Archived: Bluebird Care Alton & Bordon

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 2008 and associated Regulations about how the service is run.

Bluebird Care UK is a national franchise. A franchise is when a franchisee (the provider) has bought the rights to sell a specific company’s products in a particular area using the company’s name. Throughout the report we have referred to Bluebird Care (Alton & Alresford) as Bluebird Care.

The registered provider, Belrose Limited, operates three registered locations: Winchester, Andover and Alton & Alresford. It is registered to provide personal care services to people in their own homes. At the time of this inspection Bluebird Care supported 105 people, however a personal care service was provided to 72 people. Of these, seven received live in care services.

Why have we rated this service as Outstanding?

People received an exceptionally safe service. The service had robust contingency plans in place to ensure when events occurred these did not impact upon service delivery. During the snowy weather in March 2018 the plans they put in place resulted in no care calls being missed. This was because of the total commitment of the care and management team. The systems in place for the management of medicines were exceptional. Records of administration were made electronically and care assistants could not log out of a care call until this had been completed. This meant those people who needed support with their medicines were able to take their tablets as prescribed. Any changes to people’s medicines could be updated immediately in the care records and acted upon. Staff completed safeguarding adults and moving and handling training to ensure they maintained people’s safety. Risk assessments were completed as part of the care planning process. Where risks were identified there were plans in place to reduce or eliminate the risk. Safe staff recruitment procedures were followed to ensure people were not looked after by unsuitable care and support workers. There were sufficient numbers of care assistants to meet people’s care and support needs safely.

The service was exceptionally effective. Before people received a service, a comprehensive assessment of their care and support needs was carried out. For people who had email access they were sent a video message where the customer care manager introduced themselves. The assessments were person centred and involved finding out about things that were important to the person. The staff team was well trained and the provider had a career pathway in place for all staff. Trainee care assistants completed the induction training and then had a three month probationary period during which they completed Care Certificate training. Ongoing training was arranged for all staff and included specialist training where people had specific care needs.

People were provided with assistance to eat and drink well where this had been identified as a care need. The care assistants and management team worked with other health and social care professionals to ensure people’s health and wellbeing was maintained.

People were supported to be as independent as possible. Their mental capacity was assessed as part of the whole assessment process. People were involved in making decisions and encouraged to make their own choices about their care and support. The service was meeting the requirements of the Mental Capacity Act 2005.

The service was exceptionally caring. People were provided with assistance from either one, two or three care assistants to ensure continuity of care. The care assistants knew the importance of developing good working relationships with the people they looked after and ensured they provided person centred care based on their specific needs. The staff ensured people were always treated with kindness and were listened to. The feedback we received from people being supported, their relatives and care assistants was overwhelmingly positive.

The service was exceptionally responsive. The care assistants were able to provide a particularly responsive service based on people’s needs but flexible enough to adapt to changes. The care planning and service delivery arrangements were reviewed regularly and any amendments made as required. People were provided with information about the service and details about how to raise any concerns they may have. The provider used any feedback about the service, both positive and negative, to make improvements. Feedback from people was gathered in care plan reviews and in regular surveys and their views and opinions were valued and acted upon. It was evident the service was fully focused on meeting people’s needs and they were completely satisfied.

Over the winter months the service had worked in partnership with the local GP surgeries and the NHS to provide a Bluebird Care JET (joint emergency team) rapid response service, to reduce hospital admissions and benefit the local community. A team of care assistants had been upskilled to conduct assessments to enable care and support to start within a few hours of the initial referral. This had prevented numerous admissions into hospital and people had been supported and cared for in their own homes.

The service was exceptionally well led. The office structure consisted of the registered manager, two customer care managers, a care coordinator and a support coordinator. Additional members of the management team included the owners and directors (providers), the operations director, the live in care service manager, the culture and training manager the accountant and recruitment assistant. The provider was actively involved in the service, visited on at least a weekly basis and maintained a good oversight of how things were going.

The provider had exceptional systems in place to monitor the quality and safety of the service. Feedback was obtained from people using the service, relatives and the staff team. Any improvements that would benefit the people being supported and the staff team were driven forward by the enthusiasm of the provider, the management team and the care assistants.

There was exceptional leadership and management in place with a strong focus on ensuring the service was well led and run to a high standard.

Bluebird Care UK is a national franchise. A franchise is when a franchisee (the provider) has bought the right to sell a specific company’s (the franchisor’s) products in a particular area using the company’s name.

The provider operates three Bluebird Care franchises, of which Bluebird Care (Alton & Alresford) was the second to open. It is registered to provide personal care to people who experience dementia, people with learning disabilities or who are on the autistic spectrum disorder, older people and people with a physical disability or sensory impairment. They are also registered to provide personal care to children aged 13-18 years and younger adults. The service provides both a home care and support service and a live-in care service. At the time of the inspection there were 55 people using the service and provided with the regulated activity of personal care.

The service had a registered manager. 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 extremely satisfied with the quality of the service they received. A person’s relative told us “I cannot speak highly enough. I am very happy with the care” and “They provide care to a good standard.” Other people’s comments included “I have lovely carers,” “They are really good” and “Staff are always very cheerful and ask if there is anything extra I need.”

