Bluebird Care North East Lincolnshire & West Lindsey

Bluebird Care North East Lincolnshire & West Lindsey is a domiciliary care agency providing support to people living in their own homes. At the time of the inspection, the service supported 55 people.

Not everyone who used the service received personal care. 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. At the time of the inspection, the service provided personal care to 41 people.

People’s experience of using this service and what we found

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

At the time of the inspection, the location did not support anyone whose primary need was a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

Right Support: Records did not assure us that staff supported people with their medicines safely. Medicine records were not always clear, accurate or complete. On 2 occasions the provider had not been able to attend a series of calls due to staffing issues. The provider had recruited and told us contingency plans were in place, they had sufficient staff to cover the care packages and were actively reviewing the care packages and staffing levels. Risks to people were generally assessed, monitored, and managed. People were supported to build relationships and take part in activities.

Right Care: Staff understood how to protect people from poor care and abuse. Staff had training on how to recognise and report abuse and they knew how to apply it. However, oversight and records in this area were not always robust and we have made a recommendation about this. People were asked how they liked to be supported with communication and what their preferred method of contact was. People’s support plans were person-centred. People were generally happy with the care workers and described them as ‘kind’ and ‘caring’.

Right Culture: Quality assurance systems were limited, and actions were not always implemented following audits. Staff morale was low, and staff did not always feel supported or listened to. The provider informed us one of the directors would spend a number of days at the location to be available to speak with staff, provide reassurances and address any concerns they may have. Some people were anxious about whether the service would be able to continue to meet their needs. We have made a recommendation about this. Staff involved people with their support plans and liaised appropriately with professionals.

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 outstanding (published 11 December 2018).

Why we inspected

We received concerns in relation to staffing, the quality of care, the ability of the service to respond to people’s needs and the governance of the service. As a result, we undertook a focused inspection to review the key questions of safe, responsive, and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has changed from outstanding to requires improvement based on the findings of this inspection.

We have found evidence that the provider needs to make improvements. You can see what action we have asked the provider to take at the end of this full report.

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

Enforcement and Recommendations

We have identified breaches in relation to staffing, record keeping and oversight at this inspection.

We have made a recommendation about the management, recording and oversight of safeguarding concerns. We have made a further recommendation about ensuring people's needs are met.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.

This was an ‘inspection using remote technology’. This means we did not visit the office location and instead used technology such as electronic file sharing to gather information, and video and phone calls to engage with people using the service as part of this performance review and assessment.

The service is located in Cleethorpes and supported people in North East Lincolnshire and West Lindsay. This service is a domiciliary care agency. It provides personal care to people living in their own houses in the community. It supports older people and people with mental health, physical disability or sensory impairment needs. At the time of the inspection 70 people were receiving personal care.

Not everyone using Bluebird care North East Lincolnshire and West Lindsay receives a regulated activity; The Care Quality Commission (CQC) only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

There is a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

At the last inspection the service was rated good. At this inspection, we found the service had improved to outstanding. The reasons why responsive and well-led domains have been rated outstanding are summarised below.

During this inspection, we found multiple examples to demonstrate the staff and management team were passionate about providing an innovative, excellent service.

People were protected from social isolation. Staff's extreme dedication enabled them to recognise the vital importance of providing meaningful activities and they worked tirelessly to meet people's holistic needs, hobbies and interests.

People received individualised end of life care and their lives were celebrated on a tree of remembrance.

The provider and registered manager placed a strong emphasis on continually improving the service. They were extremely passionate and dedicated about fund raising and supporting good causes that helped to make a difference to people’s lives. The provider, registered manager and staff promoted the spirit of generosity.

The provider and registered manager were wonderfully passionate about delivering an outstanding person-centred service. The providers ethos and values were promoted by the staff at the service which, benefitted the people using the service.

Quality assurance procedures were in place to assess the quality of the service provided and maintain people's welfare and safety.

The provider and registered manager valued the staff team immensely and supported them. They in turn valued the service and supported people extremely well.

Individualised end of life care was promoted at the service. Staff followed people’s recorded wishes at this time.

Staff understood their responsibilities to protect people from harm and abuse. Accidents and incidents were monitored. Robust recruitment and medicine management processes were in place. Infection control was maintained.

Staffing levels met people's needs and they remained under review by the management team. Staff undertook training and supervision to maintain and develop their skills.

People were supported by kind, caring and compassionate staff.

People’s nutritional needs were met.

People who lacked capacity to make their own decisions about their care and support had care provided by staff in their best interests following discussion with their relatives and relevant health care professionals. This helped to protect people's rights.

Staff gained advice and support from health care professionals to maintain people's wellbeing.

People's privacy and dignity was respected. People were addressed by their preferred name.

A complaints policy was in place and issues could be raised. However no complaints had been received. Compliments were received about the service provided.

J&Y Webber Services Limited trading as Bluebird Care North East Lincolnshire and West Lindsey is a domiciliary care agency which is located in Cleethorpes. The service provides personal care and support to people living in their own homes in North East Lincolnshire and West Lindsey. At their last inspection on 19 February 2014 we found they were compliant with the regulations that we inspected.

The service had a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People were protected from harm and abuse and staff understood how to report concerns about potential abuse to management, local authority and CQC.

Staff were informed about people’s preferences for their care. Support plans were in place and potential risks to people’s health and wellbeing were identified to help inform staff and keep people safe. Relevant health professionals were contacted for help and advice to maintain people’s wellbeing, where necessary. Environmental risks were assessed within people’s homes to help protect all parties.

People’s nutritional needs were understood by the staff. People were encouraged to choose what they would like to eat to aid their appetite.

Staff were training in medicine management and administration. This followed the local authority’s guidance and the provider’s policy and procedures. Training in all relevant areas was provided.

If people lacked capacity to make their own decisions then the principles of the Mental Capacity Act 2005 and codes of practice were followed to protect people’s rights.

Staffing levels were monitored by the registered provider to make sure there were enough skilled and experienced staff to meet people’s needs. Staff undertook training in a variety of subjects to maintain and develop their skills. Supervision and appraisals were provided for staff to identify any further training needs and allow discussion regarding their performance.

An ‘on call’ system was in place outside of office hours. This allowed people, their relatives or staff to gain help and advice, at any time.

Quality monitoring systems were in place in the form of audits and surveys. Senior staff undertook ‘spot check’ visits to observe how staff delivered care to people. People using the service were asked for their views and feedback was acted upon to maintain or improve the service.

A complaints policy was in place, people could raise any issues to be dealt with by the management team.

People who used the service understood the care and treatment choices available to them. They told us they were involved in making decisions about their care and treatment and found the service to flexible in meeting their needs.

People's needs were assessed and care and treatment was planned and delivered in line with their individual care plan. People told us they were satisfied with the care they received and said they received a consistent group of carers.

People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening. People told us that they felt safe, particulary as they were introduced to carers before they started to work with them.

People were cared for, or supported by, suitably qualified, skilled and experienced staff. People told us they liked the staff who cared for them.

The provider told us they were committed to providing a high quality service and that to ensure this they give a 100% money back guarantee if people were not satisfied. People who used the service told us they were satisfied with the service they received and felt their views were heard.