Background to this inspection
Updated
2 March 2017
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This announced inspection was conducted by one adult social care inspector on 28 December 2016, 13 January and 31 January 2017. We gave the provider two days’ notice of the inspection because Bluebird Care (Hammersmith and Fulham) is a domiciliary care agency and senior staff are sometimes out of the office supporting people who use the service and care staff.
We looked at information we held about the service in order to help us to plan the inspection, which included the inspection report for our last inspection in February 2014, any complaints that people had informed us about and statutory notifications. These are notifications of significant incidents which the provider is required by law to report to us. Before the inspection, the provider completed a Provider Information Return (PIR). This is a form the provider completes to give some key information about the service, what the service does well and the improvements they plan to make.
During the inspection we spoke with a field supervisor, the registered manager and the director. We spoke by telephone with eight people who use the service, three relatives and four care staff. A range of documents were checked which included five care and support plans, five recruitment files, staff records for training, supervision and appraisal, and a variety of policies and procedures. We also looked at specific records relating to the management of the service. Five local health and social care professionals with knowledge and experience of the service were contacted to find out their opinions and we did not receive any comments.
Updated
2 March 2017
This announced inspection was carried out on 28 December 2016, 13 January and 31 January 2017. We gave the provider 48 hours’ notice of our intention to conduct this inspection, as we needed to ensure that key staff would be available to access the information we required. At our previous inspection on 21 February 2014 we found the provider was meeting regulations in relation to the outcomes we inspected. The service is registered to provide personal care to people residing in their own homes and at the time of our inspection 47 people were receiving a personal care service. The provider is a franchisee of Bluebird Care UK (the franchisor) and does not offer services outside of the London Borough of Hammersmith and Fulham, in accordance with the terms and conditions of its franchise. (Franchising is the granting of a license to entitle franchisees to own and operate their own business under the brand, systems and model of the franchisor).
A registered manager was in post. A registered manager is a person who has registered with the 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.
People informed us they felt safe with staff, who were described as “trustworthy” and “reliable”. Staff demonstrated their understanding of how to protect people from the risk of abuse and harm, and had received training in relation to safeguarding adults and children. They were aware of how to report any concerns about a person’s safety to their line manager; however, some staff were not confident about how to use the provider’s whistleblowing procedure in order to contact external organisations if necessary. Systems were in place to identify risks to people’s safety and welfare, and written information was provided for staff to enable them to mitigate these risks.
Staff were provided with training, support and supervision in order to meet people’s needs and wishes. Recruitment practices demonstrated that staff had been robustly vetted in order to determine their suitability to work for the provider. People told us they thought there were sufficient staff to ensure their personal care and support was provided in a stable manner by regular care staff, although a few people told us that they had previously been unsatisfied with inconsistently delivered care at weekends.
People confirmed that staff spoke with them politely and asked for their consent before they provided personal care and other support. Staff spoke about the importance of always supporting people in a respectful way that maintained people’s independence, dignity and privacy.
The individual assessments and care plans we looked at showed that people were consulted about how they wished their personal care and support to be delivered. People’s care plans were regularly reviewed and amended when necessary to reflect any changes to how their care and support should be provided.
The provider issued people and their relatives, where applicable, with written information about how to make a complaint. People told us they were confident about speaking with the registered manager if they had any concerns and felt that he would promptly respond in an open and professional way.
Practices were in place to monitor the quality of the service, which included the auditing of a range of records and ‘spot check’ visits to people’s homes. Different methods were used by the provider in order to seek people’s views about the quality of the service, which included telephone monitoring calls, detailed surveys and other correspondence that invited people to comment about their care. People told us that the provider had listened to their feedback and made improvements.