Bluefield Care Services

Updated 28 March 2024

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 Health and Social Care Act 2008.

Inspection team

This inspection was carried out by 2 inspectors and 2 Experts 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 houses and flats.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there were two registered managers in post. However, there seemed to be minimal input by one of the registered managers to the running of the service.

Notice of inspection

The inspection was announced. We gave the service 24 hours’ notice of the inspection. This was because we needed to be sure that the provider would be in the office to support the inspection.

What we did before the inspection

We reviewed information we had received about the service since they registered with CQC. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 10 people using the service, 22 of their relatives, 1 registered manager, care manager, intern human resources manager and 12 care staff.

We reviewed a range of records. This included 16 people’s care records. We looked at staff files in relation to training and staff supervision. A variety of records relating to the management of the service, including policies and procedures were reviewed.

We continued to seek clarification from the provider to validate evidence found. We reviewed further risk assessment, care plans and information relating to the management of the service.

Updated 28 March 2024

Bluefield Care Services is a domiciliary care agency that provides personal care and support to people living in their own homes and flats. 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 our inspection, 64 people were receiving personal care and support.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

Right Support: 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. People’s care individual needs and preferences were assessed and met.

Right Care: People were protected from the risk of avoidable harm. One person told us, “Yes, I feel safe.” Staff understood their responsibility to protect people from harm and abuse and knew when to whistle blow concerns. Risk assessments were undertaken and support plans put in place. This ensured staff had guidance to provide care safely.

Right Culture: People did not always receive care when expected. Staff were sometimes delayed for long periods in arriving to provide care, which left people distressed, without care or medication. People did not always receive care from a regular team of staff which made it difficult for them to develop meaningful relationships. The registered manager told us they had an ongoing recruitment exercise as they experienced a massive staff turnover due to the COVID-19 pandemic.

We found three breaches of regulation relating to safe care and treatment, staffing, good governance and notifications. Quality assurances systems were not effectively used to monitor the quality of care. Supervisions and appraisals were not consistently undertaken or recorded to reflect some of the issues we found.

The provider did not ensure records of care provided to people, staff meetings, supervisions, appraisals, training were maintained consistently and that follow up actions were undertaken. In addition, quality assurance records were not consistently kept and missed key information such as dates or names of staff involved when incidents happened.

The provider had not submitted notification to CQC or the local authority safeguarding teams on significant events as required by law. The provider failed to monitor out of date or required learning/training. They could not always demonstrate staff had the right knowledge and skills to meet people’s needs. Systems were not used robustly to encourage staff to learn lessons when things went wrong.

People using the service and their relatives had mixed feelings about the running of the service. Views ranged from complaints not being resolved on time and persistent lateness by staff. The provider did not consistently promote a culture of learning when things went wrong to minimise the risk of incidents happening again. The provider had not always understood their responsibility to report concerns as required to relevant agencies including the CQC.

People received care from staff who were recruited safely. Staff underwent probationary training and received an induction before they started providing care. People were supported to take their medicines. Staff received training in infection control and prevention and knew to practice good hygiene when delivering care.

People’s dignity and privacy were upheld. Staff sought people’s consent before they delivered care to them. People received the support they required to maintain their independence and to make decisions and choices about their day to day living.

People were supported to access health services when needed to maintain their well-being. People had an assessment and regular review of their needs. Care and support plans were in place and reflected each person’s needs. People and their relatives knew how to make a complaint when they were not happy with the care provided.

The registered manager worked in partnership with other agencies to ensure people received the support they required to meet their needs.

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 good (published 24 April 2018) at this inspection, the rating has deteriorated to requires improvement.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.