Bluebird Care (Wiltshire North)

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence. At our last assessment we rated this key question good. At this assessment the rating has changed to outstanding. This meant people’s outcomes were consistently better than expected compared to similar services. People’s feedback described it as exceptional and distinctive.

This service scored 88 (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 always made sure people’s care and treatment was effective by thoroughly assessing and reviewing their health, care, wellbeing and communication needs with them.

Leaders demonstrated an exceptional commitment to ensuring people’s needs were comprehensively assessed, understood and responded to in a timely and proactive way. Assessment processes were dynamic, holistic and consistently informed by specialist clinical insight, with directors taking an active and visible role in strengthening diagnostic pathways to improve outcomes for people.

Directors worked in partnership with health professionals to ensure early identification and accurate diagnosis of complex health conditions. They established robust systems to escalate potential concerns and actively led on reviewing trends in people’s health presentations. This resulted in a proactive approach to health assessment, where emerging needs were recognised quickly and responded to effectively, reducing the risk of deterioration and avoidable harm.

For example, directors identified a pattern of undiagnosed health conditions affecting people’s wellbeing and quality of life. In response, they led a service-wide initiative to strengthen links with primary and specialist healthcare services. This included introducing structured health review checkpoints and advocating for timely referrals. This meant people received earlier diagnoses of conditions such as atrial fibrillation enabling care plans to be adapted promptly. This led to measurable improvements in people’s independence, comfort and overall health outcomes.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

Staff had completed specialist training for people with a learning disability and autistic people. Staff were positive about their training and felt it enabled them to better meet people’s needs. The service had information about people’s specific health conditions from GPs and used these when planning people’s support. This helped to ensure care was planned in line with current best practice guidance.

Leaders told us they had access to good practice information through networking with other providers and from effective oversight of the service.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff described effective communication within the team. Records of team meetings demonstrated a collaborative and reflective approach, where staff reviewed how care was delivered and identified areas for improvement. Comments from staff included, “[Manager] is caring, understands, listens. They are the best Bluebird Care Wiltshire North has had.”

Records viewed showed staff had worked with dieticians to support people at risk of health conditions to maintain healthier lifestyles. They also showed work which had been completed with the dementia nurse to improve staff knowledge and understanding in this area. This had a positive impact on the care provided and enabled staff to better support relatives and people with information and guidance.

The provider always supported people to manage their health and wellbeing to fully maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

There was a strong culture of promoting healthier lives across the service. The provider encouraged participation in exercise, community groups, social activities and opportunities that supported both physical and mental wellbeing. Staff supported people with building mealtime menus to promote healthy eating while respecting people's preferences and choices, and staff provided practical support to help people understand the benefits of healthier options. For example, one person had diabetes. We saw evidence staff supported them with healthy meal preparation which respected people’s choice while contributing to maintaining low sugar intake levels.

The provider demonstrated exceptional partnership working with healthcare professionals. Staff routinely liaised with GPs, specialist nurses, dentists, opticians, podiatrists and other professionals to ensure people received timely interventions and ongoing monitoring. Referrals were made promptly when concerns were identified, and recommendations were acted upon without delay. This proactive approach helped prevent avoidable deterioration, reduced the need for emergency healthcare interventions and ensured people received the right support at the right time. Directors took a proactive approach and supported people with health checks which ensured people felt safe and looked after. One person commented, “Without Bluebird Care Wiltshire North’s early diagnosis, I feel like my needs would have gone untreated.”

The impact of the provider's approach was consistently positive. People experienced improved health outcomes, increased independence and enhanced wellbeing. Risks associated with deterioration were identified early and effectively managed, healthcare needs were met promptly, and people were supported to live healthier, more fulfilling lives. One person told us, “[Provider] is great at supporting me with healthier food choices.” The provider’s commitment to prevention, empowerment and collaborative working resulted in sustained improvements to people's health and reduced the likelihood of increases in care packages and deterioration of health.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Leaders had developed a strong culture of continuous learning and improvement, with a focus on achieving meaningful outcomes for people. Directors maintained direct oversight of outcomes through a range of quality assurance systems, including regular audits, outcome-tracking tools, people's reviews, feedback analysis and governance meetings. They had a direct link to people and took pride in providing an individualised service for people. Information was used proactively to identify trends, evaluate the effectiveness of support and drive service improvements that enhanced people's quality of life.

Directors demonstrated a detailed understanding of the healthcare outcomes being achieved for people and routinely challenged themselves and staff to consider how support could be further improved. Leaders focused on whether people were living the lives they wanted and achieving goals that were important to them. Outcome data was reviewed at both an individual and organisational level, enabling directors to identify opportunities for innovation, share good practice and address barriers to progress.

For example, directors reviewed outcome-monitoring information relating to people's community participation and independence goals. Where analysis showed some people were not accessing the community as they wanted to, leaders worked with staff, people and relatives to explore the reasons why. This resulted in the provider creating additional opportunities for people to access community groups and activities. Subsequent reviews showed people were developing greater independence, expanding their social networks and reporting improved wellbeing. People told us, “Since going to the events organised by Bluebird Care Wiltshire North, I have made friends with others” and “I didn’t realise how important getting out and about was until I started doing it.”

Directors also regularly evaluated health-related outcomes. In one instance, governance reviews identified inconsistent progress for people with long-term health conditions. Leaders introduced enhanced monitoring arrangements, strengthened links with healthcare professionals and provided a medical based service free of charge. Follow-up reviews demonstrated improved engagement with health services, better management of health conditions and a reduction in avoidable health deterioration, contributing to improved quality of life for people.

Further, the Provider demonstrated a proactive and highly individualised approach to improving outcomes for autistic people. Staff took time to understand people's specific interests and used these as a foundation for promoting independence, confidence and community inclusion. For example, one autistic person was supported to pursue their passion for cricket through attendance at local clubs and events. Staff worked with the person to overcome barriers to participation, resulting in increased social engagement, improved confidence and the development of meaningful community relationships.

Another autistic person was supported to achieve their goal of horse riding. The provider coordinated support with external organisations and tailored arrangements around the person's communication and sensory needs, enabling them to access an activity they valued. As a result, the person experienced increased confidence, improved emotional wellbeing and greater opportunities to make choices about how they spent their time.

Leaders monitored these outcomes through regular reviews and could clearly demonstrate how personalised support helped autistic people achieve goals, reduce social isolation and live the lives they chose. This resulted in sustained improvements in wellbeing, independence and quality of life. Relatives told us: “Since [person] has received care from Bluebird, they have been great at going out and developing outcomes based on what [person] wants to achieve”.

The provider carefully explained to people what their rights around consent were, made sure they fully understood them and respected these when delivering person-centred care and treatment.

People's capacity to make specific decisions was clearly documented within their care plans, with assessments demonstrating consideration of the principles of the Mental Capacity Act (MCA) 2005. Staff were knowledgeable about consent and understood that people with capacity had the right to make their own decisions, including decisions that others may view as unwise or potentially risky. Comments included, “[Person] has capacity, so their care plan is designed to be as interactive as possible.” Records and discussions with staff showed they worked to support people to understand the risks and consequences of their choices, while ensuring their rights and independence were upheld.

This approach had a positive impact on people's wellbeing, as they were enabled to maintain control over their lives and make choices that were important to them. People were protected from unnecessary restrictions, and staff promoted a culture that respected individual autonomy while providing appropriate support to minimise risks and keep people as safe as possible.

Staff spoke to us about what consent meant and gave examples of how they were thoughtful in their support of people. Records indicated staff asked for consent and checked to ensure people were happy with the care provided.