Bluebird Care (Eastbourne & Wealden)

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• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question inadequate. At this assessment the rating has changed to good.This meant the service was consistently managed and well-led. Leaders and the culture they created promoted high-quality, person-centred care.

This service scored 75 (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 shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

The registered manager had a clear vision about the future of the service that placed people at the centre of changes and any developments.They were committed to improving the service and had invested a great deal of time and energy to establish clear systems to underpin their planned improvements. Clear policies and procedures were in place and followed to support this vision.

Staff were enthusiastic about the changes implemented and the established culture since the registered managers’ appointment. They felt they had been included and involved in the planned changes. Comments included, “The culture is very good, the manager has put staff and customers at the forefront of everything. It has all been positive since new manager; they are so committed they have not taken a break till now. They are focussed on improvement and it’s great to be part of getting this service back to where it should be,” “The manager is on fire to get things right. Staff have felt the changes, accountability and communication has improved so much,” and “It’s so nice to see the changes, the manager has made a difference. We have more direction and clearer processes to follow.”

The provider had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

Following the last assessment, a new manager was appointed and registered with the CQC. They had provided a stable leadership and established an effective management strategy and team. This included an office manager and care co-ordinators and supervisors. The registered manager was visible, available and had a clear oversight and understanding of the service and how it was delivered. They led by example and demonstrated a caring and compassionate approach to people and staff. An inclusive working environment had been established where staff felt comfortable to approach them and other office staff directly. Regular staff supervision and on-site care reviews were undertaken. These were completed with a clear focus on the quality of care along with supporting staff training and welfare. Staff appreciated this approach and the support it provided.

All staff spoke highly of the registeredmanagerand wider management team. Comments included, “The manager and office staff are very supportive,” and “When we are on call the manager calls to make sure everything is OK.”

Relatives and people spoke highly of the management team. One person said, “I can go to the manager about anything and both managers have been out to see me.”

The provider fostered a positive culture where people felt they could speak up, and their voice would be heard.

Staff were encouraged to be in regular contact with any of the management team based in the office. They were able and supported to share their views and any concerns on a regular basis and felt they were valued and listened to. They told us, “They respect you they ask for your view, they ask what do you think we should do and ask for your opinion.” “You can ring the office at any time they are always there to respond to you.”

Visits in person to the office were also encouraged and if staff had to attend with their children due to caring responsibilities they were welcomed. A speak up policy and procedure was available to staff and discussed during induction training.

Staff meetings were held, and staff were encouraged and supported to attend and share their views. When issues were raised, these were responded to effectively. Staff told us, “Any situation can be discussed it’s nice to be supported and nice to have a work placement that understands what you need and listens.”

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

Staff were very happy working for the service and told us they were valued, treated with respect, and did not experience any discrimination or harassment. One staff member said, “I love my job and what I do, and I put my heart into it.” Staff were well motivated and proud of their work and the team they worked with.

The provider was committed to promoting equality and inclusion across the workforce. They showed an empathy towards staff and their individual backgrounds and how these impacted on their working and daily lives. They described adjustment made to support staff. This included adapting working schedules for people with caring responsibilities and providing different training for staff who learnt differently. One staff member said, “I like the one-to-one support we receive they explain things clearly and I learn better by observation and practical learning.” Another said, “Care plans are printed in the office, and they go through them with you. They understand the extra support that I need and that I may take longer to understand things.”

The provider had clear responsibilities, roles, systems of accountability and good governance. They used these to manage and deliver good quality, sustainable care, treatment and support. They acted on the best information about risk, performance and outcomes, and shared this securely with others when appropriate.

Since the last assessment the new registered manager had worked hard to clarify staff roles responsibilities and accountability. They had provided effective and stable leadership to oversee the required improvements identified at previous assessments and inspections.

Systems to monitor the quality of the service had been overhauled and embedded into practice. For example, care plans were reviewed and updated regularly with current information used to guide staff taking account of any risk. Staff working with any person came to the office to read care plans in the presence of a senior staff member, so any questions were discussed and clarified at this time. Care plans seen confirmed they reflected people’s individual needs and any risks associated with their care and support.

In addition, feedback from people was seen as vital and sought through regular contact and feedback forms. Regular supervision of staff in people’s homes ensured regular contact and discussion on the quality of the service.

The registered manager had ensured the organisations policies and procedures were being followed. Staff had received further training and confirmed that they had read and understood them. Staff had appreciated the clarification of systems and processes. One said, “Things have improved vastly, steps are clear it becomes second nature, and you know what is expected from you, when anything occurs.”

A number of quality monitoring and audit tools were used to provide a clear managerial overview of quality and to identify when improvements were required. For example, medicine audits and checks were completed. Any discrepancies were raised with the registered manager who investigated and took appropriate action to minimise any risk and possibility of re-occurrence. This had recently included contacting 111 NHS help line for advice when one person had taken their medicine at a time that was not recommended for safety. Also, the investigation of staff practice and performance. Any investigation and actions taken were documented.

The registered manager had ensured all required statutory notifications had been sent to the CQC as required. They had also completed monthly reports confirming ongoing governance to the CQC as required in accordance with enforcement action taken following the last assessment. There was regular contact between the provider and registered manager, this supported a cohesive approach which was documented within an improvement plan.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement.

The registered manager and management team were positive about their links with local health and social care teams. They were proactive when approaching other organisations. and had an open positive attitude to receiving support. Visiting professionals confirmed this attitude and how useful it was. One said, “They were observed to be thorough in the care and support planning ensuring that the adult, her family member and the live in carer were in agreement to use the equipment prescribed.”

They understood how and where they could access support and had used the local authority for advice and support to improve how the service was run and organised.

The provider focused on continuous learning, innovation and improvement across the organisation and local system. They encouraged creative ways of delivering equality of experience, outcome and quality of life for people. They actively contributed to safe, effective practice and research.

The registered manager and management team responded well when things were found to have gone wrong.Staff felt they were encouraged to be open and honest and supported to learn from mistakes. One told us, “I made a mistake, I was not made to feel bad they understood mistakes happen and looked to how things should be done. They are very clear on how things should be done so they retrained and revisited me at the home to go through things until I was comfortable and able to do things properly. They don’t make you feel less of yourself they make sure you follow procedures.”

Complaints and safeguarding issues were used as learning opportunities. An oversight of these was maintained by the registered manager and any learning was shared with staff. If the issue was urgent staff telephone messaging was used. This was then backed up through team meetings and during supervision meetings to make sure everyone had received the message.

To maintain continuous improvement, positive feedback was also shared with staff. Best practice advice from the local authority and feedback from the CQC was noted and shared with staff.