Bluebird Care (Epsom, Kingston & Sutton)

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.

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

People received safe care and support. There were risk assessments and care plans in place for people and staff knew people and their needs and preferences very well. However, at the time of our inspection not all people’s risk assessments included sufficiently detailed and personalised information about their level of vulnerability to COVID-19. After our inspection the provider put a new process in place to ensure all people’s risk assessments contained all the necessary information and level of detail required regarding their individual risk of COVID-19.

People received their medicines safely. However, at the time of our inspection some people did not have sufficiently detailed and personalised information in their care records regarding some of their ‘when required’ medicines. After our inspection the provider updated the relevant people’s medicines information to include this. The provider also put a new process in place to ensure people’s records contained the necessary information and detail concerning their 'when required' medicines.

There were systems and processes in place to safeguard people from the risk of abuse. Staff had received safeguarding training and knew how to recognise and report abuse.

There were sufficient numbers of staff to meet people’s needs and staff recruitment followed safer recruitment procedures.

Infection prevention and control followed best practice guidance and we were assured the provider was responding effectively to risks and signs of infection.

Accidents and incidents were recorded and reported. The provider used the information to identify why things had gone wrong and took action to improve the service.

Managers and staff were clear about their roles, they understood regulatory requirements and their duty to be open and honest with people when something went wrong. There were quality assurance systems in place and action was taken to improve the care provided when issues were identified. However, at the time of inspection not all the provider’s audits were effective, as the provider had not identified the issues we found. During our inspection the provider put in place new processes to ensure their audits were effective and would identify the issues in future.

We have recommended the provider reviews all their compliance systems and processes to ensure the procedures in place are robust and effective.

There was a caring and positive culture that was person-centred, open, inclusive, empowering and achieved good outcomes for people. People were supported to be as independent as possible. The provider engaged and involved people, their relatives and staff in people’s care and the development of the service. Managers provided staff with a good level of support. People, their families, staff and managers spoke positively about each other and feedback from people and their families about the service was complimentary.

Staff worked in partnership with healthcare services, other professionals, and community organisations to meet people’s needs.

Managers were proactive and engaged in a number of professional networks for sharing learning to improve practice.

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.

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 (10 January 2018).

Why we inspected

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

We undertook a focused inspection to look at the key questions Safe and Well-led. For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

The overall rating for the service has remained good based on the findings of this inspection.

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

Follow up

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

Bluebird Care Sutton is a domiciliary care service that provides care and support to adults of all ages, in their own homes. The service provides help with people's personal care needs in Sutton and the surrounding areas. This includes people with physical disabilities and dementia care needs. At the time of the inspection they were providing personal care for 96 people.

The service had a manager who was in the process of applying for registration with the Care Quality Commission (CQC). The previous registered manager left the post recently. A registered manager is a person who has registered with the Care Quality Commission (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 2008 and associated Regulations about how the service is run.

The service was safe. Risk assessments were completed to enable people to receive care with a minimum of risk to themselves or the care staff. Robust recruitment procedures were followed to ensure as far as possible only suitable staff were employed. Staff were trained to safeguard and protect people. They were aware of their responsibility to report concerns.

People were cared for and supported by staff who had received training to support people to meet their needs. The registered manager had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005. People were supported to eat and drink enough to ensure they maintained a balanced diet and referrals to other health professionals were made when required.

People were cared for and supported by staff who knew them well. Staff treated people with dignity and respect. People's views were actively sought and they were involved in making decisions about their care and support.

People and their relatives were involved in the planning and review of their care. Care plans were reviewed on a regular basis and also when there was a change in care needs. People were given information about how to make a complaint and the people we spoke with knew how to go about making a complaint and were confident that they would be responded to appropriately by the provider. We saw evidence the manager responded to complaints received in a timely manner.

There was a positive culture within the staff team and staff spoke positively about their work. Staff were complimentary about the management team and how they were supported to carry out their work. The manager and other senior staff were committed to providing a good service for people. There were quality assurance systems in place to help ensure any areas for improvement were identified and action taken to continuously improve the quality of the service provided. People told us they were regularly asked for their views about the quality of the service they received.

At this inspection we spoke with the new manager who is in the process of registering with the Care Quality Commission; with six people who use the service and two staff. We considered our inspection findings to answer the questions we had asked previously: Is the service effective and is the service responsive?

Was the service effective?

We found that people were supported by staff who had received effective supervision, appraisal and training and this helped to ensure they were able to meet the specific needs of people using the service.

