The Care Quality Commission
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Bluebird Care (Eastbourne & Wealden)

Overall: Good read more about inspection ratings

Suit 4, The Workshop, 20 Wharf Road, Eastbourne, BN21 3FG (01323) 727903

Provided and run by:
Holly Rise Consultants Ltd

All Inspections

During an assessment under our new approach

The service is a domiciliary care agency providing support to adults of all ages including those living with dementia. Not everyone being supported 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. There were 28 people who were being supported with personal care.

This assessment was undertaken to review any improvements from the last inspection completed October 2024 when it was rated requires improvement with 3 repeated breaches to regulation and enforcement action was taken. A condition to their registration was imposed to require evidence of governance to be sent to the CQC on a monthly basis.

The provider was previously in breach of the legal regulations related to good governance, safe care and treatment and safeguarding. Significant improvements were noted at this assessment; this meant the provider was no longer in breach of these regulations and the service has been rated Good.

The service now had a registered manager who had established effective governance procedures that provided clear oversight for the provider and management team. Concerns identified at the last inspection had been actioned with monthly reports submitted to the CQC to document. Audits were completed and included the review of care plans and risk assessments. Care plans were reviewed and updated regularly. Staff were clear on their roles and responsibilities, and this had improved staff accountability. Appropriate records had been completed to record concerns, complaints and incidents, showing these had been responded to appropriately. When necessary, referrals and advice was sought from other agencies and documented.

Staff worked with other professionals promoting good outcomes for people. People were involved and consented to care and support provided. People were treated as individuals and encouraged to be independent. Staff were kind and compassionate and enjoyed working with people. Staff well-being was promoted by their managers. People and relatives knew how to raise concerns and were confident they were acted on. People received fair and equal care and support was provided in a tailored and flexible way.

Staff and people benefited from an open and positive culture that had been developed by the registered manager. People were supported by a team of staff who knew them well and worked well together. Staff felt valued, undertook regular training and received supervision.

 

During an assessment under our new approach

Date of Assessment: 28 October to 11 November 2024. The service is a domiciliary care agency providing support to adults of all ages including those living with dementia. This assessment took place to follow up previous enforcement action we had taken. We found 3 on-going breaches in regulation in relation to safe care and treatment, safeguarding and governance. The service did not have robust quality assurance processes in place. Audits were lacking and those which had been completed, did not identify the concerns found during the assessment. Care plans contained conflicting or inaccurate information which placed people at risk of harm. Reviews had not been regularly completed and guidance to staff was not consistent. Risks had not always been documented in enough detail to ensure people were supported to minimise these. The service did not have a registered manager, and oversight from the provider was lacking. This led to the concerns identified at the previous inspection not being resolved. It was not always clear that appropriate referrals had been made to external bodies, such as the safeguarding team. We identified incidents which should have been reported and had not. Where referrals had been made to other professionals, such as district nurses, it was not always documented whether these visits had taken place, or what advice had been given for staff to follow.

Although care plans contained conflicting information about care needs, they had been improved in relation to people’s personalised wishes. Consent was also clearly documented, and we saw evidence of staff delivering care in line with people’s wishes. Enough improvement had been made to meet the previous breaches in relation to need for consent and person-centred care.

In instances where CQC have decided to take civil or criminal enforcement action against a provider, we will publish this information on our website after any representations and/or appeals have been concluded.

25 November 2022

During an inspection looking at part of the service

About the service

Bluebird Care (Eastbourne and Wealden) is a domiciliary care agency and provides personal care to people living in their own homes. Not everyone using Bluebird Care (Eastbourne and Wealden) received personal care. People that were being supported had a range of needs such as Dementia, physical disabilities and older people.

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, the service was supporting 25 people.

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

Safeguarding concerns had not been reported to the local authority to help protect people from harm or abuse. Staff knew how to look out for signs of abuse however, training had not been completed in some time and not all staff knew where to report concerns.

Risks to people were not well managed. Risk assessments were out of date and assessment tools were not appropriately used to help assess and monitor risk.

Medicines were not managed safely. Gaps were found in people’s electronic medicine administration records. Where medicines were discontinued by the GP records were not updated. People’s care plans were not kept up to date when changes had been made to their care calls. This left people at risk of not receiving their medicines as prescribed.

Staff were recruited safely. However, a high level of agency were being used in particular to cover live in care calls. We received mixed feedback regarding the agency workers. We were also concerned about how agency staff were monitored and where incidents had occurred, lessons had not been learnt. Staff had not received up to date training and not all supervisions had been carried out.

People had their needs assessed before receiving care. However, care plans were not regularly reviewed and kept up to date. People who were receiving care and support from district nurses did not have wound care plans in place. Guidance for staff was not clear as to what support people required. Positive behaviour support plans were not in place for people where incidents had occurred. Staff were not given the tools to help support people in a positive way.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

Quality assurance processes were not effective in identifying concerns found on the inspection. Audits had not always been carried out and where they had, issues were not picked up and addressed. Under the previous provider, there had been a lack of provider oversight at the service and the registered manager had not received much support. The provider had recently changed and had already been more visible in the service.

At the time of the inspection, the location did not care or support for anyone with a learning disability or an autistic person. However, we assessed the care provision under Right Support, Right Care, Right Culture, as it is registered as a specialist service for this population group.

People told us staff were kind and caring. People gave us examples of how staff promoted their independence and respected their privacy and dignity.

