Bluebird Care (Eastbourne & Wealden)

Bluebird Care (Eastbourne and Wealden) is a domiciliary care agency and provides personal care to people living in their own homes. Not everyone using Bluebird Care (Eastbourne and Wealden) received personal care. People that were being supported had a range of needs such as Dementia, physical disabilities and older people.

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 was supporting 25 people.

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

Safeguarding concerns had not been reported to the local authority to help protect people from harm or abuse. Staff knew how to look out for signs of abuse however, training had not been completed in some time and not all staff knew where to report concerns.

Risks to people were not well managed. Risk assessments were out of date and assessment tools were not appropriately used to help assess and monitor risk.

Medicines were not managed safely. Gaps were found in people’s electronic medicine administration records. Where medicines were discontinued by the GP records were not updated. People’s care plans were not kept up to date when changes had been made to their care calls. This left people at risk of not receiving their medicines as prescribed.

Staff were recruited safely. However, a high level of agency were being used in particular to cover live in care calls. We received mixed feedback regarding the agency workers. We were also concerned about how agency staff were monitored and where incidents had occurred, lessons had not been learnt. Staff had not received up to date training and not all supervisions had been carried out.

People had their needs assessed before receiving care. However, care plans were not regularly reviewed and kept up to date. People who were receiving care and support from district nurses did not have wound care plans in place. Guidance for staff was not clear as to what support people required. Positive behaviour support plans were not in place for people where incidents had occurred. Staff were not given the tools to help support people in a positive way.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

Quality assurance processes were not effective in identifying concerns found on the inspection. Audits had not always been carried out and where they had, issues were not picked up and addressed. Under the previous provider, there had been a lack of provider oversight at the service and the registered manager had not received much support. The provider had recently changed and had already been more visible in the service.

At the time of the inspection, the location did not care or support for anyone with 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.

People told us staff were kind and caring. People gave us examples of how staff promoted their independence and respected their privacy and dignity.

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 17 May 2018).

Why we inspected

The inspection was prompted in part due to information we had received about the service.

Enforcement and Recommendations

We have identified breaches in relation to person-centred care, consent, safe care and treatment, safeguarding and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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.

Bluebird Care (Eastbourne and Wealden) is a domiciliary care agency and provides personal care to people living in their own homes. It provides a service to older adults, people who lived with dementia, people who lived with learning disabilities and younger adults with physical disabilities. At the time of the inspection, the service was supporting 40 people in Eastbourne and Wealden. Not everyone using Bluebird Care (Eastbourne and Wealden) receives regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating and drinking.

At the last inspection in June 2015, the key question of effective required improvement as staff needed to gain more confidence and understanding of the Mental Capacity Act 2005 (MCA). The key questions for safe, caring, responsive and well led were rated good and there was an overall rating of good. Staff had received further training in MCA and were now fully confident in how to gain consent and the key question effective that required improvement is now rated good.

There was a registered manager in post. 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 and associated Regulations about how the service is run.

People told us they were very satisfied with the care and support that Bluebird Care (Eastbourne and Wealden) provided.

People who used the service had the capacity to make decisions about what they did and the choices they made. People were supported to have choice and control of their lives and staff enabled people in the least restrictive way possible: the policies and systems supported this practice.

There were systems in place to protect people from harm, including how medicines were managed. Staff had been trained in how to recognise and respond to abuse and understood their responsibility to report any concerns to the management team. Safe recruitment processes were followed and appropriate checks had been undertaken, which made sure only suitable staff were employed to care for people.

Risks to people's safety were assessed and managed to keep them safe. They were supported by sufficient numbers of a well-trained staff group who arrived on time and supported them in the time allocated in their care package. People who received medicines were supported in a safe way as staff had had the necessary training to administer medicines safely. They were protected from the risks of infection through good working practices by staff.

People's care was delivered in line with legislation and evidenced based practice. People who used the service had the capacity to make decisions about what they did and the choices they made. People were supported to have choice and control of their lives and staff supported people in the least restrictive way possible: the policies and systems supported this practice. Staff received regular training in all aspects of their role and received regular supervision from the registered manager. Where people were supported with their nutritional needs, staff showed a good awareness of their dietary needs and where to get further support should this be required. Staff worked with people, their relatives and health professionals to manage people's health needs, making appropriate referrals for individuals when necessary.

People who used the service felt they were treated with kindness and said their privacy and dignity was respected. Staff had an understanding of legislation designed to protect people’s rights and were clear that people had the right to make their own choices.

Care plans provided comprehensive information about how people wished to receive care and support. This helped ensure people received personalised care in a way that met their individual needs.

Staff felt supported by the registered manager and could visit the office to discuss any concerns. There were systems in place to monitor the quality and safety of the service provided. Accidents and incidents were monitored, analysed and remedial actions identified to reduce the risk of reoccurrence.