25 July 2016
During a routine inspection
Bluebird Care Dorchester office is registered to provide personal care to people living in their own homes. At the time of our inspection, the service was providing support to 58 people. The service was run out of a central office in Poundbury.
The service did not have 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. The registered manager had left the service and they had made the appropriate application to CQC. The manager had been in post for five months and was in the process of applying to CQC to become the registered manager.
People were not always supported safely by the service. Staff knew how to support people, but there were no individual risk assessments for people which identified what risks they faced or how to appropriately manage these. The manager said that they would work to put these into place.
Medicines were given by staff who had received appropriate training. However there were gaps in recording medicines on the new electronic system and although observational checks of staff competencies around medicines were carried out regularly, this information was not used to highlight gaps in knowledge or to improve practice.
Recruitment at the service was not robust and there were some gaps with references obtained for new staff and checks about gaps in people’s employment history. The manager and operations manager advised us that they would ensure these were improved.
People were generally supported by staff they knew and there were very few missed calls reported. Any missed visits triggered an alert on the system.
The service was not always working in line with legislation around capacity and we found that information was incorrect or conflicting in some incidences.
People were able to access healthcare services when needed.
Staff received a planned induction and training was provided in a range of topic areas. Refreshers were regularly undertaken and staff were encouraged to undertake further training opportunities. The service was also in the process of rolling out training for a range of number of other areas including dementia friends and the Gold Standard Framework for end of life care.
Supervision was provided regularly and records showed that staff had face to face supervision and also spot checks where they were observed in practice. The manager also received regular supervision and support from senior management.
Staff supported some people with their meals and drinks. They knew what people liked, offered appropriate choices and recorded where there were concerns about inadequate food or drink intake.
Staff were kind and caring and we observed that interactions between people and staff were empathetic and compassionate. Staff knew peoples preferences and how they liked to be supported.
People and relative were involved in planning what support they would receive and were also invited to reviews about how the support was going. People and relatives felt able to raise any concerns but although these were listened to, they were not always acted upon.
Since the move to an electronic system, paper records had been removed from peoples homes and people and relatives were not aware that they could request copies of these
People told us that calls were rarely missed, however they were not told about changes to times of visits or if a different carer was going to be arriving.
Quality assurance systems at the service were not always robust. Information was gathered and collated about some areas of the service but for other areas, information was not used to identify gaps or trends.
Staff spoke highly about the manager and told us that communication with the office was good. There were regular staff meetings and staff were encouraged to contact or drop in to the office to discuss any concerns.