided with a good induction when they started to work for the agency and a package of training which included topics relating to people’s needs.

Is the service caring?

Comments we received when we spoke with people and their representatives included, “I couldn’t wish for a better service, they do everything on the care plan and more if needed”, “Our main carer is a star, she goes the extra mile; I would recommend the service to anyone” and “My carer understands my needs very well.”

People also told us the staff who supported them always maintained their dignity and privacy when they carried out care tasks. They also said staff respected them as people, listened to their views and made sure their wishes and preferences took priority in the care and support they provided.

Is the service responsive?

We found the manager and provider were quick to respond to any issues raised by people, their representatives and staff.

The representative of one person using the service said, “I only have to ring the office and they address things straight away.”

One staff member told us, “I get lots of support from Bluebird Care, they’re really helpful and sort things out. I feel valued and listened to, it’s nice to be appreciated.”

Is the service well led?

Staff told us there was generally good communication within the agency. They said the manager and senior staff were approachable and easy to talk to. They made comments such as, “It’s an excellent company to work for” and “xxx [the manager] is brilliant.”

There was a clear line of management within the agency. Staff told us they knew who to go to if they had any problems. We found there was always a manager on call for evenings and weekends and they responded quickly to calls from staff.

There was a system in place for the provider and the manager to regularly monitor the quality of the services they provided for people. We saw regular audits were carried out with actions to address any issues highlighted.

We spoke with the relatives of two people who used the service. One relative told us; “They provide a brilliant service for my relative. I don’t know what we would do without them”.

However we found that people's care and treatment had not always been planned effectively to meet their care needs.