Archived: Bluebird Care Selby & part East Riding

Bluebird Care Selby & part East Riding is a domiciliary care agency providing personal care to people living in their own homes. The service was supporting 20 people at the time of our inspection.

Not everyone who used the service received personal care. The Care Quality Commission (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 were at increased risk of harm, because robust systems were not in place to ensure the safe management of medicines. There were gaps in staff’s training and clear records were not always in place to support management oversight and to ensure the quality and safety of the service. Whilst there had been some improvements, issues and concerns identified at our last inspection had not been fully addressed.

Despite these concerns, people felt safe with the support staff provided and gave generally positive feedback about the staff and the person-centred care they delivered. Care plans contained more detailed information about people’s needs and to guide staff on how those needs should be met. Staff were safely recruited.

People gave mixed feedback about the inconsistency of call times and we made a recommendation about the management of the rotas.

The provider had an end of life policy and most staff had been trained on how best to support people with this. We made a recommendation about recording in relation to people’s end of life wishes.

Staff wore personal protective equipment to manage and minimise risks associated with COVID-19.

People gave positive feedback about the service. They felt comfortable speaking with management if there were any issues or concerns and praised the communication.

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

Rating at last inspection and update

The last rating for this service was Requires Improvement (published 26 March 2020) and there were breaches of regulation relating to the safe management of medicines and the provider’s oversight and governance arrangements. At this inspection, not enough improvements had been made and the service remains rated Requires Improvement. This service has been rated Requires Improvement for the last three consecutive inspections.

Why we inspected

We carried out an announced comprehensive inspection of this service in January and February 2020. Breaches of legal requirements were found.

We undertook this focused inspection to check whether improvements had been made and the provider was meeting the legal requirements. This report only covers our findings in relation to the Key Questions Safe, Responsive and Well-Led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection.

The overall rating for the service remains Requires Improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Bluebird Care Selby & part East Riding on our website at www.cqc.org.uk.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

Bluebird Care Selby & part East Riding is a domiciliary care service that provides care and support to older people and young disabled adults living in their own homes. There were 24 people being supported with personal care at the time of our inspection.

Not everyone who used the service received personal care. The Care Quality Commission (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:

There continued to be some inconsistency in the service provided. Quality assurance checks had not been effective in identifying and addressing all issues we found. New electronic systems had been introduced since our last inspection, and there had been improvements in some aspects of care planning. However, not enough progress had been made to meet all legal requirements. This included requirements in relation to medicines management and record keeping. There were gaps in care and medication records, and risks were not always comprehensively assessed or mitigated.

We have made recommendations in relation to recruitment practices and the management of complaints.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests.

People were supported with their health and nutritional needs and staff worked alongside other health professional to meet people’s needs. Care staff were kind and respected people’s privacy and dignity.

Some people did not feel involved in decisions about changes to their care package and the care staff who visited them. Office staff needed to communicate better with care staff and people using the service; action was being taken to address this.

Staff received induction, training and support to enable them to carry out their role. However, records in relation to training were inconsistent, and in some cases inaccurate. The provider advised us of action they planned to take in response to our inspection feedback.

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

Rating at last inspection and update:

The last rating for this service was requires improvement (published 7 March 2019) and there were two breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found not enough improvement had been made and the provider was still in breach of regulations.

Why we inspected:

This was a planned inspection based on the previous rating.

Enforcement:

We have identified breaches at this inspection in relation to risk and medication management, and record keeping and governance. Please see the action we have told the provider to take at the end of this report.

Follow up:

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

People’s experience of using this service: The service had been inconsistent in the quality of the care and support they provided.

Medicines were not always managed safely and the management team had raised safeguarding alerts about these with the local authority.

Care plans and risk assessments lacked detail and were not robust. Quality of record keeping varied and some care records did not have the right information in them to manage people’s care safely.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. However, the recording of this in the care plans was inconsistent and needed to be better. We have made a recommendation around this.

Accidents and incidents were being recorded and action was taken to reduce risk when issues occurred. However, the management team were not analysing the information to look for trends and patterns.

People told us they felt safe and well cared for and staff afforded them respect and dignity. Staff had positive links with healthcare professionals which promoted people’s wellbeing.

People said they received care in a timely way from a regular team of care workers and they had good communication with the office. Although they were not given information about which care staff would be making their visits, they were satisfied with the support they received.

Staff had received appropriate induction, training and support to enable them to carry out their role.

The provider and manager worked with the staff team and led by example to ensure people received a good service. People and staff told us the management team were approachable and listened to them when they had any concerns. Feedback from people and relatives was being used to make continuous improvements to the service.

Recent changes to the management team had been positive and resulted in better and consistent care being provided The provider demonstrated their motivation to improve by working with us during the inspection.

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

Rating at last inspection: There is no previous rating for this service. The service registered with CQC in February 2018. This is the first inspection of the service since it registered.

Why we inspected: This was a planned inspection based on it being a ‘new’ service.

We identified two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 around safe care and treatment and good governance. Details of action we have asked the provider to take can be found at the end of this report.

Follow up: We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.