Bloom & Care Limited

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• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

As part of this assessment, we looked at 7 quality statements for the key question of well-led. These were shared direction and culture, capable, compassionate, and inclusive leaders, freedom to speak up, workforce equality, diversity and inclusion, governance, management and sustainability, partnerships and communities and learning, improvement and innovation. Staff had an exceptional understanding of equality, diversity, and human rights, and they provided safe, high-quality, compassionate care. The management team were very experienced and had an excellent understanding of the key principles and focus of the service, based on the organisation’s values. The management and staff team demonstrated an open honest and transparent culture, and all staff were confident their voices would be heard. There was a strong organisational commitment and effective action to ensure there was equality and inclusion across the workforce. There were robust governance arrangements and staff understood their role and responsibilities. The management and staff teams worked in partnership with key organisations to support high quality care. There were processes in place to ensure that learning happened when things went wrong, and best practice guidance was sought and shared. The provider had a strategy in place to address environmental sustainability and was committed to ensuring this was embedded into the service.

This service scored 100 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The staff training, supervision and support systems fully enabled staff to progress within their roles, and to achieve their full potential. There was a shared commitment to all staff working cohesively with 1 shared goal. Staff had an excellent understanding of the provider's values and the vision of the organisation. One staff member told us, “They have come a long way. They started this company because they really care about providing the best care and that has continued. Look at us now. We all know the ethos is putting people first and that’s what we do.”

Staff were required to complete an equal opportunity form when they first commenced their employment. This was based on equality and diversity whilst highlighting people’s own protected characteristics and cultural backgrounds. Staff, families and people using the service completed a Key Lines of Enquiry (KLoE) survey which enabled them to engage in influencing management decisions through a survey format. Staff completed end of life training as part of their induction and any staff undertaking end of life care were always prompted to debrief any concerns and worries they may have.

The management team had the experience, capability and integrity to ensure the smooth running of the service and that risks were well managed. The registered manager and the nominated individual had completed extensive training aimed at aspiring leaders and managers in adult social care services to help them develop their leadership potential. Risk assessments addressed people's diverse needs. For example, people's specific needs around dementia and diabetes. Risk management plans were proportionate and centred around the needs of the person. They were regularly reviewed with other health care professionals, and they took note of equality and human rights legislation. Records demonstrated that strategies were in place to make sure that risks were known, anticipated, identified, and managed. The provider was committed to continually motivating the staff team and recognising their commitment to their role. For example, staff birthdays were recognised with gift vouchers and there was always a Christmas party where all staff could attend around their shifts. The minutes to staff team meeting showed these were very interactive which meant staff felt valued and included in the organisation.

Staff said the management team were excellent role models who actively sought and acted on the views of people. Comments from staff included, “This is the best company I have ever worked for. The managers are very professional which results in a lot of loyalty from staff. We always strive towards excellence because that’s the culture of this company.” And. “Both managers and senior staff are very caring. That shows through every aspect of this company.” Promoting independence, health promotion and safe risk taking were fundamental aspects of the ethos of care and support at all levels. The feedback, culture, and attitude of all the staff was that nothing was too much trouble; and everyone involved was willing to go above and beyond expectations to ensure people could have enriched and fulfilled lives. We received feedback from a healthcare professional involved in people’s care and support. They commented, “We have nothing but praise and admiration for [registered manager] and [nominated individual] in regard to the respect, inclusion, dedication and professionalism for their clients, company and staff. Our wish is that more companies offering care at home could emulate Bloom and Care. Just as the name suggests.”

Freedom to speak up was highlighted in the staff handbook which all staff had a copy of when they first commenced employment at Bloom and Care. Staff also had access to ‘SPEAK UP’ information via the whistleblowing policy and we saw it was discussed thoroughly in safeguarding training. Surveys were sent out to people and staff so that they could share their views on the organisation or raise any concerns. Records showed that during staff meetings/supervisions and appraisals staff were encouraged to speak up and be heard. Any information was acted on and respected. The provider had an electronic communication aid where staff could send private messages to management and to the Mental Health First Aider if they felt they needed to speak to someone for support. There was a ‘client guide’ that detailed ways in which people and their families could share their views or give feedback anonymously if required.

All staff we spoke with told us they were encouraged to speak up and this was always discussed in team meetings. One member of staff said, “The managers have created a culture where we are empowered and enabled to speak up and we know we will be listened to. Even if it’s a trivial little thing.”

Staff completed surveys so they could give their views and staff were also able to send feedback via the care app on their mobile phone. We saw from the minutes of the staff meetings they were fully informed of what was happening in the service and any incidents were shared for lessons learnt. There was a strong organisational commitment and effective action to ensure there was equality and inclusion across the workforce. There were preferred pronouns in the application forms and within people’s files. Action was taken swiftly to improve any disparities in the experience of staff with protected equality characteristics. For example, much of the training was carried out in-house which was always adaptable to suit the needs of the staff. An example of this was that a new staff member had a visual impairment and they requested that 2 colours were removed from the presentation so that they were able to participate accordingly.

