Bluebird Care (Stroud and Cirencester)

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 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 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.

The service had a robust approach to the continual improvement of care quality. They took a proactive approach to learning from events and to ensure that maintaining safety was everyone’s responsibility. Staff were confident that when they raised matters with the registered manager, they would be taken seriously to drive improvements. Lessons were learnt to continually identify and embed good practice. Accident, incidents and safety concerns had been reported appropriately by staff and fully investigated by the management team. Lessons learned were shared with staff to mitigate the risk of it happening again.

1 staff member told us, “We have forms to records this and we then investigate. We speak with carers and families. All the forms are on the electronic system. The mangers review this and we can amend as necessary. Investigations are very thorough and we have weekly debriefs where we can talk through things. We identify themes and learning as well.”

Another staff member said; “Everything is recorded in the care notes and an alert is raised with the office. Serious accidents will be recorded in the legally correct way. We do get debriefs with management where we can chat through what has happened and any lessons learnt for other people, they check that we are ok and if there is anything they can do to help. They will make sure families and professionals are aware.”

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.

Staff kept important information about people up to date and easily accessible to professionals who needed it. Where other agencies were involved, staff ensured the right information was shared with the right people to ensure continuity of care. 1 relative told us “The representative of bluebird care came into the hospital and asked the questions about what [person] would need. I was there as well.” Another said, “Firstly when we enquired, they took all the details and said they would set up a meeting with us and [person] so he could be involved. One of the care coordinators came out. They wrote down what was needed. [Person] was involved and answered any questions.”

A staff member told us, “We have supervisors that will have an informal chat and establish care needs and see if Bluebird care can support. Sometimes it goes straight into an assessment where all the information is gathered. We get this from the client themselves if they have capacity, or families or Power Of attorney if they do not have a capacity. All risks, medication and wishes are recorded in detail.” A second staff member said, “On the path system it is written on there about 'about me' and respect forms etc. Wishes and preference are in the care plan. We have Gold Standards Framework coding which tells the carers what stage a person is in their life and everyone is trained to know what these codes are and what to do if something changes.”

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.

Without exception, people told us they felt safe with the staff supporting them. Staff members had been trained in identifying abuse and ill treatment and knew what to do if they suspected wrongdoing.For example, where a carer had identified carer fatigue in the home, they worked with the family in a sensitive and caring manner, whilst raising concerns with the appropriate authority. The trust between staff and the family meant that the family were much more open to further support helping to maintain the family life the person wanted.

Staff completed safeguarding training and knew how to recognise and report safeguarding concerns. A staff member said, “We have body maps where we can document bruises. We look of for loss of appetite, not sleeping and not being themselves, building up the relationships with them. It is about getting to know the customer. You become close to them [it helps to identify if there are problems and where people may need more support].” Another staff member told us, “Yes, I have had safeguarding training, and I am always on the lookout for this in the role. I try to chat to them about their day and monitor for any signs of concern.”

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 were aware of people's individual safety risks and told us they had access to information on how to manage these risks. Care plans incorporated risk assessments, we saw risk assessments in place for specific health conditions and medicines. Staff told us “One person has limited mobility and she had hardwood flooring with rugs everywhere which were a slip hazard. The occupational therapist [OT] and our staff advised to remove the rugs but they had capacity and it was their own home. Following another fall recently someone from the office came to have a chat with her about the risk and they agreed to have the rugs removed for their safety now.” Another staff member said, “We speak to the customer about risks to their health and put alerts in the system and also call the office to explain the situation and get permission to do what is safe. I need to ensure that what I am about to do is agreed to. They can add to the paperwork as well.”

People and their relatives confirmed they felt staff understood their needs well. 1 relative told us, “Yes, they’re very safe with them. ‘No concerns. They’ve been very good. They’re most helpful on giving us advice on getting out of bed to use the commode and using the stair lift. They calm them down.” Another relative told us, “They always check that they’ve got their falls detector on their arm. They phone up when the detector is missing. They will help [person] to look for it. They would encourage them to use their walker.”

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 carried out checks on people’s home environments to identify any possible risks and how these could be reduced.People had individualised environmental risk assessments which detailed any hazards. This included how to safely support people in the event of an emergency, any pets that people had, and any increased vulnerabilities to be aware of or such as stairs in their home where people had mobility needs.

Staff were supported to keep safe when working alone. There were lone working risk assessments in place which included measures to help keep staff safe. The provider carried out regular checks at the office where the service was run from. Checks included electrical equipment, fire alarms and heating.

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.

Staff were supported with a thorough induction programme. All staff were trained in in the care certificate, meeting with a supervisor every week as part of their induction and probation periods. Staff received regular competency checks for administering medicine and moving and handling. The management team carried out spot checks in these areas of practice every 3 months.

Staff told us, “I feel very well supported, training is great. It is nice to see other carers at the training sessions.” Another staff member said, “I feel well trained and supported by Bluebird. I have worked in care a long time and I have never had such a good induction, 3-4 days of in-person paid training is absolutely fantastic. It was a really welcome refresher for me.”

The provider told us they had their own training academy where they use a mix of internal and external trainers to meet their service objectives. They provided regular face to face training in many areas of their induction and training programme. Staff told us this supported their learning and development.

The service was registered to support people living with a learning disability and/or autism. At the point of assessment, the provider had not completed part 2 of the required learning disabilities training. The provider told us this was booked to take place in the near future. This had not impacted on the quality of care people received.

Staff had been recruited safely following the required pre-employment checks. Following our feedback during the assessment the registered manager introduced enhanced checks for staff that provided live in care for people and may return home abroad during rest periods.

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.

The provider had infection prevention control [IPC] policies in place. There were effective infection, prevention and control measures to reduce the risk of infection for people being supported and for staff. Staff told us personal protective equipment [PPE] was readily available and knew for which tasks it was appropriate to wear this and how to safely dispose of it.

A staff member told us, “We are responsible for ensuring we have enough PPE to carry out our role. There is never a question of not being able to get more we just have to request from the office.” Another staff member told us, “We are responsible for ensuring we are stocked up. We can always go to the office and get more. We dispose of it in the customer's homes or take it with us according to the customer's wishes. Foot covers are optional, but aprons and gloves are always necessary.”

People and their relatives told us staff were always equipped with the correct PPE and followed people’s wishes. 1 person told us, “There’s a thing on the care plan that says PPE worn. That seems to be consistent.” Another person told us, “They put on blue gloves and white plastic apron always.”

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. Staff supported some people with medication or prescribed cream, sometimes there was a shared arrangement between staff and people and their relatives. Generally, this worked well. People and their relatives told us said that staff record medication that’s given and adhere to the instructions given.

Regular audits of medicines took place, and the provider took action where themes were identified, including additional checks and supervision. Staff told us spot checks took place on their practice regularly. 1 staff member said, “They do random spot checks 3 monthly and meds checks and moving and handling also gets checked 6 monthly. These will be at random so we never know when exactly they are coming.”

Staff demonstrated they knew what to do if a missed medication or continued refusal occurred. 1 staff member told us, “We are trained on administering the medication. We know what to do if there is a missed dose or a refusal. We will try a few times to convince the client to take their medication. If they continue to refuse we will leave an alert and contact the office.”

A relative told us staff were competent in administering medicines, they said, “They’ve been doing it for quite a long time now…They do it exactly as the doctor says…They make sure I’ve spoken to the doctor about any extra medication my [relative] needs – whether its compatible.” Another relative told us “They have a list of things they’re allowed to do. They do support with some medications. If it’s not on the list, they don’t do it.”