Background to this inspection
Updated
6 July 2023
The inspection
We carried out this performance review and assessment under Section 46 of the Health and Social Care Act 2008 (the Act). We checked whether the provider was meeting the legal requirements of the regulations associated with the Act and looked at the quality of the service to provide a rating.
Unlike our standard approach to assessing performance, we did not physically visit the office of the location. This is a new approach we have introduced to reviewing and assessing performance of some care at home providers. Instead of visiting the office location we use technology such as electronic file sharing and video or phone calls to engage with people using the service and staff.
Inspection team
This inspection was carried out by 2 inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.
Service and service type
This service is a domiciliary care agency. It provides personal care to people living in their own homes.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was not a registered manager in post. A new manager had been in post for 1 week at the start of our inspection.
Notice of inspection
We gave the service 24 hours’ notice of the inspection. This was because we carried out the inspection remotely and needed to arrange an initial video call with appropriate people from the management team.
Inspection activity started on 24 May 2023 and ended on 9 June 2023.
What we did before the inspection
We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used all this information to plan our inspection.
The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make.
During the inspection
This performance review and assessment was carried out without a visit to the location’s office. We used technology such as video calls, telephone calls and emails to enable us to engage with people using the service and staff, and electronic file sharing to enable us to review documentation.
During the inspection we spoke with 5 people who use the service and 5 relatives about their experience of the care provided. We spoke with and obtained feedback from 10 members of staff including the manager and 9 support workers. We also spoke with the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.
We reviewed a range of records. This included 3 people’s care records, 3 staff recruitment files and medication records for 3 people. A variety of documents relating to the management of the service, including policies, audits and training records, were reviewed.
Updated
6 July 2023
About the service
Bluebird Care North East Lincolnshire & West Lindsey is a domiciliary care agency providing support to people living in their own homes. At the time of the inspection, the service supported 55 people.
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 the inspection, the service provided personal care to 41 people.
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 support anyone whose primary need was 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: Records did not assure us that staff supported people with their medicines safely. Medicine records were not always clear, accurate or complete. On 2 occasions the provider had not been able to attend a series of calls due to staffing issues. The provider had recruited and told us contingency plans were in place, they had sufficient staff to cover the care packages and were actively reviewing the care packages and staffing levels. Risks to people were generally assessed, monitored, and managed. People were supported to build relationships and take part in activities.
Right Care: Staff understood how to protect people from poor care and abuse. Staff had training on how to recognise and report abuse and they knew how to apply it. However, oversight and records in this area were not always robust and we have made a recommendation about this. People were asked how they liked to be supported with communication and what their preferred method of contact was. People’s support plans were person-centred. People were generally happy with the care workers and described them as ‘kind’ and ‘caring’.
Right Culture: Quality assurance systems were limited, and actions were not always implemented following audits. Staff morale was low, and staff did not always feel supported or listened to. The provider informed us one of the directors would spend a number of days at the location to be available to speak with staff, provide reassurances and address any concerns they may have. Some people were anxious about whether the service would be able to continue to meet their needs. We have made a recommendation about this. Staff involved people with their support plans and liaised appropriately with professionals.
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 outstanding (published 11 December 2018).
Why we inspected
We received concerns in relation to staffing, the quality of care, the ability of the service to respond to people’s needs and the governance of the service. As a result, we undertook a focused inspection to review the key questions of safe, responsive, and well-led only.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service has changed from outstanding to requires improvement based on the findings of this inspection.
We have found evidence that the provider needs to make improvements. You can see what action we have asked the provider to take at the end of this full report.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Bluebird Care North East Lincolnshire & West Lindsey on our website at www.cqc.org.uk.
Enforcement and Recommendations
We have identified breaches in relation to staffing, record keeping and oversight at this inspection.
We have made a recommendation about the management, recording and oversight of safeguarding concerns. We have made a further recommendation about ensuring people's needs are met.
Please see the action we have told the provider to take at the end of this report.
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.
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.