Bluebird Care East Devon

Updated 12 July 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check 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 comprehensive inspection took place on 8 and 9 May 2018. This inspection was announced and took place over two days. We gave the provider 48 hours' notice because the location provides a domiciliary care service and we needed to make sure the provider and registered manager would be available for the inspection. It also allowed us to arrange to telephone and visit people receiving a service in their own homes.

The inspection team comprised of an 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 services for older people.

Prior to the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We reviewed the information included in the PIR along with information we held about the service, such as feedback we received from health and social care professionals and notifications. A notification is information about important events which the service is required to send us by law. This enabled us to ensure we were addressing any potential areas of concern.

Prior to the inspection we sent 40 questionnaires to people, and received 10 replies. We sent 40 questionnaires to relatives/friends, and received five replies. We sent 28 questionnaires to staff and received seven replies. We sent four questionnaires to community professionals and received one reply.

During the inspection we visited a person in their own home and spoke by telephone to six people and three relatives to seek their views about the service. We looked at three people's care records and at their medicine records. We spoke with the provider, registered manager and with 10 staff which included care and office staff, care supervisors, training manager and marketing manager. We looked at five staff files which included details of recruitment, training, supervision and appraisals. We also looked at staff meeting minutes, staff training records, accident and incident reports, and at complaints and compliments. We also looked at the provider’s quality monitoring systems which included audits of medicines, care records and at ‘spot checks’ where senior staff monitored care staff providing care in people's homes.

We sought feedback from commissioners, and health and social care professionals. We received a response from two of them.

Updated 12 July 2018

This comprehensive inspection took place on 8 and 9 May 2018 and was announced. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure the registered manager would be available for the inspection. It also allowed us to arrange to telephone and visit people receiving a service in their own homes. This was the first inspection since the provider registered at their new address in Honiton in January 2017.

Bluebird Care East Devon is a domiciliary care agency. It provides personal care to older adults and younger disabled adults in Honiton, Ottery St Mary, Sidmouth, Seaton, and surrounding areas. The provider is W & S Flint Services Limited, a husband and wife team who runs three branches of the agency in the Devon area. At the time of the inspection the branch provided personal care to about 42 people and employed 40 staff, known as Devon Bluebirds.

The inspection was carried out by an 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 services for older people.

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.

People and relatives praised staff as exceptionally caring and compassionate. People were partners in their care. Their views, experience and contributions were sought and valued. The agency had a strong, visible person centred culture. People were at the heart of everything they did, they were made to feel valued and that they mattered. The service went that extra mile to exceed people’s expectations of the service. For example, they held a monthly wellbeing programme to get people out socialising, having new experiences and having some exercise. Feedback showed this significantly improved people’s physical and emotional wellbeing and reduced their risk of isolation.

People were supported in innovative ways, to be proactively involved in making decisions about their care, treatment and support. For example, the provider undertook a ‘Talk Care’ campaign to promote a conversation about care that was positive, informative, open-minded and inclusive. They made a series of informative short videos of conversations with health and social care representatives to highlight key things people needed to know about care. These included the importance of planning ahead for care, options for care, and simple explanations about lasting power of attorney, benefits and paying for care. These were posted on social media which enabled people and families to be better informed about care options and what was important in planning their care.

The service had embraced the possibilities of using technology in innovative ways to improve the quality of people’s care and to enable them to stay living at home for longer. The service had explored possibilities of using sensor technology by working with a specialist provider to pilot its use to assist families to support and monitor a person’s wellbeing. For example, data about frequent trips to the bathroom highlighted early signs of a urine infection for one person. This led to them being seen earlier by their GP and antibiotic treatment started, which helped them recover more quickly. An electronic computer record system meant staff could read new people’s care records before they visited, and follow up any health concerns. The system quickly highlighted when a person’s needs changed, so their care needs could be reviewed. Other benefits included health professionals and relatives being able to access parts of the system, with the person’s consent.

The service worked in partnership with local health and social care providers to respond to the changing needs of local people. For example, they participated in a pilot project to enable people to be discharged home from hospital as soon as possible. They also worked with other services to train staff in health promotion. Currently they were working with a local GP to identify new ways to support health professionals to improve healthcare of people they supported. For example, through staff undertaking health monitoring checks such as blood pressure, weight and monitoring oxygen levels for people with chronic lung conditions to report them to the person’s GP.

People experienced a personalised level of care and support that promoted their physical and mental wellbeing and enhanced their quality of life. People praised the exceptional skills of staff who supported them. A training manager had developed a comprehensive flexible training programme for staff that reflected various learning styles. They worked collaboratively with professionals to deliver bespoke training to meet individual health needs. A staff member was a ‘Dementia Friends’ champion to provide information and practical tips to encourage other staff to make a positive difference to people living with dementia.

People received a consistently high standard of care because the service used evidence of what works best to continually review and improve their practice. For example, by using The Social Care Institute for Excellence (SCIE) and National Institute for Health and Care Excellence (NICE) guidelines. People and relatives spoke about the exceptional quality of care provided by staff at Bluebird Care East Devon and recommended the service to others. Staff were highly motivated, enthusiastic and were proud to work for the agency. The registered manager set high expectations of staff and was a role model. A provider award scheme recognised, re-enforced and rewarded positive staff values, attitudes and behaviours. For example, through ‘Carer of the month’ and ‘Carer of the year’ schemes.

The provider had robust quality monitoring arrangements through which they continually reviewed evaluated and improved people's care. A range of awards showed the service was consistently high performing.

Personalised risk assessments provided comprehensive guidance for staff, who were vigilant in identifying risks and took steps to reduce them. People received their medicines safely and on time from staff who were trained and assessed to manage medicines safely. Staff were trained to be aware of signs of abuse and were encouraged to report concerns, which were investigated. A robust recruitment process was in place to make sure people were cared for by suitable staff.

People were asked for their consent and staff acted in accordance with their wishes. Where people appeared to lack capacity, mental capacity assessments were completed and involved the person, their family and professionals in best interest decision making.

Complaints, concerns and feedback were taken seriously and used as an opportunity to improve the service. The registered manager had informed the CQC of significant events. Record systems were accurate, well maintained and kept securely.