Bluebird Care (Welwyn & Hatfield)

Bluebird Care (Welwyn and Hatfield) provides personal care to people living in their own homes. 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 this inspection there were 30 people receiving support with their personal care needs.

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

On arrival at the offices of Bluebird Care we noted that the vertical window blinds were not secure and a desk was positioned along the window. This meant there was a risk of passers by having sight of personal and private information they did not have the authority to view. The registered manager took immediate action to move the desk further away from the window and to better secure the window blinds.

Feedback from care staff, discussion with the registered manager and review of staff rotas confirmed that there were enough staff deployed to meet people's needs in a safe and timely manner.

Newly recruited staff had received training to support them in their roles. However, the registered manager reported that some areas of training, such as moving and handling and safe administration of medication, were not appropriate to be delivered by remote means as these are more practical and hands on training sessions. In that instance newly recruited staff worked alongside more senior and trained staff to help ensure the safety of people using the service.

The registered manager had introduced a system whereby if any care worker felt unwell they were to immediately go home and take three days away from work, only returning after a negative COVID-19 test result received. All care workers we spoke with were aware of this and felt reassured because of it.

People were protected from the risk of acquiring infections and the service was clean. Personal protective equipment (PPE) was readily available to staff and all staff were following the latest government guidance.

Rating at last inspection

The last rating for this service was Good (published 03/05/2018)

Why we inspected

We undertook this targeted inspection to check on a specific concern we had about staffing levels, training for newly recruited staff, sickness management and some aspects of document security. The overall rating for the service has not changed following this targeted inspection and remains Good.

CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Bluebird Care (Welwyn and Hatfield) on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

The service had 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 2008 and associated Regulations about how the service is run.

The inspection of the office location took place on 15 June and 06 July 2017. We spoke with people and their relatives by telephone on 19 June and 04, 10 July 2017 to ask them for their feedback about the service people received.

At our last inspection of the service on 17 and 20 November 2015 we found there were not effective systems in place to monitor missed or late care calls and did not have sufficient systems in place to review, analyse and plan monitor the quality of care people received. At this inspection we found the provider had undertaken significant improvements to the quality of care people received.

People told us the service they received was responsive to their needs and that staff went the extra mile to encourage them with interests and hobbies. People at risk of isolation were supported by staff with visits to café’s, shopping etc. to maintain their community inclusion. Social activities were organised where staff and people were able to get together. People told us they felt able to raise concerns and complaints with the management team, and felt confident their concerns would be addressed.

Staff and the registered manager recognised people at risk of social isolation and they encouraged and organised the right support for people to access the community.

People were encouraged to retain or regain their independence by staff that recognised how important independence meant for people who often were living on their own. Staff told us they were well trained and mentored by the registered manager who supported them to understand how to provide care and support for people in a dignified way.

The management and staff team demonstrated a very strong and visible person centred culture and were committed to providing a service that placed people at the heart of everything they did. Staff employed to key caring positions had been with Bluebird Care (Welwyn and Hatfield) since they registered in 2012 so were familiar with both the organisational approach and people’s needs.

People told us staff were kind which in turn helped them to feel safe. People and staff told us there were sufficient staff to provide care to people and we found no missed calls had occurred for this year. Risks to people’s safety and wellbeing were positively managed with appropriate equipment in place to support people’s health needs. People were supported by staff that had undergone a robust recruitment process to ensure they were suitable to work with vulnerable people. People’s medicines were managed safely and people received their medicine as the prescriber intended.

People were supported by staff who were well trained and supported by effective leadership to develop their skills and provide effective care. Care staff received regular supervision of their conduct and practise. People's consent was sought and the service worked in line with the principals of the MCA where people lacked the capacity to make their own decisions. People were happy with the support given to them to maintain their weight and hydration and staff took appropriate actions to support their welfare. People were supported by a range of health professionals who were positive about working with staff from Bluebird Care Welwyn and Hatfield.

People and relatives told us that the service was caring, and that staff and management would go beyond their job role to support them. Staff demonstrated a caring attitude when talking about people and were able to describe in detail to us how they assisted people in an individual manner. People told us they felt listened to and that when they raised a worry or concern, staff responded positively and helped remove their anxiety by acting decisively. People told us that the attitude and care provided by the service had a positive impact of their life.

People told us they made their own decisions which were respected by staff who then supported them to retain as much of their independence as was possible. People told us a key part of retaining their independence was because they were involved in planning and regularly reviewing the support they needed.

The provider and registered manager carried out regular audits in areas such as medicines, care planning and health and safety. Visual spot checks were carried out regularly where staff competency was assessed and feedback was obtained from the person to complement this. The results of these audits formed the basis of both service improvement and development for staff.

