Archived: Bluebird Care (Elmbridge & Runnymede)

Bluebird Care (Elmbridge & Runnymede) provides care and support to people in their own homes. The service provided personal care to 72 older people at the time of our inspection, five of whom were receiving live-in care.

Mr Jonathan Billington is the Director of the business and is registered with the CQC as the Nominated Individual for the provision of personal care. Mr Billington is referred to in this report as ‘the provider’. There was a no registered manager in post at the time of our inspection. 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 and associated Regulations about how the service is run. The service manager had begun the process of registering with CQC.

At the last inspection in August 2015, we found the provider was in breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. On two occasions care workers had missed visits, which had serious or potentially serious consequences for people. The agency’s monitoring systems had failed to highlight that care workers had not arrived, which meant no action was taken to ensure that the person received the care they needed or to check the care workers’ safety and welfare.

Following this inspection, the provider submitted an action plan telling us how they would make improvements in order to meet the relevant legal requirements.

At our inspection in June 2016, we found the provider had introduced measures to address these concerns. The provider had implemented a new app-based system, which all care workers had installed on their smart phones. The system enabled the provider to monitor visits more effectively and to support lone working care staff. The manager told us there had been no missed calls since our last inspection.

People and their relatives told us their care workers were reliable and had never missed a visit. The provider had carried out risk assessments to keep people safe and developed plans to prioritise the delivery of care to those most at risk in the event of an emergency. Staff received training in safeguarding and recognising the signs of abuse. They knew about their responsibilities if they suspected abuse and how to report their concerns. People were protected by the provider’s recruitment procedures. The provider carried out pre-employment checks to ensure they employed suitable people to work at the agency. People’s medicines were managed safely.

People received their care from regular care workers who knew their needs well. Staff had access to the training and support they needed to fulfil their roles. Care workers attended an induction when they joined the agency and shadowed experienced colleagues until the provider was confident in their ability to provide people’s care safely and effectively.

People’s consent was obtained before their care was provided. Where people were did not have capacity to give consent, the provider sought the views of their representatives. The agency worked co-operatively with people’s families to ensure they received the care they needed. Relatives said care workers were observant of any changes in their family member’s needs and that the provider contacted them if they had any concerns about people’s health or welfare. People’s nutritional needs were assessed when they began to use the service. Where people needed assistance with eating and drinking there was a care plan in place to outline the support they required.

People were supported by kind and caring staff. People told us their care workers were polite, courteous and treated them and their property with respect. They said they had developed good relationships with their care workers and looked forward to their visits. Relatives told us that care workers knew their family members preferences about their care and promoted their independence.

People received a service that was responsive to their individual needs. They told us they had been involved in developing their care plans. People and their relatives said their care workers provided care and support flexibly according to their wishes.

People and their relatives had opportunities to give their views about the service and these were listened to. People told us they received surveys and regular contact from the management team to ask for feedback. Any complaints received were recorded and investigated appropriately.

The monitoring and governance of the service had improved with the establishment of a full management team. The management team communicated regularly to ensure all aspects of the service functioned effectively.

Care workers told us the management support they received had improved. They said the management team was supportive and that they could always contact the office if they needed to. The manager had introduced regular team meetings, which aimed to improve communication and promote good practice. A member of the management team regularly carried out spot checks on care workers to observe their practice when caring for people. The manager had taken action to address any shortfalls in care provision.

Below is a summary of what we found. The summary is based on our observations during the inspection, speaking with people using the service, the staff supporting them and from looking at records. If you want to see the evidence supporting our summary please read our full report.

• Is the service safe?

The provider had effective recruitment and selection processes in place and carried out appropriate checks before staff began work.

Staff had access to training and support to enable them to deliver care safely and in a way that maintained people’s dignity.

• Is the service effective?

People told us that their care workers almost always arrived on time and that they were contacted if their care worker was behind schedule. They said that their care workers always stayed for the correct amount of time and that they did not feel hurried when receiving their care.

People said that they received a weekly rota informing them which care workers would be attending at each visit. However some people said that the care workers who arrived were not always the member of staff indicated on the rota.

• Is the service caring?

People spoke highly of the care provided by the agency’s staff. They told us that care workers were polite, hard-working and helpful and that they provided good care. One person told us, “We’ve had very good care from them. They’re all very polite, extremely nice. I’ve recommended them to friends.” Another person said, “I’m very happy with them. The carers are friendly and helpful and they never rush me.”

Relatives also provided positive feedback about the care their family members received. One relative told us, “The carer we have at the moment is outstanding. She’s meticulous in everything she does.” Another said of their family member, “He gets on well with all the carers. He looks forward to their visits.”

• Is the service responsive?

People’s needs were assessed before they began to use the service. The assessment identified what people wanted to achieve from the service and their preferences about their care. This meant that people received a personalised service based on their individual needs.

Most people told us that they received their care from regular care workers who knew their needs well. One person said, “We get the continuity that we asked for, which is very important to us.” A minority of people told us that they were not satisfied with the continuity of care they received. One person said, “They’re all very nice but I’d prefer regular carers. The regular ones know exactly what to do but the others don’t.”

• Is the service well-led?

Care staff told us that they received the support and training they needed to do their jobs. They said that they had an induction when they started work and the opportunity to work alongside an experienced colleague. They told us that they had regular refresher training in core areas and opportunities to discuss their professional development and further training needs.

The provider encouraged people to give their views about their care. People told us that their views were listened to and that the provider had responded appropriately if they had requested changes to their care. We found evidence that the provider used comments and complaints to improve the service.

People that we spoke with told us that staff were kind and helpful. They confirmed that they had been given information about the agency prior to care being delivered. One person told us “I was given a care book all about the agency before care started.” Another person said “I was given information which indicated the carers were able to care for me well.”

Care plans and risk assessments were in place and the registered manager, or a named person from the office, carried out the assessments. Staff confirmed they looked at each person’s folder in order to carry out the correct care for people.

Staff told us they had received safeguarding vulnerable adults training. They were able to tell us the types of abuse they may see and knew how to report any incidents.

Staff confirmed they received regular training sessions. Staff confirmed they benefited from regular supervision sessions with their manager. Staff that we spoke with confirmed with us that they had an induction when they joined the agency.

Quality assessments took place. The manager told us that a recent survey for people who used the service had been completed.

We spoke with six people who used the service, or their relatives; most said they were very happy with the service being provided. One person said “They are doing a first rate job.” Another person told us “The care is good, I am happy with the service.”

All the people we spoke with said that staff acted with their consent. A relative told us “They asked for our consent to the care being given, and occasionally the carer is accompanied by office staff to check that we are still happy with what they are doing.”

People told us they were happy with the care provided. However they said that sometimes they were not told in advance which staff member was coming to support them. People said that the provider was sometimes slow to review care plans, but their needs were being met.

People told us that staff supported them with their medication. They received the right medication at the right time. One person told us “I always get my medication when I should.”

We saw that the provider was carrying out appropriate checks when employing staff. They ensured staff were of good character and had the necessary skills and experience to do the job.

The manager was regularly seeking the views of people to ensure they were happy with the service.