The service had a track record of being an excellent role model for the provision of outstanding domiciliary care provision. The registered manager provided clear leadership to the staff team and was valued by people, staff and the provider. There was a positive culture and the provider’s value system placed people at the heart of the service. There was a whole team culture whose focus was on how could they do things better for people? Staff felt able to raise any concerns with management.

There was a strong focus on continually striving to improve. There were robust processes in place to seek people’s views on the service and monitor the quality of the service. Information from customer surveys and the actions the provider took were shared openly and honestly with people. Feedback from people through surveys and complaints was used to continually drive service improvement.

The provider valued their staff and saw them as an asset to deliver high quality care to people. They appreciated that people wanted consistency in their care and that the way to achieve this was through staff retention. To achieve this they had identified a range of ways to retain their staff which enabled them to attract and retain good quality staff to deliver high quality care to people.

People consistently told us staff were well trained. Staff underwent a rigorous induction programme prior to providing people’s care. People were empowered to be directly involved in training the staff in how to deliver high quality and effective care based on best practice. The dignity care staff champion shared their learning with peers. The registered manager had used innovative and creative ways of training and developing staff that enabled them to apply their learning in their practice in order to deliver outstanding care for people.

The provider had developed strong links with the local community. They worked alongside other organisations to ensure they followed current good practice in the delivery of people’s care.

There was a strong focus on the use of technology in the delivery of people’s care and the provider understood how its’ use could improve people’s experience of the care staff provided. People’s care was being delivered more safely, effectively and responsively due to the provider’s utilisation of technology to support the planning, delivery and monitoring of care.

There was a strong emphasis on the importance of people eating and drinking well. The provider’s full utilisation of the electronic recording system meant they could very effectively monitor if people had received their required support with eating and drinking at each visit. Any issues were picked up promptly through the instant electronic feedback to the office staff from care assistants’ visits on the care they had provided to people.

People and stakeholders consistently praised staff for their caring attitudes. The registered manager and staff were able to tell us about how they went ‘The extra mile’ for people and the difference this had made for them. Staff were highly motivated and had gone out of their way to support people and used their own initiative to seek out ways to support people in a caring and kindly manner. Staff were observed to be kind and compassionate both to people and their relatives, who valued the interest staff showed in them as individuals.

People unanimously told us that staff consulted them about how they wanted their care to be provided and gave them choices about their care. Staff were observed and heard to offer people choices about all aspects of the care they were providing to them. People’s preferences were recorded in their care plans for staff to consult. Staff understood people’s communication needs and used non-verbal communication methods where required to interact with people. Staff also used verbal reassurance and touch when people had limited understanding of the care staff were providing for them, in order to enable the person to feel safe and cared for.

Everyone we spoke with told us staff ensured their dignity and privacy was promoted. People were treated with respect by staff both when they were having their care delivered and in the way people were formally referred to, in their records. Staff had considered how people’s rights to privacy could be compromised and had taken appropriate action to ensure their privacy.

People consistently told us they received personalised care from care assistants who understood their care needs. People’s care and support needs were planned proactively in partnership with them and they had individualised care plans that were delivered by skilled staff. Care assistants were able to demonstrate their level of knowledge of people’s care needs and knew how to work with each person to provide their care in response to their identified needs. External agencies confirmed to us that the service was flexible and responsive to people’s needs. The provider used technology to enable them to be highly flexible and responsive to changes in people’s needs.

People and their relatives told us the service was safe. Staff had undergone relevant training and understood their role in relation to safeguarding people and the actions they should take to keep people safe from the risk of abuse.

People told us staff managed any risks to them well. There were robust processes in place to ensure risks to people were identified and managed whilst also promoting people’s independence and their right to take risks. Staff understood how risks to people were managed and were observed to follow the written guidance provided. There were processes in place to protect people and the security of their home when they received personal care, through staff wearing uniforms and carrying identification. People received information about who they should expect to be delivering their care so they were aware of who was due to call upon them.

People told us they received their care at the times they wanted and received consistency in the staff providing their care. The provider used their electronic systems to ensure only staff with the correct training and skills were rostered to provide people’s care. They set targets for the level of consistency people should experience in their care, these were monitored weekly and action taken to address any shortfalls for people. People’s call times and delivery were monitored and office staff took immediate action to address any issues to ensure people’s safety. Robust recruitment checks had been completed to ensure staff were suitable to work with people.

Care assistants had instant access to information about people’s medicines on their smart phones and about any changes to people’s medicines. This reduced the risk of any medicines errors occurring due to people’s medicines information not being updated. People’s medicine administration records (MARs) were now held on the providers’ electronic care records system. Care assistants electronically signed people’s MARs once they had administered their medicines. The provider’s use of technology had significantly reduced any risk to people from staff either forgetting to administer their medicines or not signing their MAR. People received their medicines from trained staff whose competency had been assessed to ensure they received their medicines safely.

Any feedback from healthcare professionals was provided to staff to ensure they had up to date guidance about people’s healthcare needs and how to meet them. People were supported to maintain good health and to access health care services as required.

People told us staff had sought their consent for their care and treatment. The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. Staff had received relevant training and understood the principles of the Act. People’s consent to their care had been sought in line with legislation and guidance.

The provider had a compliments, concerns and complaints policy which outlined to people how and to whom they could address any concerns they had with the servi