Bluebird Care (Canterbury and Thanet)

Bluebird Care (Canterbury and Thanet) is a domiciliary care agency which provides care and support to people living in their own homes. Support calls varied from a 15 minute welfare check to live-in care. Not everyone who used the service received personal care. The Care Quality Commission (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 75 people were receiving personal care.

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

People told us they felt safe being supported by staff from Bluebird Care. People were protected from abuse, discrimination and avoidable harm. Staff recognised signs of abuse and knew how to report concerns. They were confident the right action would be taken to keep people safe. Risks to people’s health and well-being were assessed, monitored and regularly reviewed. Action was taken to keep risks as low as possible whilst respecting people’s freedom and choices. People continued to be supported by staff they knew and who had been recruited safely. People were supported to have their medicines on time and safely and were encouraged to manage their own medicines safely.

People’s health and social care needs were assessed and regularly reviewed. Records were kept up to date with any changes to people’s needs or preferences. Staff completed regular training to make sure they had the skills and knowledge to support people. People were encouraged to have a healthy and balanced diet and to drink enough. People were supported with appointments to their GP when needed. Staff worked with health care professionals, such as community nurses and occupational therapists, to make sure people remained as healthy as possible. People were supported to have maximum choice and control of 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 practice.

People received care that was tailored to their individual needs. People told us they were treated with kindness. One person said, “They are kind and polite. I would say they are respectful”. A relative commented, “Every single one of the girls are smashing. We have a laugh and always have a chat. At my age having a sense of humour is really important”. People were encouraged to remain as independent as possible. People and their relatives were involved in the assessment, management and reviewing of their care. When people were unable to make decisions for themselves, the provider arranged for them to have support to make decisions. People knew how to complain but did not have any complaints about the service they received. Staff worked with health care professionals to support people at the end of their life to have a comfortable, dignified and pain free death.

The provider and registered manager worked cohesively with the staff team. They promoted an open and transparent culture where everyone was valued. Regular effective audits and checks on the competency of staff were completed to make sure people received a high quality of care and support. The service engaged with the local community. People were regularly asked to feedback about their experiences of using the service, so the provider could continue to drive improvements.

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 22 December 2016)

Why we inspected

This was a planned inspection based on the previous rating.

Bluebird Care (Canterbury and Thanet) provides care and support to a wide range of people living in their own homes including, children, older people, people living with dementia, and people with physical disabilities. The support hours varied from 24 hours a day to a half hour call and from one call to four calls a day, with some people requiring two members of staff at each call. At the time of the inspection 53 people were receiving care and support from the service.

A registered manager was leading the service, supported by the provider. 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.

People told us that staff were “very caring” and “fantastic”. One person’s relative told us, “Nothing's too much trouble for the staff who visit my relative”. Everyone we visited told us the service they received from Bluebird Care helped them to stay at home, which was where they wanted to be. People had been asked about their care preferences at the end of their life and staff had worked with community nurses and hospice staff to support people who wanted to remain at home.

Staff and the provider shared a commitment to treat people with dignity and respect at all times and support them to be as independent as possible. It was their philosophy to 'do with, not do for'. People told us staff demonstrated these values when they provided their care and support. Staff went ‘the extra mile’ to provide compassionate care to people and support them when they were upset or worried.

The registered manager and other senior staff supported staff to provide a good standard of care and held them accountable for their practice. Staff were clear about their roles and responsibilities and were highly motivated to provide the support and care that each person wanted. Checks on the quality of the service people received were completed every month to make sure they were of the standard the people and the provider required. Action was taken quickly to address any shortfalls found.

People told us they had regular carers who knew them well, and provided their care in the way they wanted. People's age and personality had been considered when deciding which staff provided people’s care. Staff worked as a team and provided cover for sickness or holidays.

Recruitment systems were robust. Checks, including criminal records checks had been completed to make sure staff were honest, trustworthy and reliable. Staff had completed the training and development they needed to provide safe and effective care to people and held recognised qualifications in care. Plans were in place to regularly refresh staff’s skills and further develop them in their role. Senior staff met regularly with staff to discuss their role and practice.

Staff knew the signs of possible abuse and the registered manager had raised any concerns they had with the local authority safeguarding team. People's care was planned and reviewed with them to keep them safe and help them be as independent as possible. Possible risks to people had been identified and action had been agreed with people to keep them safe, while supporting them to be independent.

Assessments of people's needs had been completed to identify any changes. Detailed guidance was provided to staff about how to meet people's needs as soon as they began to use the service. People's care plans had been reviewed with people and their relatives and changed when people's needs changed.

Accurate records were maintained about the care and support people received and about the day to day running of the service. Information was available to staff to help them provide safe and consistent care to people.

