Bluebird Care Docklands, Stratford and Wapping

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 72 (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, honesty and continuous learning. Staff listened to concerns about safety, and incidents, accidents and complaints were investigated with learning used to improve practice and reduce the risk of reoccurrence.

Staff told us management were approachable, listened to concerns and created opportunities for learning through monthly team meetings, supervisions and training. One staff member said, “When new people start using the service, we have a phone handover where care plans and risk assessments are discussed so we understand people’s needs and how to support them safely. Accidents, incidents and complaints are also discussed so we can learn and prevent them happening again.” Records showed incidents were reviewed, root cause analysis was completed where required, and lessons learnt were shared with staff. A team supervisor told us monthly audits were completed across medicines, care records and staff practice, with findings used to drive improvement.

Relatives and professionals also gave positive feedback about the provider’s learning culture. One family member told us, “As a family member, my input is always taken seriously and I am given feedback about what action has been taken.” A professional told us, “When feedback is given, the provider responds quickly, takes action and there is clear evidence of learning.” This showed the provider had effective systems in place to promote openness, accountability and continuous improvement.

The provider had systems in place to ensure people experienced safe care, treatment and support when moving into the service or when their needs changed. People’s care and support was planned and delivered in a coordinated way to reduce risks and promote continuity of care.

The registered manager told us initial care information such as care and support plans were received from the local authority or commissioners before people started using the service. The management team then completed their own initial assessment, including visiting people in their homes to understand their needs, preferences, risks and desired outcomes before care commenced. Following this, personalised care plans and risk assessments were developed to guide staff on how to support people safely and consistently.

Relatives told us they were involved in care planning from the start. One relative said, “They asked us what support was needed and involved us from the beginning.” A professional also told us, “The service was able to allocate the right staff based on skills and cultural match.” This showed the provider supported safe transitions and continuity of care. Care plans were shared with staff before packages of care started, helping to ensure continuity and safe transitions into the service. The management team also carried out regular visits to people in their homes to review care delivery.

The provider worked with people, families and partner agencies to protect people from abuse, neglect, discrimination and avoidable harm. Staff understood their responsibilities to safeguard people, and concerns were shared appropriately with relevant agencies when required.

Staff completed safeguarding training during induction and refresher training thereafter. When we spoke with staff, they were able to describe different types of abuse people may experience, including physical, emotional, financial, neglect and discriminatory abuse, and explained the action they would take to keep people safe. One staff member told us, “If I had any concerns, I would make sure the person was safe, report it immediately to management and follow safeguarding procedures.” Records showed safeguarding referrals had been made to the local authority where concerns arose, and statutory notifications had been submitted to CQC as required. Investigations were completed, reflective learning discussions took place, and root cause analysis was used to identify learning and reduce the risk of reoccurrence. The registered manager was supported by senior management, including the nominated individual, to ensure oversight and timely action.

The provider had robust safeguarding policies and procedures in place and worked effectively with external professionals, including GPs, social workers and other healthcare partners, to protect people. Management completed regular audits and reviews of safeguarding practices, and spot checks were used to test staff knowledge and practice. Relatives told us they knew how to raise concerns and access safeguarding information. One family member said, “I know who to contact if I ever had concerns, whether that’s the office, social services or CQC.” This showed the provider had effective systems in place to safeguard people and promote a culture of openness and accountability.

Risk assessments were completed with people, relatives and other professionals where required and were used to develop personalised care plans that reflected people’s needs, preferences and routines. These included risks relating to mobility, falls, moving and handling, medicines and the use of equipment. However, systems to review and update risk assessments were not always effective.

Staff told us they were involved in reviewing people’s risks and reporting any changes in needs to management. One staff member said, “If I notice any changes in a person’s risks, I tell the manager so the care plan and risk assessment can be updated.”

During the assessment, we identified that one person’s bed rail risk assessment had not been updated to reflect their current needs and circumstances. The provider had not identified this through their own auditing or review processes. Following our feedback, the provider took immediate action to review and update the assessment. While this reduced the immediate risk, it demonstrated that oversight arrangements had not been sufficiently robust to ensure risk assessments remained accurate and up to date.

This meant people could not always be assured that risks associated with their care and support were being consistently assessed and reviewed. Improvements were required to strengthen governance processes and ensure changes in people’s needs were identified and reflected in risk assessments in a timely manner.

The provider identified and managed potential risks within people’s home environments to help ensure equipment, facilities and other resources supported the delivery of safe care. Staff took action to reduce environmental risks and promote people’s safety and wellbeing.

