Background to this inspection
Updated
6 September 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was carried out over two days by one inspector. After the on-site part of the inspection had finished, an Expert by Experience contacted people receiving this service and their relatives. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
This inspection was announced. We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
What we did before the inspection:
Before the inspection we reviewed the information we had received from the service including notifications about incidents in the service the registered manager is required to make. We assessed the information we require providers to send us at least once annually to give some key information about the service, what the service does well and improvements they plan to make. We also asked the local authority, safeguarding teams and other professionals, including Healthwatch who have contact with the service for any information they could share. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England. We did not receive any information of concern.
During the inspection we spoke with the registered manager, nominated individual and six members of staff, five people who received this service and five relatives. The nominated individual is responsible for supervising the management of the service on behalf of the provider. Throughout the report we refer to the nominated individual as the registered provider. We looked at two people's care plans in detail and a further care plan for specific information, as well as other records including those connected with recruitment and training, medicines administration and quality monitoring.
Updated
6 September 2019
About the service
Bluebird Care is a service which is registered to provide personal care to adults in their own home. At the time of our inspection there were 30 people using the service. The Care Quality Commission 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.
The registered manager was dual registered with this service and a ‘sister’ service which also provides care in people’s homes. They split their time between the two services.
People’s experience of using this service and what we found
Risk assessments for aspects of care such as falls and choking were not always in place, or not updated following an accident or incident. The absence of such records meant we could not see what steps were being taken to reduce risks to people.
There was a lack of detail in care records we looked at. Key information about people’s needs and preferences was not recorded, although staff were able to demonstrate a knowledge of people’s needs.
Some systems used to demonstrate oversight were not effective. The care plan audit did not contain specific actions or timescales. Medication audits were being carried out, but there were no prompts for the user to check different areas of medicines management.
People were receiving their medication as prescribed from staff who were trained and assessed as competent.
People felt safe and protected from harm whilst receiving this service. Staff were able to identify abuse and knew how to report this. Staff had adequate supplies of materials to ensure good infection control.
There were sufficient numbers of staff to meet people’s needs. Staff told us they had sufficient travel time between calls. Two people said their calls were not always on time, but the other people we spoke with had no such concerns. Safe recruitment procedures were being followed.
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; the policies and systems in the service supported this practice.
Staff support was evident through regular supervision and appraisal as well as training records. Staff were motivated and worked in a positive culture. The registered manager and registered provider were accessible to staff and encouraged strong team working. The registered provider was actively involved with various community groups.
Feedback from people and staff was received through satisfaction surveys which showed positively. People and relatives consistently told us staff provided safe, compassionate care. Staff supported people to access and attend healthcare services when they needed this support.
Complaints were recorded and responded to appropriately. Unannounced spot checks on staff were regularly taking place. Staff said they attended staff meetings where they were encouraged to participate.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (published 23 September 2016). Since this rating was awarded the registered provider of the service has changed. This service was registered with us on 16 July 2018 and this is the first inspection. We have used the previous rating to inform our planning and decisions about the rating at this inspection.
Why we inspected
This was a planned inspection.
Enforcement
We have identified breaches in relation to the management of risks to people and the lack of detail recorded in care plans.
Please see the action we have told the provider to take 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.