Background to this inspection
Updated
22 May 2019
The inspection: We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
Inspection team: The inspection team consisted of one adult social care inspector and an Expert-by-Experience. An Expert-by-Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type: This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. Not everyone using Bluebird Care Shropshire receives a regulated activity; CQC only inspects the service being received by children and young people provided with personal care; help with tasks related to personal hygiene and eating. For people the provider helps with tasks related to personal hygiene and eating, we also consider any wider social care provided.
The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
Notice of inspection: We gave the service 24 hours' notice of the inspection visit because we needed to be sure that the registered manager would be in the office.
Inspection activity started on 22 March 2019 with a visit to the office location by the inspector. We made telephone calls to people, staff and relatives on 26 March 2019 and 3 April 2019.
What we did: Before the inspection the provider sent us a Provider Information Return. Providers are required to send us information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We reviewed information we held about the service and events which the provider is required to tell us about by law. We contacted commissioners to seek their feedback. We received no information of concern.
During the site visit we spoke with the registered manager and the care manager. We reviewed a range of records. These included three people’s care records. We also looked at two staff files to check staff recruitment and their training records. We reviewed records relating to the management of the service. After the site visit we contacted 14 people and five relatives of people who use the service and five support workers.
Updated
22 May 2019
About the service: Bluebird Care Shropshire is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to younger and older adults including people who live with dementia or learning disabilities. At the time of inspection 40 people were using the service.
People’s experience of using this service: At this inspection we found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. These related to safe care and treatment and governance.
People said they felt safe with the service provided. However, systems were not robust, staffing capacity was not sufficient and staff deployment was not effective to ensure people's needs were met in a safe, timely and consistent way.
Records did not all provide guidance to staff to ensure people received safe, person-centred, appropriate care and support. Systems were not all in place for people to receive their medicines in a safe way.
A robust quality assurance system was not in place to assess the standards of care in the service. Audits that were carried out were not effective as they had not identified issues that we found at inspection.
Systems were not all in place to treat all people with dignity and respect to ensure they were kept informed and received consistent care from the same staff.
Information was accessible to involve people in decision making about their lives.
People had the opportunity to give their views about the service. There was consultation with staff and people. People said they knew how to complain. However, some people said they did not always feel listened to.
People were involved in some decisions about their care and staff supported them in the least restrictive way possible. However, some improvements were required to support people to have maximum choice and control of their lives. The policies and systems in the service currently did not all support this practice.
Staff knew about safeguarding procedures. There were other opportunities for staff to receive training. We have made a recommendation that all staff receive specialist training to give them more insight into the needs of the people they support.
Staff worked well with other agencies to ensure people received care and support.
All people were complimentary about the care provided by support staff. They trusted the workers who supported them. They said staff were kind, caring and supportive of people and their families.
Communication was effective and staff felt listened to. Staff said they felt well-supported and were aware of their responsibility to share any concerns about the care provided.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Why we inspected: This was the first inspection of Bluebird Care Shropshire since it was registered in October 2016.
Follow up: We identified concerns at this inspection. We will therefore re-inspect this service within the published timeframe for services rated requires improvement with two breaches.