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 17 May 2018).

Why we inspected

The inspection was prompted in part due to information we had received about the service.

Enforcement and Recommendations

We have identified breaches in relation to person-centred care, consent, safe care and treatment, safeguarding and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

27 March 2018

During a routine inspection

This announced inspection took place between 27 March and 10 April 2018. The office visit took place on 6 April 2018.

Bluebird Care (Eastbourne and Wealden) is a domiciliary care agency and provides personal care to people living in their own homes. It provides a service to older adults, people who lived with dementia, people who lived with learning disabilities and younger adults with physical disabilities. At the time of the inspection, the service was supporting 40 people in Eastbourne and Wealden. Not everyone using Bluebird Care (Eastbourne and Wealden) receives regulated activity; CQC only inspects the service being received by people provided with 'personal care'; help with tasks related to personal hygiene and eating and drinking.

At the last inspection in June 2015, the key question of effective required improvement as staff needed to gain more confidence and understanding of the Mental Capacity Act 2005 (MCA). The key questions for safe, caring, responsive and well led were rated good and there was an overall rating of good. Staff had received further training in MCA and were now fully confident in how to gain consent and the key question effective that required improvement is now rated good.

There was a registered manager in post. 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 they were very satisfied with the care and support that Bluebird Care (Eastbourne and Wealden) provided.

People who used the service had the capacity to make decisions about what they did and the choices they made. People were supported to have choice and control of their lives and staff enabled people in the least restrictive way possible: the policies and systems supported this practice.

There were systems in place to protect people from harm, including how medicines were managed. Staff had been trained in how to recognise and respond to abuse and understood their responsibility to report any concerns to the management team. Safe recruitment processes were followed and appropriate checks had been undertaken, which made sure only suitable staff were employed to care for people.

Risks to people's safety were assessed and managed to keep them safe. They were supported by sufficient numbers of a well-trained staff group who arrived on time and supported them in the time allocated in their care package. People who received medicines were supported in a safe way as staff had had the necessary training to administer medicines safely. They were protected from the risks of infection through good working practices by staff.

People's care was delivered in line with legislation and evidenced based practice. People who used the service had the capacity to make decisions about what they did and the choices they made. People were supported to have choice and control of their lives and staff supported people in the least restrictive way possible: the policies and systems supported this practice. Staff received regular training in all aspects of their role and received regular supervision from the registered manager. Where people were supported with their nutritional needs, staff showed a good awareness of their dietary needs and where to get further support should this be required. Staff worked with people, their relatives and health professionals to manage people's health needs, making appropriate referrals for individuals when necessary.

People who used the service felt they were treated with kindness and said their privacy and dignity was respected. Staff had an understanding of legislation designed to protect people’s rights and were clear that people had the right to make their own choices.

Care plans provided comprehensive information about how people wished to receive care and support. This helped ensure people received personalised care in a way that met their individual needs.

Staff felt supported by the registered manager and could visit the office to discuss any concerns. There were systems in place to monitor the quality and safety of the service provided. Accidents and incidents were monitored, analysed and remedial actions identified to reduce the risk of reoccurrence.

12 June 2015

During a routine inspection

This inspection took place on 12 June 2015 and was announced. We gave the provider 48 hours’ notice. Bluebird care (Eastbourne & Wealden) is a domiciliary care agency that provides personal care to people in their own homes. At the time of inspection there were 29 people using the service.

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 were asked for their consent appropriately. The registered manager and staff had a basic understanding of the Mental Capacity Act 2005 (MCA). This legislation provides a legal framework for acting and making decisions on behalf of adults who lack the capacity to make decisions for themselves. The registered manager had taken action to ensure they developed their own and staff members knowledge of the MCA.

There were enough staff to meet people’s care needs and staff had regular training, supervision and appraisal to support them. Staff said: “I’m really impressed with the level of training” and “the training is brilliant”. All of the appropriate pre-employment checks had been completed before staff began working for the provider.

People who used the service told us they felt safe. One person told us: “I feel very safe with my carers. They always turn up on time and stay for the full time.” Staff knew how to recognise the signs of abuse and what to do if they thought someone was at risk. Risk assessments had been completed and plans to manage identified risks were in place. People were supported to take their medicines safely when needed.

Incidents and accidents were thoroughly investigated and action taken to reduce the risk of them being repeated. The registered manager and staff understood the importance of learning from incidents so they could make improvements to the service.

People were supported to eat and drink enough and staff knew what to do if they thought someone was at risk of malnutrition or dehydration. People’s day to day health care needs were met.

People gave us very positive feedback about the care they received. Comments included: “They are very caring and I am very fond of two of them because they treat me like a member of their family” and: “The care is excellent”. People were able to express their views and preferences about their care and these were acted on. People were treated with respect and their privacy was protected.

People’s care needs were regularly assessed and people and those important to them were involved in making decisions about their care. People knew how to make a complaint or raise concerns with the registered manager and told us these were acted on when they did so. There was an appropriate complaints system in place and any complaints had been thoroughly investigated.

The provider carried out regular audits to ensure they were meeting the requirements of the regulations. People were asked for their feedback about the quality of the service, and where areas for improvement were identified appropriate action was taken.

The registered manager knew the people who use the service well and was aware of the attitudes and behaviours of staff. People said there was good communication with the service and it was well managed. All of the registrations requirements were met and records were good.