Background to this inspection
Updated
4 December 2019
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.
Inspection team
The inspection was undertaken by one inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own homes.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be in the office to support the inspection.
What we did before the inspection
Before the inspection, we reviewed all the information we held about the service including previous inspection reports and notifications received by the Care Quality Commission. A notification is where the registered manager tells us about important issues and events which have happened at the service.
We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections.
We used all of this information to plan our inspection.
During the inspection
We spoke to 12 people who were using the service about their experience of the care provided and with six relatives. We also spoke with the registered manager, registered provider, the operations manager, culture and training manager and the live-in care manager. We spoke with a customer relations manager and a care co-ordinator. We either spoke to or received written feedback from 13 care staff. We viewed the care and support records for seven people, the recruitment, training and supervision records for three staff and other records relating to the management of the service such as staff rotas, audits and policies.
After the inspection
Following the inspection, we received feedback from four health and social care professionals about the care provided by the service.
Updated
4 December 2019
About the service
Bluebird Care are a large national provider of care and support services to people in their own homes. It operates a franchise model with Belrose Limited, (The provider) managing four of these locations locally one of whom was Bluebird Care Andover and Stockbridge. The support provided included, short term help to recover from illness or following an admission to hospital, daily visits to support with personal care, meal preparation or medicines management, domestic support, companionship and live in care.
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. 71 People were receiving a regulated activity when we inspected.
People’s experience of using this service and what we found
The leadership team had nurtured a culture within the service where there was a focus on the provision of outstanding care to people. There were high levels of satisfaction amongst the staff team and all staff told us they felt valued and their achievements were recognised. The views of people and their relatives remained central to driving forward improvement and service development. There were consistently high levels of engagement with staff to ensure that their views were heard and acted upon. The leadership team used its presence within the heart of the local community to undertake a number of initiatives to help benefit local citizens.
Care and support was tailored to meet people’s individual needs and had made a positive difference to their lives. The service continued to use technology to enhance the service they provided. The support being provided was helping to avoid the risk of isolation and assist people to enjoy their hobbies and interests. Staff demonstrated an understanding of the importance of compassion when caring for people at the end of their life and worked alongside community healthcare professionals to ensure that people had a pain free and dignified death.
Overall people’s medicines were managed safely and the systems in place supported this. There were some areas where improvements could be made in line with best practice standards. The registered manager and provider demonstrated a culture of openness and transparency in relation to safety and to learning from incidents. However, our review of people’s records showed that there had been a number of incident forms which had not been escalated to the registered manager. People told us they felt safe when receiving care. Staff had a positive attitude to reporting concerns. They were confident the registered manager would act upon these. Risks to people, and to the care workers supporting them had been assessed and planned for. Systems were in place to help ensure there were enough staff to provide people with a service that was reliable and safe. Good practice guidance was followed to ensure infection prevention and control processes were implemented.
The provider had robust systems in place to build a team of reliable and competent staff. Staff were extremely positive about their induction and training and the provider was continuously looking for ways to improve the training programme. Healthcare professionals consistently described the service as providing very effective care and the service continued to work collaboratively and seek innovative ways to support people with their healthcare needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Staff supported people to have access to food and drink of their choice and found solutions to encourage people to eat and drink well.
Everyone told us they were supported by staff who were kind and caring. Staff displayed a genuine desire to enhance people's wellbeing and spoke of the importance of making a difference to people’s lives. There was a clear focus on staff building trusting and meaningful relationships with people. Staff showed a good understanding of how to protect people’s rights and of the importance of supporting people to make express their choices. Staff allowed people to direct their own care and demonstrated a thorough understanding of the importance of providing just the right amount of support to maximise people’s independence.
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 outstanding (16 January 2017).
Why we inspected
This was a planned inspection based on the previous rating.
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 received any concerning information we may inspect sooner.