Bluewood Care Limited

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

At our last inspection, the provider was in breach of regulation as the provider had failed to assess and manage risks associated to people’s care. The service had made improvements and is no longer in breach of regulations. However, the improvements made needed to be sustained and embedded to ensure the safety of people. Individual and environmental risks were assessed and regularly reviewed. People received their medicines safely, when needed, by staff trained in medicines management. People told us they felt safe. There were sufficient staff available to meet people’s needs and staff were recruited safely. Where accidents or incidents had occurred, action was taken to reduce the chance of reoccurrence and any learning was shared with the staff team.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and relatives spoke positively about the changes made following the last inspection and told us they were happy with the service provided. One relative said, “I feel the manager listened to my concerns and together we resolved them.”

Staff told us they enjoyed working at the service and were positive about the improvements made, describing the management team as supportive. Staff felt able to raise any concerns and were confident action would be taken. Staff received training suitable to their role to meet people’s needs safely. However, some staff had not retained all of the knowledge and skills from training, for example first aid skills. Other staff were able to demonstrate a good knowledge and demonstrated an understanding of how to monitor a person’s health and the importance of reporting any changes to the appropriate healthcare professional. The management team understood the need to be open and honest when things went wrong in line with their responsibilities under the duty of candour.

Improvements had been made to improve the safety and managerial oversight of the service following our last inspection which demonstrated lessons had been learnt. However, further time was needed to ensure these processes are fully embedded and sustained. Staff recorded accidents and incidents, and these were reviewed by the management team to identify any trends or patterns so actions could be taken to mitigate emerging risks. Any lessons learnt were discussed in team meetings.

People told us staff supported them to meet their health needs. One person said, “Staff fully understand my needs and support me to the GP and other healthcare appointments as needed.”

Staff worked in partnership with other healthcare professionals such as GP’s, mental health teams and district nurses. This supported people’s health and wellbeing.

Feedback shared by healthcare professionals who worked closely with the service was “They have made significant progress since the last inspection.”

Processes were in place to ensure people were supported by a consistent team of staff, overseen by a team leader. Staff knew people well and demonstrated a good understanding of people’s needs, working closely with health and social care professionals to ensure the person achieved good outcomes.

People and relatives felt safe with staff. One person said, “I am happy with the service and feel safe with the staff. They are all good and I have a consistent team.” A relative told us, “I feel [Person] is safe with the staff.” People knew how to raise concerns if they had any.

Staff understood their responsibilities to keep people safe. One staff member said, “I would report any concerns to the managers immediately.” The registered manager had made appropriate alerts to the Local Authority (LA) and Care Quality Commission (CQC).

Care records viewed during our assessment did not clearly inform staff if people had capacity to make day to day decisions for themselves. Despite this oversight staff were aware of this important information. Staff were up to date with their safeguarding training and the registered manager had a process in place to monitor staff training. The management team understood their responsibility to report any concerns to the LA and to CQC to ensure any allegations or suspected abuse were investigated. There was a safeguarding policy in place to provide guidance for staff on how to report any concerns.

People said staff supported them to help manage risks related to their care. One person said, “Staff monitor my catheter and help with my oxygen when I feel I need it.”

Staff spoken with understood the risks associated with people’s care. For example, staff described how they supported a person to monitor their blood oxygen levels and knew when to administer oxygen and to report any concerns to the GP. Risk management had improved since the last inspection and risks associated with people’s care were assessed. One staff member told us “The information in the risk assessments has definitely improved they are more detailed now.”

The management of risks associated with people’s care needs had clearly improved since the last inspection. Risk assessments were in place to inform staff how to provide safe care and were regularly reviewed alongside the multidisciplinary team (MDT). However, we identified a known risk which had not been fully assessed. When we raised this, the registered manager took immediate action to address this shortfall. People who wished to book their own health appointments were supported to do so. This was monitored by staff to ensure any risks and concerns were not missed and people continued to achieve good outcomes.

People told us they had the equipment they needed in their home and staff supported them to ensure it was safe and well maintained.

Environmental risk assessments had been completed with people to ensure their homes were well maintained and free from hazards. Guidance was in place for staff to follow on how to check equipment prior to use to ensure it was safe and in good working order. Records held information on how to report any faults with the equipment to either the manufacturer or relevant healthcare professional so they could be resolved promptly.

People told us staff were “Kind, caring and polite”. One relative said, “Staff are very good, and some will go the extra mile to help”.

Staff told us they received training and support appropriate for their role. One staff member told us, “I enjoy working here, I think it’s a good organisation”. Another said, “I think the managers are supportive and we have enough staff to cover the shifts”.

Rotas demonstrated staffing levels were maintained and people were being supported by a consistent staff team. Agency staff were not used by the provider. Staff were recruited safely. The provider sought references and completed DBS checks. Disclosure and Barring Service (DBS) checks provide information including details about convictions and cautions held on the Police National Computer. The information helps employers make safer recruitment decisions. Records viewed showed staff were up to date with their training.

People and relatives told us staff supported them to reduce the risks of infection. One person told us, “Staff wear gloves and aprons when supporting me with personal care”.

Staff had completed infection control training and demonstrated an understanding of how to reduce the risks of infection. Staff told us, “Personal protective equipment (PPE) was always available for staff to use to help keep us and the person safe”.

Following our last inspection guidance was now in place to ensure people’s specialist equipment such as oxygen therapy was thoroughly cleaned to reduce the risks of bacteria growth in face masks and delivery tubing. The management team carried out competency checks to ensure staff carried out their duties in line with their training and best practice.

People confirmed they received their medicines as needed.

Staff told us they received medicines training and were assessed as competent before supporting people with their medicines.

Some guidance in place needed to be more detailed to provide staff with clear directions on how to support people take their medicines safely. For example, we identified guidance for prompting a person to self-administer their medicines needed to be more robust. When we raised this, the registered manager took immediate action to address this shortfall. People had regular reviews of their medicines to ensure they were prescribed the most effective medicines to support their health and wellbeing. Medicine records viewed were fully completed and demonstrated people were receiving their medicines as prescribed. Records showed staff had received medicines training and their competencies were regularly checked.