The service had an open culture where staff had opportunities to share information, this culture encouraged excellent communication and learning, which achieved positive outcomes for people. A member of staff said, "We are always encouraged to speak up, to give our views and opinions. We are listened to, and our opinions are respected and acted on to make things better for our clients. This is the only service where I feel a proper part of the company." The registered manager told us, “Last summer 1 of our team members asked for ways of managing in the warmer weather due to a medical condition. We ordered Bloom & Care polo shirts that can be worn in line with infection control during warmer days. We also provided a team member with a shoulder fan that can remain in place between care visits.” Staff welcomed these ideas and felt that these small changes made a big impact during their shifts.

The provider had successfully embedded a very robust auditing system. This included regular internal audits in areas such as accidents and incidents, risk management plans, staff training, staff supervision, reviews of people's goals and recruitment records. Best practice was shared throughout the team, identifying what had worked well for each person, or what had not worked well. The provider completed a monthly risk rating system to monitor the levels of care. For example, where a person needed full support to take their medication this area of their care was rated red which highlighted this was a high priority. This was shared with all staff.

The registered manager informed us, “Leadership is key to the success of each of our staff members. Understanding what’s required of them in their role, with managers, seniors and champions becoming role models and attending training sessions to reinforce not only their responsibility as a manager/seniors and champions, but how to cascade this ethos down to the team.” The management team were highly committed to improving the service they provided and had introduced a number of initiatives to help make improvements. These included introducing champions within the care team for a variety of relevant subjects such as dementia, diabetes, infection, control and prevention, pressure ulcer, mental health, end of life, epilepsy, Parkinson’s and Mental Capacity Act champions.

The service was transparent, collaborative, and worked in partnership with key organisations to support care provision, service development and joined-up care. For example, the provider had worked very closely with the neurological rehabilitation team, when 1 person had become bedbound because of a health condition. With their support and training for staff, they worked closely with the person to support them in being able to walk again. The person was now able to live an independent life and access the community again with the support of their family. There were excellent avenues of communication with other health professionals such as the occupational therapist, district nurses, Tibbs dementia foundation, social workers and the palliative care nurse to ensure timely actions were taken when people required the support from different services.

The registered manager told us they were approached by the University of Bedfordshire to support student nurses in their practice placements, from February 2024. The service would be a practice placement for future, first year healthcare staff that meant the service would be able to share how care in the community was invaluable and best practice could be shared. The registered manager informed us how the service was very keen to become involved in the local communities. They were organising a cardiopulmonary resuscitation (CPR) training event during National Heart Month for anyone that wanted to learn how to do this. The event would also raise funds for a local special school and the National Heart Foundation. All staff training was in line with the recommendations of Skills for Care, and the provider had regular contact with their local Skills for Care representative who signposted them to appropriate training.

We received very positive feedback from health professionals involved in people’s care provided by Bloom and Care. One said, “They bring their own personal experience as well as professionalism to the client to provide the best possible care and are always open to suggestion, constructive criticism and forward thinking to benefit clients and staff alike.” Another commented, “Bloom & Care are easy to speak to and understand what support we need them to provide. We often speak to the managers who are nurses or their knowledgeable office team on a regular basis to make sure our patients are having the best care. Our patients that are cared for by Bloom & Care get the highest quality of care and you can tell even by their appearance that they are in good hands. All the staff that I’ve met from Bloom & Care are welcoming, professional and very caring and they really know the people they care for. From what we see in the local community they’re the company we’re always relieved to find out our patients are being supported by. We are not allowed to recommend care agencies but if I could it would always be them.”

There were processes in place to ensure that learning happened when things went wrong, and best practice guidance was sought and shared. A staff member told us, “In our team meetings we always discuss any accidents or incidents and what we can learn from them. They don’t happen often though which is good.” The registered manager informed us, “We use our nursing knowledge and access to services to innovate and teach our team when and when not to report to other services.” This helped staff know when support from other health professionals such as the Tissue Viability Nurse (TVN) or district nurse were needed.

The provider was extremely committed to improving the service they provided and had introduced a number of initiatives to help make improvements. These included introducing champions within the care team for a variety of relevant subjects to ensure staff were kept up to date and could gain support and advice when needed. There was a focus and importance placed on ensuring staff had the skills to do their jobs well with opportunities for continued learning and development linked to the needs of people. The provider embraced success and promoted good practice. For example, outside services, where possible, were invited to team meetings to provide up to date training and best practice guidance. This ensured that people’s care, treatment and support achieved good outcomes and was based on best available evidence. Supervisions and team meetings were used to openly discuss training needs and further training would be accessed if staff felt they needed it, which in turn better supported safe and effective practice.