Blue Sapphire Care Limited

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last inspection we rated this key question good. At this inspection the rating has changed to requires improvement.

This meant people’s needs were not always met.

This service scored 57 (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 did not always make sure that peoples records were reflective of their care and treatment. Therefore, the provider could not be assured people consistently received care that reflected their current needs and preferences.

Care plans were not always reviewed promptly when people's needs changed, and updates did not always reflect their current circumstances. Some care records lacked sufficient information to guide staff in delivering personalised care, while others contained conflicting information. This created a risk that people may not always receive consistent support.

Despite these concerns, people benefited from continuity of care and were supported by regular carers who knew them well. People and their relatives spoke positively about the service and told us they were happy with the care they received. Staff demonstrated a good understanding of people's needs, preferences and routines. One staff member said, "I do believe we are very good at caring for people holistically and catering to their individual needs."

There was also evidence the provider responded appropriately when people's needs changed. Healthcare professionals were involved to assess people's needs and provide guidance for staff to follow, and relevant information was shared with family members where appropriate. The service worked with other professionals to arrange equipment to support people safely, and care calls were adjusted to reflect changes in people's support needs.

However, leaders had not ensured care records were consistently accurate, complete and up to date. As a result, positive responsive practices were not always supported by clear and reliable documentation, and the provider could not be assured people consistently received care that reflected their current needs and preferences.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

People experienced continuity of care because they were supported by a regular team of carers who knew them well. People and their relatives told us staff understood their needs and preferences and provided support in the way they wanted. Staff told us they were given time which allowed them to get to know people. Staff worked effectively with healthcare professionals and made referrals when people's needs changed. Care packages were adjusted promptly following professional advice, and information was shared appropriately with people and their families. This helped ensure care was coordinated, flexible and responsive to people's changing needs. One relative told us the service provided them with peace of mind and said staff had developed positive relationships with their family member. Another relative said, "They're all very good, we know them all."

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

The provider had taken some steps to meet people's information and communication needs, including providing information in large print. However, systems were not in place to ensure people's individual communication preferences were fully assessed and met. One person told us they would have found it more accessible if information had been read through and explained to them. This meant the provider could not always be assured people received information in a way that met their individual needs and supported their understanding.

However, people and their relatives, where appropriate, were kept informed about matters relating to their care and support. Staff and managers communicated changes in a timely way and ensured people had the information they needed to make informed decisions. People told us they knew how to contact the service and felt listened to when discussing their care. Feedback about communication was positive, with people describing staff and managers as approachable and responsive. One person told us, "If there is any issue, they always phone and let me know."

The provider did not have robust systems in place to identify trends. Oversight of complaints could be strengthened. Although complaints were recorded and responded to, there were no formal audits in place to support the identification of trends or learning. This meant opportunities to use feedback to drive improvements across the service may not always have been maximised. As a result, the provider could not be assured that recurring concerns, themes, or areas of poor practice would be identified and addressed in a timely manner.

However, people had opportunities to share their views about the service and their care. The provider sought feedback through annual surveys and carried out reviews with people and, where appropriate, their family members. This helped to ensure people were involved in discussions about their care and support. People received a service user guide and contract when their care package started. These documents contained information about the complaints process, including details of how to escalate concerns to CQC and the Local Government and Social Care Ombudsman if required.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

People were able to access the care and support they needed when they needed it. The provider worked flexibly to meet people's individual circumstances and adjusted care arrangements when required. Staff supported people to access healthcare services and worked with other professionals to ensure people received appropriate care and treatment. People and their relatives told us the service was reliable and responsive.

Staff and leaders had not consistently identified where people may require information in different formats. This had the biggest impact on people most likely to experience inequality in experience or outcomes.

The provider had an equality and diversity policy in place and had considered reasonable adjustments for some people using the service. For example, one person was provided with information in large print to support their communication needs.

However, the provider had not consistently identified whether other people may benefit from information being provided in alternative formats or additional support to access and understand information. One person told us they would prefer support to complete surveys verbally rather than being asked to read and respond in writing. This indicated opportunities to further tailor engagement methods to meet individual needs and preferences.

In addition, there were no systems in place to monitor outcomes relating to equality, diversity and inclusion.

As a result, there was limited evidence available to demonstrate how people's experiences and outcomes were monitored in relation to equality, diversity and inclusion, or how any areas for improvement were identified.

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

People were not consistently supported to plan for future changes in their care needs. None of the people receiving care from the service had documented end-of-life care plans or recorded discussions about their wishes and preferences should their health deteriorate. In addition, there were no arrangements in place to identify and support people who may require end-of-life care in the future.

Most staff had not received training in end-of-life care. This meant they may not have the knowledge and skills required to support people to discuss, plan for and receive care in line with their wishes at the end of their lives.

The provider had not ensured systems were in place to support people to make informed decisions about their future care needs, including their preferences for end-of-life care. As a result, people could not be assured their wishes would be known and respected should their circumstances change.

However, the provider was responsive to people's changing needs and was able to reflect this in the support they received. Records showed care packages were adjusted when people's circumstances changed, and staff worked with healthcare professionals and family members to ensure people received appropriate support. Staff knew people well and were able to support them in the way they preferred. People were happy with the care they received.