Background to this inspection
Updated
10 March 2022
The inspection
We carried out this performance review and assessment under Section 46 of the Health and Social Care Act 2008 (the Act). We checked whether the provider was meeting the legal requirements of the regulations associated with the Act and looked at the quality of the service to provide a rating.
Unlike our standard approach to assessing performance, we did not physically visit the office of the location. This is a new approach we have introduced to reviewing and assessing performance of some care at home providers. Instead of visiting the office location we use technology such as electronic file sharing and video or phone calls to engage with people using the service and staff.
Inspection team
This inspection was carried out by one inspector and one Expert by Experience who made telephone calls to people using the service and their relatives. 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 four days’ notice of the inspection. This was because we needed to be sure that the provider or registered manager would be available to support the inspection.
Inspection activity started on 12 January 2022 and ended on 25 January 2022.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. This included notifications, complaints, safeguarding alerts and feedback from local authorities and people using the service. We used information gathered as part of monitoring activity that took place on 21 December 2021 and 7 January 2022 to help plan the inspection and inform our judgements. We called 23 people who used the service or relatives of those who used the service as part of the monitoring activity to seek feedback on the quality of the service. There was negative feedback about timekeeping, missed calls and communication with the office which prompted this inspection.
The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report. We used all of this information to plan our inspection.
During the inspection
This performance review and assessment was carried out without a visit to the location’s office. We used technology such as telephone calls to enable us to engage with people using the service and staff, video calls with the management team and electronic file sharing to enable us to review documentation.
We spoke with the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider. We also spoke with the registered manager and the quality assurance manager about the management of the service. We spoke with seven staff including two care coordinators, care plan assessor and four care workers. We also spoke with 18 people who used the service and/or their relatives.
We looked at the care records for ten people who used the service. This included risk assessments, care plans, records of their care calls over two weeks and medicines records. We also looked at staff training records, recruitment records for three staff, complaints and records related to the management and quality monitoring of the service.
After the inspection
We continued to seek clarification from the registered manager and nominated individual to validate evidence found
Updated
10 March 2022
About the service
Bluebird Care (Calderdale and Bradford South) is a domiciliary care service. It provides personal care to people living in their own homes in the community. The service supports people with a range of needs including people with dementia. At the time of this inspection there were 140 people using the service.
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
Some people told us they experienced late and missed calls where the care worker did not arrive at all. They said they were happy with the care workers, but some people were not happy with the way the service was organised and managed.
People liked their care workers and said the quality of care was generally good. They received good support with their personal care, taking their medicines and with their meals. People and their relatives told us staff were kind and caring and did a good job.
Some relatives told us they were not happy with the communication from the service. They said it was at times hard to get through to the office on the telephone. The management team explained this was because office-based staff were having to go out to cover staff who were off sick so were not available to respond to phone calls.
The provider’s systems for monitoring that care calls were taking place were not always effective. The monitoring system produced alerts for office- based staff when a care worker had not arrived at a customer’s house to provide their care. However some alerts were missed due to the responsible person being out providing care and this had a negative impact on a few people who told us they had missed a meal and/or were upset by the missed call.
For several months the service had not been carrying out assessment visits to people before they started providing their care. This meant there were no environmental risk assessments for some people and other people had assessments and care plans which had not been updated for some time. The service relied on care workers to tell office based staff the risks they observed in a customer’s home. The provider told us that this was improving at the time of the inspection.
Staff were happy working for this service. They said the registered manager and nominated individual (the person who represents the company) were responsive and helpful. The training was of a good standard but the service was not up to date with the monitoring of care workers to ensure they were doing a good job.
The service had a comprehensive action plan in place to improve standards and the registered manager and nominated individual were very committed to improvement.
Rating at last inspection
The last rating for this service was good (published 01 May 2018).
Why we inspected
This inspection was prompted by a review of the information we held about this service. The inspection was prompted in part due to concerns received about staffing shortages having an impact on care. A decision was made for us to inspect and examine those risks. As a result, we undertook a focused inspection to review the key questions of safe, responsive and well-led only.
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 changed from good to requires improvement based on the findings of this inspection.
We have found evidence that the provider needs to make improvements. Please see the well led key question section of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Bluebird Care (Calderdale and Bradford South) on our website at www.cqc.org.uk.
Enforcement and recommendations
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified a breach of regulation in relation to the monitoring of care calls to ensure all required care is provided safely.
The provider has taken some action to address immediate concerns and also has a comprehensive action plan in place to improve the service.
We have made on recommendation to personalise emergency protocols for people who have diabetes.
Please see the action we have told the provider to take at the end of this report.
Follow up
We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.