Bluebird Care (Wiltshire North)

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 78 (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 and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Incidents, accidents and near misses were recorded in detail, including the circumstances leading up to the event and the factors that may have contributed to it. For example, when a person took more medication than prescribed, records clearly documented the sequence of events and the actions taken in response. The provider demonstrated learning from incidents and adapted their approach to support positive outcomes and reduce the likelihood of similar events happening again. For example, following an incident, leaders wrote to a person outlining why their behaviour was risky. They did this as if they had spoken to the person directly, this would have caused anxiety. This enabled them to process the information at their own pace, reflect on what had happened and better understand how to avoid a recurrence. As a result, the provider demonstrated learning from incidents and adapted their approach to support positive outcomes and reduce the likelihood of similar events happening again.

Incidents were reviewed by the management team to ensure actions were taken to reduce the risk of reoccurrence. Staff told us learning from incidents was shared with them and gave them clear information on any changes to the way they needed to support people. Comments from staff included, “We use team meetings as learning points for us all”.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

Relatives told us the service worked effectively with the healthcare professionals involved in people's care. People's health conditions were clearly documented, and staff supported them to access a range of healthcare services, including GPs and specialist professionals, when required. For example, the provider's directors, who were also qualified GPs, identified symptoms and concerns that had previously gone unrecognised, leading to people receiving appropriate medical assessment and diagnosis. This meant people experienced timely pathway access to healthcare, received the treatment and support they needed, and were less likely to experience deterioration in their health due to unmet needs.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

Relatives said they felt people were safe and knew who they could talk to if they had any concerns.

Staff demonstrated a good understanding of their safeguarding responsibilities and said they completed regular safeguarding training. Staff were confident managers would take appropriate action if they reported safeguarding concerns. Comments included, “I feel confident the manager would know what to do” and “[Manager] understands the needs of the clients.” Staff were also aware how to raise these concerns outside of the organisation if they needed to. Safeguarding was discussed in staff meetings and individual supervision meetings. The manager told us this helped to keep safeguarding on the agenda and gave staff the opportunity to raise any concerns if they had any.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Staff demonstrated a good understanding of the risks people faced and how to support them safely. Staff told us, and we saw in the records, that risk management plans were regularly reviewed and updated as people’s needs changed to ensure information was accurate. Leaders told us how plans were followed to ensure people were able to take positive risks.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

The provider completed various health and safety checks to make sure people’s homes, and any equipment was safe. Equipment was serviced regularly and staff completed regular checks of the environment to identify any shortfalls.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

Pre-employment checks had been completed for staff before starting work. New staff received an induction, including shadowing experienced staff. Staff told us they received regular training, supervision and an annual appraisal. People told us staff were well trained. Staff told us the induction they received when starting work for the provider was one of the most in-depth inductions they had received. Managers confirmed this by sharing their induction template with us. This ensured a competent and safe workforce when supporting people.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

Staff had appropriate access to personal protective equipment and had received training on infection prevention and control good practice. Staff told us they had all the equipment they needed and received suitable training.

The management team completed regular infection prevention and control audits, which included an assessment of how staff put their training into practice.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff involved people in planning, including when changes happened.

Medicines were stored safely in people’s homes. Staff received training in medicines management and records demonstrated there were regular checks for their competence in administering medicines safely.

The provider was signed up to STOMP (Stopping over medication of people with a learning disability and autistic people). This is a national initiative to stop over prescribing of psychotropic medicines.

Medicines errors were recorded and escalated in line with the provider’s policies and procedures. Each person had a medicines risk assessment which detailed guidance for how to support people and contained information of any risks and allergies. This meant people’s documentation clearly defined what level of support they required with their medicines. This was in line with the National Institute for Care Excellence (NICE) recommendations of best practice.

People had body maps for emollient application and information about the risks of flammable based emollients. Medicine Administration Records (MAR) showed all prescribed medicines, including topical creams, were administered as required. This meant people received the correct medicines at the right time, promoting safe care delivery.