Bluebird Care (Totton)

Bluebird Care (Totton) is a domiciliary care agency in the New Forest District and County of Hampshire. It provides care and support to people living in their own homes. Forty -four people were receiving support with personal care needs. 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. At the time of the inspection, 25 care workers provided care and support to 44 people, two of whom had 24-hour care.

People’s experience of using this service and what we found

People benefited from a service that was extremely well-led and focused on maintaining and if possible improving high standards of care. People who used the service, their relatives and local health and social care professionals said they were very confident that the service ensured people’s safety and well-being and was alert to any concerns. The organisational structure provided staff with strong leadership and support and the provider maintained close oversight of standards. There was a comprehensive and robust system to monitor levels of care. This included spot check visits, audits and analysis of incidents to learn lessons and improve the service. Managers shared learning with staff to enable continuous improvement in standards of care for people.

Staff were highly motivated and exceptionally well-trained and benefited from a strong learning and development programme. This included some specific training delivered by local healthcare professionals where needed to support specific people using the service.

The service worked with other professionals and organisations to promote positive outcomes for people, for example with community nurses on protecting people's skin integrity and with the local reablement team for people who had recently come home from hospital.

People's needs and wishes were at the heart of everything the service did. The service carried out detailed assessments of people’s needs and preferences, in discussion with people and their families to ensure people received care and support tailored to them as individuals. People looked forward to care workers visits and valued the punctuality and continuity of staff. One person told us “they often make my day”. People’s views were valued and responded to, and used to shape the service. Bluebird was seeking people's views about the qualities they valued in care workers to inform their recruitment. People and their relatives praised the caring and capable staff and all told us they would recommend the service to others. A family member said, “I couldn’t ask for anything better either from the office team or the carers”.

Staff had responded effectively to improve people’s lives and enable them to continue to live at home, in accordance with their wishes. Staff were alert to people's changing needs. For example, when one person, with no immediate family was assessed as unsafe to use their gas cooker, staff arranged for the cooker to be disconnected and sourced a frozen meal delivery service and a freezer, so the person could have microwave meals instead.

Staff understood their responsibilities to protect people from abuse and harm. People said they felt safe using the service and trusted the staff. Staff identified individual and environmental risks and managed them appropriately. People received their medicines safely as prescribed.

Staff showed empathy and kindness towards people they cared for. They showed clear commitment to building trusting and caring relationships to enhance people’s lives as much as possible. People said the staff often went over and above their job roles to support them.

People’s dignity and privacy was respected by staff. Care was delivered in a way that promoted people’s independence. Staff said, “Supporting the independence of people in their own homes is key to what we do”.

People and their relatives knew who to speak to if they had a concern. They were confident that if they raised a concern staff would deal with it promptly and appropriately. We saw evidence that this happened. A relative told us how staff were, “On to it at once” when they had raised a concern

People were supported to have the maximum choice and control over their lives, and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this. Staff sought people’s consent and supported them to have choice, control and independence. A person said, “They always ask if there is anything they could do for me and how I like it done”.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

The last rating for this service was Good (published July 2017). At this inspection, the rating remained Good,

Why we inspected

This was a planned inspection based on the previous rating.

The overall rating for the service remains 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 (Totton) 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.

The service had 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.

Management provided strong leadership, were constantly working to drive improvement and always celebrated success. Feedback from people, staff and relatives confirmed management were respected and led by example.

Staff told us that they felt their achievements were recognised and that they felt valued. Staff had a clear understanding of their roles and responsibilities. We observed staff were confident in performing their jobs and when speaking with people, other staff and the registered manager.

Audits had been completed and were linked to CQC’s regulatory standards of ensuring a service is safe, effective, caring, responsive and well-led. The audits effectively captured the level of detail needed to provide reliable data and lead to positive change.

People, their families and professionals told us they felt the service was safe. Staff had received safeguarding training and had their competencies checked. They were aware of the types of abuse that could happen to people, what signs to look out for and their responsibilities for reporting any concerns.

The registered manager had a good understanding of their responsibilities to notify the Care Quality Commission of important events that happened within the service. People and their families had been given information so that they knew what to expect from the service.

People who required assistance with their medicines were supported by appropriately skilled and qualified staff. They had received training and competency checks and had a good understanding of the risks associated with the medicine people were taking.

New care staff completed the Care Certificate. The Care Certificate is a national induction for people working in health and social care who did not already have relevant training. Staff consistently told us the training they received supported them to meet the needs of people safely.

Staff said they felt supported in their role. They told us they received regular supervision and had a yearly appraisal.

Staffing levels met the needs of the people using the service. Staff had been recruited safely.

Staff acted in accordance with the principles of the Mental Capacity Act (MCA) 2005.

People had good access to healthcare. This included GP’s, district nurses, occupational therapists opticians and chiropodists.

People wherever possible had care workers who shared common interests and had gained the knowledge to understand people’s individual needs. They also had a good knowledge of people’s families and others important to them.

Care files included a privacy statement which explained to people the information that the service collected about them and why they kept it and staff understood their role in protecting a persons’ privacy.

People, their families and other professionals had been involved in an assessment before the service provided any support. The assessment had been used to create care and support plans that addressed people’s individual identified needs. Staff demonstrated a good understanding of the actions they needed to take to support people.

A complaints procedure was in place and people told us they were confident and concerns would be dealt with appropriately by management.

Staff were supported and encouraged to share ideas about how the service could be improved and had been pro-active in supporting changes. They spoke enthusiastically about the positive teamwork and support they received.