Bluebird Care (Norwich & North Norfolk)

Bluebird Care (Norwich & North Norfolk) is a domiciliary care service providing personal care to people living in their own homes. Not everyone who used the service 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. At the time of our inspection there were 47 people receiving the regulated activity of personal care.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

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.

Right Support: Model of Care and setting that maximises people’s choice, control and independence

People, relatives, and staff were asked their opinion about the service and were listened to. There was effective communication. There were enough staff and people did not experience late or missed calls. 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.

Right Care: Care is person-centred and promotes people’s dignity, privacy and human rights

People were supported to stay safe. Safeguarding concerns were identified and reported as required. Medicines were managed safely. Staff wore personal protective equipment and displayed good hygiene practices.

Right Culture: The ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives.

There was a positive culture. Staff felt well supported and enjoyed working for the service. There were effective governance systems in place. These helped identify any issues and actions were taken to develop and improve the service.

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 7 December 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

This was an 'inspection using remote technology'. This means we did not visit the office location and instead used technology such as electronic file sharing to gather information, and video and phone calls to engage with people using the service as part of this performance review and assessment.

At our previous inspection in August 2016, we found concerns in relation to the level of detail of guidance for staff in people’s care plans and the culture and communication between some office staff and people and care staff. We found that there had been an improvement in the quality of information in people’s care plans and these provided clear guidance to staff. The registered manager had taken steps with the introduction of new systems and processes to help drive improvement in communication between the office staff and people using the service. Following the most recent satisfaction survey the registered manager recognised further action was still needed to improve communication for some people; this was being fully reviewed.

Bluebird Care (Norwich and North Norfolk) is a domiciliary care agency that provides personal care to people living in their own houses and flats in the community. It provides a service to older adults. At the time of our visit 95 people were using the service.

Not everyone using Bluebird Care (Norwich and North Norfolk) receives a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

There was a registered manager at this agency who was supported by a deputy manager and other senior staff.

The registered manager had implemented an effective quality assurance system to monitor the standards of the service. The registered manager used feedback from people using the service, staff and others to drive continuous improvement.

Staff knew how to respond to possible harm and how to reduce risks to people. Lessons were learnt about accidents and incidents and these were shared with staff members to ensure changes were made to staff practise to reduce further occurrences. There were enough staff who had been recruited properly to make sure they were suitable to work with people. Medicines were administered safely. Staff used personal protective equipment to reduce the risk of cross infection to people.

People were cared for by staff who had received the appropriate training and had the skills and support to carry out their roles. Staff members understood and complied with the principles of the Mental Capacity Act 2005 (MCA). People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People received support with meals, if this was needed.

Staff were caring, kind and treated people with respect. People were listened to and were involved in their care and what they did on a day to day basis. People’s right to privacy was maintained by the actions and care given by staff members.

There was enough information for staff to contact health care professionals if needed and staff followed the advice professionals gave them. People’s personal and health care needs were met and care records guided staff in how to do this.

A complaints system was in place and there was information available so people knew who to speak with if they had concerns. Staff had guidance to care for people at the end of their lives if this became necessary.

Further information is in the detailed findings below

The service did not have a registered manager in place at the time of our inspection and has not had one since May 2016. A new care manager had been recruited who would be applying to become the 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 supported by staff who understood the risks people could face and knew how to make people feel safe. People were supported in a way that protected them from risks whilst maintaining their independence.

People were usually supported by a regular staff member or group of staff who they knew. People who required support to take their medicines received assistance to do so when this was needed.

People were provided with the care and support they required by staff who were trained and supported to do so. People’s human right to make decisions for themselves was respected and they provided consent to their care when needed.

People were supported to consume a sufficient amount of food and fluids that promoted their wellbeing. People received support from staff who understood their health needs.

People were treated with respect by staff who demonstrated kindness and understanding. People were involved in determining their care and support. They were shown respect and treated with dignity in the way they wished to be.

People could not rely on their plan of care containing all the required information to ensure their care and support was delivered as needed. People felt able to express any issues of concerns and these were responded to.

People used a service that did not have the benefits of consistent direction and management. Improvements were needed to the systems used to monitor the quality of the service.

People said they received the care and support they needed although staff sometimes were late getting to them and the office did not always ring to let them know this. We were also told by some people that they would prefer to have fewer different staff to visit them. One person said, 'each week it seems like a new face appears'. People had a copy of their care plan at home and they confirmed that reviews took place and any necessary changes to their care were made. We also saw that referrals were made to other providers of care and support as necessary and they were involved as required in the person's care.

The service had robust recruitment processes in place and good records were kept. We saw that staff were supported with appropriate training and regular supervision. Staff told us that they felt well supported in their role.

The service regularly monitored the quality of the service and we saw the results of the most recent satisfaction survey, including the action plan that had been developed as a result of the findings. People also told us they knew how to complain and felt confident they would be listened to. Complaint records were seen and showed that the service acted promptly to resolve any concerns people had.

Records were kept in good order and were stored securely. Computers were password protected and security locks fitted to all the main office doors. The service was able to access all the records we requested quickly and information within those records was easy to find. Entries in records were legible and clearly written.