We carried out a review of the data available to us about Bluebird Care (Bexley) on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Bluebird Care (Bexley), you can give feedback on this service.
Bluebird Care (Bexley) is a domiciliary care agency. It provides personal care to people living in their own houses and flats. The service provides a reablement service, personal care to adults, of whom some live with dementia. At the time of the inspection there were 104 people receiving personal care from 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
People benefitted from an improved service. However, travel time was not always enough during peak times.
We have made a recommendation about the deployment of staff.
People were kept safe from avoidable harm and were cared for by staff who understood how to protect them from abuse. Staff were knowledgeable about safeguarding vulnerable people and knew how to raise any concerns of abuse.
Risks to people's health and safety had been identified, assessed and had appropriate risk managed plans in place. People’s medicines were managed safely, and people were protected from the risk of infections and diseases. The service followed appropriate pre-employment checks before staff began working with the service and lessons were learnt from accidents and incidents to prevent repeat occurrences.
The management team demonstrated a commitment to provide high quality care and knew they had to be honest, transparent and open when things went wrong. Effective systems were in place to monitor and access the quality of the service. Feedback was sought from people, their relatives and staff to improve on the quality of the service provided. The service worked in partnership with key organisations and health and social care professionals to deliver an effective service. Staff knew of their individual roles and responsibilities, they told us they felt supported in their role and were happy working at the service.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection (and update)
The last rating for this service was requires improvement (published 29 April 2019). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.
Why we inspected
We carried out an announced comprehensive inspection of this service on 11 and 12 March 2019 and breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve staffing and good governance.
We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Bluebird Care (Bexley) on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
People’s experience of using this service:
• People were not supported by effectively deployed staff. Staff did not always attend people’s care calls as per their preferred time. People were not always supported in line with the care and support that had been planned for them.
• Staff roistering records showed staff were not always given enough time to travel between the calls, which impacted on their ability to arrive promptly or stay the full time with people.
• The provider’s quality assurance systems were not effective. The provider was not effectively monitoring people’s calls.
• The local authority quality audit recommendations from January 2019 were outstanding.
• There were effective recruitment and selection procedures in place to ensure people were safe and not at risk of being supported by staff that were unsuitable.
• People and their relatives gave us positive feedback about their safety and told us that staff treated them well.
• The provider had a policy and procedure for safeguarding adults from abuse. The registered manager and staff understood what abuse was, the types of abuse, and the signs to look for.
• Staff completed risk assessments for every person who used the service. These included manual handling risks, oral care, eating and drinking and home environment.
• There was a system to manage accidents and incidents to reduce them happening again. Staff completed accidents and incidents records.
• Staff administered prescribed medicine to people safely and in a timely manner.
• People were protected from the risk of infection.
• People’s needs were assessed to ensure these could be met by the service. Where appropriate, staff involved relatives in this assessment.
• The provider trained staff to support people and meet their needs.
• Staff supported people to eat and drink enough to meet their needs.
• The provider worked with other external professionals to ensure people received effective care.
• Staff supported people to maintain good health.
• People’s capacity to consent to their care and support was documented. People and their relatives confirmed that staff obtained consent from them before delivering care to them.
• Staff supported people and showed an understanding of equality and diversity.
• People and their relatives were involved in the assessment, planning and review of their care.
• People were treated with dignity, and their privacy was respected.
• People were supported to be as independent in their care as possible.
• Care plans were person centred and contained information about people’s personal life and social history, their health and social care needs, allergies, family and friends, and contact details of health and social care professionals.
• The provider had a clear policy and procedure for managing complaints and this was accessible to people and their relatives. However, People and their relatives gave us a mixed feedback about how complaints were managed.
• The provider had a policy and procedure to provide end-of-life support to people. However, people did not require end-of-life support at the time of the inspection.
• The director, the registered manager and staff worked well together and acted when things went wrong.
• People who used the service completed satisfaction surveys. The provider developed an action plan in response to the feedback from the survey to show how the identified concerns were addressed.
• The provider completed checks and audits on accidents and incidents, complaints, staff training, and safeguarding.
• The registered manager and the provider remained committed to working in partnership with other agencies and services to promote the service and to achieve positive outcomes for people.
Rating at last inspection: Good (Report published on 16 September 2016).
Why we inspected: This was a planned inspection based on the last inspection rating.
Follow up: We will continue to review information we receive about the service until we return to visit as part of our re-inspection programme. If any concerning information is received we may inspect sooner.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Bluebird Care Bexley is a domiciliary care agency that provides care and support for people living independently in the London Borough of Bexley and the surrounding area. At the time of this inspection 178 people were using the service.
The service had a registered manager in post. 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.
We found the service had appropriate and robust safeguarding adults procedures in place and that staff had a clear understanding of these procedures. People using the service said they felt safe and that staff treated them with kindness and understanding. Staff understood how to safeguard the people they supported from abuse. There was a whistle-blowing procedure available and staff said they would use it if they needed to.
Medicine records showed that people were receiving their medicines, where required, as prescribed by health care professionals. People had access to health care professionals when required. Staff had completed training specific to meet the needs of people using the service and they received regular supervision. The manager and staff had a good understanding of the Mental Capacity Act 2005 and acted according to this legislation. People’s care files included assessments relating to their dietary and other essential support needs.
Assessments were undertaken to identify people’s support needs before they started using the service. Care plans were in place detailing how people wished to be supported and people were involved in making decisions about their care. People were aware of the complaints procedure and said they were confident their complaints would be listened to, investigated and action taken if necessary.
The provider was committed to continuous improvement and used a variety of methods to assess and monitor the quality of the service. These included implementation of technology, annual satisfaction surveys, spot check and care reviews. We found people were satisfied with the service they were receiving. The registered manager and staff were clear about their roles and responsibilities and were committed to providing a good standard of care and support to people in their care.
Some people we spoke with had reservations about frequent changes of carers and punctuality. For example, one person said: 'I don't like all these changes. I have to keep explaining things all the time.' Most people told us the office had not let them know in advance that there had been a change of carer, or that the carer was going to be late. Some people told us they had not told the office, and so given the provider an opportunity to resolve the problem.
We found people were asked for their consent before they received care and the provider acted in accordance with their wishes. People experienced care and support that met their needs; were cared for by suitably skilled staff; and were protected from unsafe or unsuitable equipment. The provider had an effective system to monitor the quality of service people received in place and was taking action to address people's concerns about the inconsistency of allocated carers.
We found people using the service were involved in decisions about their care and were treated with dignity and respect. They experienced care that met their needs and were cared for by suitably qualified, skilled and experienced staff. People were protected from the risk of abuse, and the provider had systems in place to monitor the quality of the service people received.