The registered manager was a member of a reputable independent care provider association which conducted an independent survey involving people, relatives, staff and other stakeholders in giving feedback about the service they received. People felt the service was well managed and that the management team were visible. Staff felt confident in approaching the registered manager and felt they were supportive of them.

There was a manager in post who had registered with the Care Quality Commission (CQC). A registered manager is a person who has registered with the CQC 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 felt safe, happy and well looked after. There were not effective systems in place to monitor missed or late care calls. Staff had received training in how to safeguard people from abuse and knew how to report concerns, both internally and externally. Safe and effective recruitment practices were followed to ensure that all staff were suitably qualified and experienced to carry out their duties safely. Arrangements were in place to ensure there were suitable staff available to meet people’s individual needs.

Relatives were positive about the skills, experience and abilities of staff that provided care at their home. Staff had received training and refresher updates relevant to their roles and had regular supervision meetings to discuss and review their development and performance. Staff sought consent when they needed to, and were knowledgeable about how to obtain consent from people who lacked capacity. Where people lacked capacity, the correct consents had not always been seen and verified to ensure decisions were made in people’s best interest.

People were supported to maintain good health and had access to health and social care professionals when necessary. They were provided with support to maintain a healthy balanced diet that met their individual needs.

Staff had developed positive and caring relationships with the people they cared for and knew them very well. People were involved in the planning, delivery and reviews of the care and support provided. Care was provided in a way that promoted people’s dignity and respected their privacy. People received personalised care and support that met their needs and took account of their preferences.

People and staff told us they thought the manager and provider were approachable, and listened to their views about the running of the service. The provider had taken steps to monitor the quality of services provided, but did not have sufficient systems in place to review, analyse and plan for service improvements.

The summary is based on what we found at the inspection by looking at records and what people told us about their experiences of the service. We spoke with three people using the service, three relatives, six care workers, including senior carers and two management representatives.

The inspection was undertaken by one inspector over one day and included visiting people receiving support in their own homes, contacting people by telephone and looking at records and systems at the provider's main office.

Is the service safe?

People told us they felt safe. Safeguarding vulnerable adults from abuse procedures were robust and staff understood how to safeguard people they cared for. Systems were in place to make sure that managers and staff learnt from events such as accidents, incidents, complaints and whistleblowing investigations. This reduced the risks to people and helped the service to continually improve.

The service had policies and procedures in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). DoLS are put into place to ensure that people's human rights are protected should their liberty be restricted in any way. Staff had been trained to understand when an application should be made and knew how to submit one.

Staff knew about risk management plans and showed us examples where they had followed them. People were not put at unnecessary risk but also had access to choice and remained in control of decisions about their care and lives.

People who used the service told us they were treated with dignity and respect. Comments included 'They are so helpful and kind' and 'They are brilliant.'

The service had robust recruitment processes in place and undertook full employment checks when recruiting new care workers. This meant the service had taken all reasonable steps to ensure people were protected from risk of harm and suitable staff were employed appropriately to work with vulnerable people.

Is the service effective?

This service was found to be effective because we saw people were supported in a way that suited their personal needs and maintained their quality of life. People and their relatives told us they had been included in all decisions relating to the care they had received. It was clear from our observations and from speaking with people and care workers they had a good understanding of people's care and support needs and they knew them well.

People's health and care needs were assessed and their care plans and assessments were reviewed monthly. This showed people were having care delivered effectively in accordance with their assessed needs.

Is the service caring?

We found the service was caring. People were supported by care workers who were understanding and sensitive to their needs. We were told by people and their relatives care workers met their care needs in a way that was appropriate for them.

All of the people we spoke with were very complimentary about the care provided by the service. People we spoke with gave examples of care workers going out of their way to meet their needs. For example one person told us, 'My carers accompany me to all my medical appointments and stay with me even when we are delayed.'

Is the service responsive?

We found the service was responsive because the service had appropriate systems in place for gathering, recording and evaluating information about the quality and safety of the overall service. Systems were in place to make sure the provider learnt from events such as accidents and incidents and risks were minimised.

The service took account of complaints and comments to improve the service. We saw a complaints procedure in the handbook given to people when they started using the service. The complaints procedure guided people who to contact if they wanted to make a complaint. People we spoke with told us they had not had any reason to make a complaint and they felt the service would be responsive if they raised a concern. People were assured the service acted upon complaints, which were investigated and action was taken as necessary.

We found people's personal care records were accurate and fit for purpose.

Is the service well-led?

We found the service was well led. Care workers and people who used the service told us they found the new manager very approachable. Comments included, "Our manager is very approachable" and 'I am very well supported, our manager is great to work for.'

Systems were in place to regularly assess and monitor the quality of the service provided.