Before people started using the service, the management team and team supervisors completed environmental risk assessments within people’s homes. This included assessing for trip hazards, access arrangements, moving and handling risks, fire safety and the safe use of equipment. Where additional support was needed, the provider worked jointly with other professionals including occupational therapists, physiotherapists, speech and language therapists (SALT) and district nurses to make sure people had the right equipment and support in place. Relatives told us they were involved in discussions about environmental risks and equipment needs and were kept informed of any changes required to maintain people’s safety. One relative told us, “I am always involved in discussions, and they keep me informed about any risks or changes needed.”

Staff completed health and safety and fire safety training and reported they understood their responsibilities in identifying environmental risks during care visits. Regular reviews of risk assessments and care plans were undertaken to ensure they reflected people’s current needs. Team supervisors completed spot checks during visits, which included checking for environmental hazards, the safe use of equipment, medication storage, fire safety arrangements and the condition of people’s home environments.

The provider made sure there were enough qualified, skilled and experienced staff to meet people’s needs safely and effectively. Staff worked together well to provide consistent care that met people’s individual needs and preferences.

Appropriate pre-employment checks were completed before staff started working at the service. Personnel records showed a clear recruitment pathway from application through to offer of employment, including application forms, proof of identity, right to work checks, references and Disclosure and Barring Service (DBS) checks, which help employers identify whether prospective staff have any criminal convictions or information that may make them unsuitable to work with vulnerable people. We identified that gaps in employment history were not always fully recorded at the point of application or pre-employment checks. This was raised with the provider, who acted promptly and provided evidence these gaps had been reviewed and addressed.

Staff reported they felt supported by management through regular supervisions, annual appraisals, spot checks and ongoing professional development opportunities. One staff member told us, “I completed a full induction before working independently, which helped me feel confident in my role.” Training records showed staff completed mandatory training, refresher training and opportunities to complete recognised qualifications. Staff had completed training in areas including safeguarding, moving and handling, medication administration, dementia awareness, infection prevention and control, fire safety, GDPR, oral health, person-centred care, mental capacity and positive behaviour support. This demonstrated the provider promoted a supportive and collaborative culture to help staff maintain safe and effective practice.

People and their relatives told us they received support from regular staff who understood their needs and preferences. One relative shared that their family member had made significant progress since receiving support from the service and attributed this to the consistency and quality of care provided by staff. Another person told us staff had encouraged and supported them to regain independence, helping them achieve outcomes that were important to them. Feedback from people and relatives demonstrated confidence in staff skills, knowledge and ability to meet their needs effectively. This was supported by training records showing staff completed mandatory and role-specific training, regular refresher training and recognised qualifications

The provider assessed and managed the risk of infection and had systems in place to reduce the risk of infection spreading. Staff reported that they understood their responsibilities and followed infection prevention and control procedures to support safe care delivery.

Staff had access to appropriate personal protective equipment (PPE) including gloves, aprons, hand sanitiser and other protective equipment, and told us these were readily available during care visits. Staff completed infection prevention and control training during induction and refresher training thereafter to ensure practice remained in line with current guidance. One staff member told us, “We always carry PPE, wash our hands between visits and follow infection control procedures to keep people safe.”

The provider completed infection control audits, spot checks and observations of staff practice within people’s homes to ensure procedures were being followed consistently. Management had oversight of infection prevention and control through regular audits, spot checks, staff supervision and competency assessments. The provider had an infection prevention and control policy which guided staff on safe working practices, PPE use and hand hygiene. Systems were in place to monitor compliance, respond to infectious outbreaks and work with relevant healthcare professionals where required. This showed the provider had effective systems in place to minimise infection risks and promote people’s safety and wellbeing.

People received their medicines safely and in line with their assessed needs, preferences and prescribed treatment plans. The provider had systems in place to ensure medicines were managed safely and people were involved in decisions about their support.

Care plans included clear guidance for staff on how people wished to receive support with their medicines, including any risks or specific health needs. Staff completed medicines training and competency assessments before administering medicines independently, with ongoing competency checks and observations completed by management. One staff member told us, “We complete medication training and competency checks before giving medicines, and if there is ever an issue, we report it straight away and follow the medication policy.” Medication administration records (MAR) were fully completed with no gaps observed, regularly audited, and staff understood the action to take if a medicines error or omission occurred.

During the assessment, we identified one person’s asthma action plan was not available within their care records. Although staff were supporting the person safely with their prescribed medicines and understood their healthcare needs, the provider had not ensured all relevant supporting documentation was in place. This was raised during the assessment and the provider acted promptly to obtain and implement the updated asthma action plan.