21 July 2023
During an inspection looking at part of the service
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 provide 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.
Bluebird Care (Croydon) is a domiciliary care agency providing personal care to people living in their own houses and flats. The service provides support to older people, people living with dementia, people with disabilities and people living with a learning disability and/or autism. At the time of our inspection there were 35 people using the service.
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.
People’s experience of using this service and what we found
Right support
The provider had not always followed guidance for medicines management and people’s medicines had not always been administered safely. However, we found no evidence anyone had been harmed and during our inspection the provider told us they would review and improve their medicines management systems, processes, and procedures.
Accidents and incidents were recorded and reported. However, the provider had not regularly analysed and used the information to identify why things had gone wrong. This meant the process for learning lessons when things went wrong was less likely to be timely and therefore, less likely to be effective. The provider had taken action to improve the service and the care provided when something had gone wrong. During our inspection the provider said they would carry out accident and incident audits more regularly.
Infection prevention and control followed best practice guidance and we were assured the provider was responding effectively to risks and signs of infection.
The service followed the Mental Capacity Act (MCA) and supported people to make decisions in accordance with the principles of the MCA.
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
There were risk assessments and care plans in place for people and staff knew people and their needs and preferences well. However, at the time of our inspection people’s risk assessments did not include detailed and personalised information about their level of vulnerability to COVID-19. During our inspection the provider told us they would ensure people’s risk assessments contained the information required regarding their individual risk from COVID-19.
There was a sufficient number of staff to meet people’s needs and staff recruitment followed safer recruitment procedures.
People and their families said staff were caring, friendly and kind and respected their diversity, preferences and dignity.
There were systems and processes in place to safeguard people from the risk of abuse. Staff had received safeguarding training and knew how to recognise and report abuse and raise concerns. Safeguarding incidents and been reported appropriately and in a timely manner.
Right culture
Managers and staff were clear about their roles, they understood regulatory requirements and their duty to be open and honest with people when something went wrong. There were quality assurance systems in place and action was taken to improve the care provided when issues were identified. However, not all the provider’s audits were effective, as the provider had not identified the issues we found.
We have recommended the provider reviews their compliance systems and processes to ensure they are robust and always effective.
There was a positive and supportive culture that was person-centred, open and inclusive, which achieved good outcomes for people. The provider engaged and involved people, their relatives and staff in people’s care and the development of the service. Managers provided staff with a good level of support. People, their families, staff and managers spoke positively about each other and feedback from people and their families about the service was mostly complimentary.
There were systems and processes in place to support continuous learning and the improvement of the service and the care and support provided.
Staff worked in partnership with healthcare services, other professionals, local authorities and voluntary organisations to meet people’s needs.
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 (16 February 2018).
Why we inspected
This inspection was prompted by a review of the information we held about this service.
We undertook a focused inspection to look at the key questions Safe and Well-led. 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 to requires improvement based on the findings of this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Bluebird Care (Croydon) on our website at www.cqc.org.uk
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.