Staff supported people to continue to take part in activities they enjoyed. For example, staff obtained one person’s favourite books on CD when they found reading difficult.

Staff supported people who needed help to take the medicines they needed to keep them safe and well. Staff recognised changes in people's health supported them to contact their health care professionals.

Staff helped people who asked for support to prepare the meals, snacks and drinks wanted in the ways they preferred. They made sure food and drinks they left for people were within their reach.

Staff followed the principles of the Mental Capacity Act 2005 (MCA) and supported people to make choices in all areas of their support.

Systems were in place to manage complaints received. People and their representatives were confident to raise concerns and complaints they had about the service. They told us that any concerns were addressed quickly to their satisfaction and did not occur again.

People, their relatives and staff were asked for their views of the service regularly. Their feedback had been used to improve the service offered.

Is the service safe?

The service was safe. Practices in the service protected people using the service, staff and visitors from the risk of harm. One person told us, 'I feel very safe, I never have any troubles with them, I trust them all'.

Systems were in place to make sure that managers and staff learned from complaints, whistleblowing and investigations. This reduced the risks to people and helped the service continually improve.

People using the service were protected from infection because the provider had processes in place to assess the risks to them and manage these effectively.

Each person had a care plan detailing their care and support needs. These had been re-written since our last inspection and contained guidance for staff to follow to provide effective care and reduce risks to make sure people were as safe as possible.

Is the service effective?

The service was effective. People told us that they were happy with the care that had been delivered and that their care needs were met. One person we spoke with told us, 'I would give the service 9/10'. People and their relatives told us that staff arrived on time and stayed for the agreed length of time. One person told us, 'If they finish early they sit and chat to my relative'. Another person told us 'They are usually on time but if they are 10 minutes late they leave 10 minutes later'. Everyone we spoke with said that they were informed if the staff would be late arriving at their home.

People's health and care needs were assessed with them and /or their representatives. We found that people's care plans had been re-written with them and their representatives since our last inspection and reflected their current needs.

Is the service caring?

The service was caring. People and their relatives told us they were supported by kind and caring staff. One person's relative told us, 'My relative is a very private person. The staff have brought them out of their shell and now they chat and joke together'. People we spoke with said they felt staff respected their privacy and dignity and staff were polite and caring.

Is the service responsive?

The service was responsive. People told us that they were happy with the service. Some people told us that they had raised concerns with the service about specific issues and they had been addressed immediately.

We found that people's planned care had changed when they required it or as their needs changed. Emergency and contingency plans were in place and available to staff to support them to respond quickly to changes such as staff illness and changes in people's health needs.

Is the service well-led?

The service was well led. There was a clear management structure in place quality assurance processes were in place. Staff told us they were clear about their roles and responsibilities and that they felt supported by the management team. Systems were in place to ask people who used the service, relatives and staff for their views about the service. Regular, unannounced spot checks were completed to assess the quality of the care being provided to each person.

People felt they were able to make their own decisions and choices regarding their day to day care and support. People confirmed that they had given their consent and been involved in discussions about their care, sometimes with a family member, when the service had first started.

Most people said they were satisfied with the care and support they received. One person said, "I think Bluebird Care are very good, much better than the last agency I used. ' Another person said, "They are efficient and caring, nothing is too much trouble'.

Two people told us that when there had been a few concerns when they first started to use the service. They had contacted the office and immediate action was taken to rectify the issues.

We found that care plans contained information about some of the support and care that people needed but lacked detail about people's specific needs like the risk of developing pressure areas or when people had specific medical conditions like diabetes

People knew about their care plan or confirmed that staff had talked about the care and support they required. Care was delivered by a regular team of care workers to ensure people had continuity. One person said, "I know most of them, I usually get the same staff'.

People said that they felt safe when care staff were in their homes. Policies and procedures were in place to safeguard people from harm and abuse. Everyone we spoke with said they felt safe when care staff were in their homes. People said that they trusted the care staff and said that their privacy and dignity was always respected.

Checks were made on staff, as part of the recruitment process, to make sure that people were safe and supported by appropriate people.

People said they had been asked for their views and feedback on the service provided. One person said, "They visit regularly and go through it all, the care plan and whether the staff wear their gloves etc." People told us they felt confident that any concerns would be addressed. There were systems in place to monitor the quality of the service.

People's needs were assessed before a service was provided and people were involved in planning their care and support on an on going basis.

People knew when staff would call on them and who was coming. They told us that they felt safe with staff and were treated with respect and dignity.

Everyone we spoke to said that the service they received was good. One person said, 'I would give them top marks'.

One staff member told us, 'The best thing about this service is that we get the time we need to meet peoples needs and are not rushed to get to the next person'.

You can see our judgements on the front page of this report.