Archived: Bluebird Care (Enfield)

The service had 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 2008 and associated regulations about how the service is run.

The service helped people to stay safe. Staff knew about abuse and how to report it and other incidents or accidents which took place. Risks to people were regularly assessed and there were systems in place to ensure there was enough staff to meet people's needs.

People were supported to take their medicines safely and in accordance with the prescribed instructions. Staff members received the training, support and development opportunities they needed to be able to meet people's needs.

People had a care plan that provided staff with direction and guidance about how to meet their individual needs and wishes. Assessments were carried out to identify any risks to the person using the service and to the staff supporting them. This included any environmental risks in people's homes and any risks in relation to the care and support needs of the person. People told us they were involved in decisions about their care and were aware of their care plans.

Staff had been recruited safely, received on-going training relevant to their role and supported by the registered manager. They had the skills, knowledge and experience required to support people in their care. Staff were knowledgeable about the people they cared for and responded appropriately as people's needs changed.

Staff spoke positively about the people they supported and were motivated to provide an individualised service in line with people's needs and goals.

People confirmed there was a stable staff team and that care was provided by familiar faces. Staff told us that travel times were sufficient, so they were not rushed.

People's feedback about their experience of the service was positive. People said staff treated them respectfully and asked them how they wanted their care and support to be provided. People told us they had their care visits as planned. Staff mostly arrived on time and stayed for the allotted time. Nobody reported any recent missed visits.

Staff wore protective clothing such as gloves and aprons when needed. This reduced the risk of cross infection. Supplies were available around the building for staff to use when they needed them.

People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible. People’s views on the service were regularly sought and acted on.

Staff were motivated and proud to work for the service; as a result staff turnover was kept to a minimum ensuring that continuity of care was in place for most people who used the service.

Staff were respectful of people’s privacy and maintained their dignity.

There were processes in place to monitor quality and understand the experiences of people who used the service. We saw that regular visits and phone calls had been made using the service and their relatives in order to obtain feedback about the staff and the care provided.

The service worked in co-operation with other organisations such as healthcare services to deliver effective care and support

The service listened and responded to people’s concerns and complaints, and used this to improve the quality of care. The service learnt lessons and made improvements when things went wrong.

Below is a summary of what we found. The summary is based on discussions with management during the inspection, speaking with people using the service, their relatives and the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

The provider had appropriate safeguarding policies and procedures in place and staff received appropriate training and information. Staff understood their responsibilities in safeguarding the people they supported and who to contact in the event of a concern.

Problems highlighted at the previous inspection in relation to the provision of care for those people who required two care workers had been addressed and additional checks had been introduced to make sure the correct number of staff were available. Recruitment practice was safe and thorough and ensured suitable checks were in place with regard to qualifications, employment history, identity and criminal records. There was suitable induction training for new staff and on-going supervision checks to ensure staff carried out their duties safely.

People were treated with dignity and respect by the staff. People we spoke with told us their care workers always protected their privacy when offering personal care.

Systems were in place to make sure accidents and incidents were reported along with complaints and other concerns and action was taken when required. This reduced risks to people and helped the service to monitor its performance.

There were procedures for managing emergencies and staff were aware of relevant contact details to access help and support.

Is the service effective?

People using the service experienced care which was planned and delivered to meet their needs and to mitigate any risks. People using the service and their relatives were involved in the development of their care plans. Care needs were reviewed on a regular basis and care plans could be modified if needs changed. Records showed the care delivered reflected the current care plan.

People we spoke with told us their care workers were mostly punctual and carried out their duties effectively, although views were mixed. One person we spoke with said, 'I've had problems with them in the past but the carers I have now are exceptional.' Several people we spoke with felt the service did not always keep them adequately informed if there were delays or alterations to scheduled visits.

Is the service caring?

People we spoke with were satisfied with the care and support they experienced. Staff we spoke with were aware of the importance of respecting people choices in how their care was delivered. People we spoke with told us their care workers were kind and helpful and always willing to meet their needs. They told us they were treated with dignity and respect by the staff. People we spoke with told us their care workers always protected their privacy when offering personal care. One person remarked, 'They're very kind, they treat me very well.'

Is the service responsive?

The relative of a person commented in regard to the quality of staff, 'The standard is very mixed. Some of the carers we've had have been excellent but others have been incompetent and unable to speak English well enough to communicate properly.'

People using the service received six monthly telephone reviews of the care they received during which people were encouraged to express their views. The provider conducted an annual customer satisfaction survey which indicated a satisfactory level of service.

There was a written complaints procedure which was readily available for people using the service. People were aware of the written procedure. Complaints had been recorded and had been investigated and managed correctly. One person using the service told us, 'I have made a complaint in the past and it was sorted very quickly. They've improved and are much better now.'

Is the service well-led?

Managers conducted regular checks at the homes of people using the service while care workers were there to ensure the care delivered was of good quality and in line with needs. The provider had a variety of systems to monitor the quality of service provided and audit their performance. People using the service and their relatives were provided with information about the service and were contacted regularly to obtain their feedback and views.

Most of the people we spoke with told us that they were involved in their care. They told us that they had been able to arrange changes to their care packages and carers listened to their wishes. The provider made appropriate arrangements to ensure consent was obtained from people who used the service.

All the people we spoke with were happy with the care they received. They told us that carers knew what care they required and that they would recommend the service. Although there were arrangements in place for the service to meet people's needs, care was not always delivered appropriately and care plans did not always have sufficient detail.

Although most people had no issues with the timeliness of carers, those that required two carers told us they often only received one. The provider had appropriately experienced, trained and qualified staff and had arrangements in place to check that staff were available when required.

Although it was not always clear that staff were involved in their professional development, staff were supported and developed to provide safe care.

Although a few records were not up to date, records were appropriately stored and destroyed. Most records were current and fit for purpose.

Care and support was planned and delivered in a way that was intended to ensure people's safety and welfare. A person using the service told us their carer was 'like a sister to me.' Systems in place enabled people's needs to be met and regularly reviewed.

People who use the service were protected from the risk of abuse. A member of staff we spoke with knew to report any concerns to their manager and staff had received safeguarding training. People were cared for by staff who were supported to deliver care and support safely and to an appropriate standard. Carers were described as 'very confident and polite.'

People using the service, their representatives and staff were asked for their views about their care and support and they were acted upon. Random spot checks were undertaken regularly in people's homes and any issues identified were managed. Only two complaints had been made in 2012 and we saw several compliments on file.