We were told by the manager that a review of all staff supervision had taken place since the last inspection. We were told the supervision policy in place at the last inspection was implemented effectively. The manager told us staff supervision was carried out monthly. The staff supervision records we saw for staff evidenced this. Staff told us they received regular supervision and they said they found it supportive and useful in their work with people for whom they provided care and support.

The manager told us since the last inspection staff training was improved with further training offered to all staff. We inspected staff files and the records we saw evidenced staff had completed all the necessary basic training deemed by the provider as being necessary for them to do their jobs effectively. Certificated evidence that we saw supported this. Staff confirmed that access to training had been improved significantly.

Was the service responsive?

People told us their care plans were reviewed recently and they were central to the process. They said they were asked how they would like their care to be given. One person said, 'My care plan was reviewed with me quite recently and I was asked how I wanted the support to be given, I signed the care plan in agreement with it, I am very happy with the care I receive.' Another person told us, 'Yes they came to see me at the end of last year, and went through everything with me and we agreed the care that I am now receiving. I am very happy with the support I get thank you.'

At this inspection we spoke with the manager who told us about a new IT and software package had been implemented that has helped improve the timeliness of care calls made by staff to people who use the service. They said that communication between staff and the office had also improved. We were told that people were now better informed if their care and support was to be late. People agreed with this, one person said, 'Our calls are usually on time and if not the office tells us when they are going to be late.' Another person said, 'We do get a telephone call now from the office if they are going to be late and that's much better than it used to be.' All of the people we spoke with said that they were informed if their care worker was going to be late.

We considered our inspection findings to answer questions we always ask; is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Was the service safe?

People who use the services were treated with respect and dignity by staff. They told us they liked their care worker to wear their badges and uniforms as it helped them to feel safe; one person said, 'Yes my care worker wears their uniform. When they first came here they did not have their badge and I was unhappy about that because I could not be sure who they were. But since then they have their badge on and I now know the person anyway'. Other people told us it helped them to feel safe, 'to know who the people were who were knocking on their doors'.

Recruitment practice was safe and thorough. The acting manager ensured that staff were appropriately qualified to meet the care needs of people who used the services. Risk assessments were undertaken by the agency to minimise the risks both to the person using the service and to care workers. This helped to ensure that people's needs were met safely.

Was the service effective?

People who use the service had their care and support needs assessed, together with risk assessments and they were involved in their care and support planning. We inspected six people's care files. They included essential information about the person's needs and any risks to them as well as the care that had been agreed with them.

We found that staff had not received regular and appropriate training or supervision and were therefore not able to ensure they were able to meet the specific needs of people using the service.

Was the service caring?

People who use the services were supported by staff in a polite and respectful way. All sixteen of the people we talked with said their care workers treated them well and respected their privacy. One person said, 'My care worker does what has been agreed in my care plan and then sometimes if there is time and I ask her to do some other little thing, she does it for me'. Another person said, 'Oh yes they are polite and they do what has been agreed with me before, I'm quite happy'.

People who use the services told us they had discussed their care plans with the office and that they were able to discuss relevant issues and make decisions about what they wanted to do. This reflected the caring service ethos that we found on the day of the inspection.

Was the service responsive?

People who use the services were able to ask for changes in their care and support as their needs changed. Care plans had been reviewed regularly. We spoke with sixteen people who received care and support from this agency and eleven people told us that they were not kept informed if their care worker was late. One person said, 'Our calls are often not on time and we are only informed very occasionally when they are going to be late'. Another person said, 'Although we are satisfied with what our carers do when they come, they are sometimes late'. Only three people out of the sixteen people we spoke with said that they were informed if their care worker was going to be late.

All the people we spoke with knew how to make a complaint. There was an appropriate complaints procedure in place and although no complaints had been made since the last inspection staff indicated that they would be supportive of anyone who needed to complain. People can therefore be assured that complaints would be investigated and action taken as necessary.

Is the service well-led?

The acting manager and the operational manager carried out regular checks to assess and monitor the quality of services provided and took appropriate action to address any issues or concerns raised about service quality.

The views of people who use the services, their representatives and staff were listened to. People told us that they were asked for their feedback on the services they received and that they filled out a customer satisfaction survey. Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the agency. This helped to ensure that people received a good quality service.

People told us that they had been assessed before a service was provided and that they had a care plan that set out the care and support they received. People said that they felt safe with their care workers and that staff always wore their uniforms and identity badges.

People said that their care workers were reliable, kind and courteous and always respectful. All the people we spoke to were happy with the services they received. They all knew how to make a complaint but people we spoke to said they had never needed to do so.

People said that their care workers were reliable, kind and courteous, always respectful but not always on time. All the people we spoke to were happy with the services they received. They all knew how to make a complaint but people we spoke to said they had never needed to do so.