Bluefield Care Services

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.

Bluefield Care Services is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. At the time of the inspection, 47 people were using the service.

This is the first inspection of the service since registration with the Care Quality Commission on 7 March 2017.

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’s care planning and delivery minimised the risk of abuse. People had risks to their safety and well-being assessed and managed. There were enough experienced staff to meet people’s needs.

Staff underwent appropriate recruitment procedures to determine their suitability to deliver care. Staff were trained to administer and manage people’s medicines. However, none of the people using the service required that support at the time of our inspection.

People received support to eat healthily, to maintain good health and to access healthcare services.

People’s care delivery met current legislation using evidence based practice. Staff received the support they required to undertake their roles including training and supervision. Staff applied the Mental Capacity Act 2005 (MCA) principles when supporting people. People who were unable to make decisions about their care received the support they needed.

Staff delivered care in a manner which responded to people’s individual needs. People were involved in the planning and reviewing of their care and support plans. Staff had sufficient guidance to deliver care and manage risks to people’s health and well-being.

People were treated with respect, kindness and compassion. Staff respected people’s decisions and choices about how they wanted their care delivered.

The registered manager sought people’s views about the service and acted on their feedback to improve care delivery. People had their complaints taken seriously, investigated and resolved in line with the provider’s procedure.

People using the service, their relatives and staff were happy with the registered manager and the running of the service. The registered manager monitored staff’s practice to ensure they delivered high standards of care. Staff used feedback to improve their practice.

Appropriate systems were in place and effectively used to monitor the quality of the service. Shortfalls identified were addressed which resulted in improvements to care delivery.

The registered manager worked closely with other agencies to provide effective care.