We carried out a review of the data available to us about Big Blue Door on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Big Blue Door, you can give feedback on this service.
Big Blue Door provides personal care, day care and respite care to children and young adults with learning disabilities, autism and physical disabilities. In this service CQC regulates the personal care provided to adults. At the time of inspection there were six adults receiving personal care, including overnight respite. The respite service is registered for personal care rather than residential care because the service is mainly provided to children and is regulated by Ofsted. This means CQC do not regulate the premises in this service. The most recent Ofsted report can be viewed at https://reports.ofsted.gov.uk/provider/2/SC489038
People’s experience of using this service and what we found
The provider ensured people received safe care from suitably recruited staff. People had been supported to manage the risks they faced in person-centred ways which upheld their rights. Relatives were confident that people were supported safely and protected from avoidable harm and abuse. Staff provided safe support with medicines including for some people whose routines were very complex.
The provider assessed people's needs thoroughly, involving other professionals and families which helped ensure they were confident they could meet people's needs. The provider ensured staff had been provided with training suitable to their roles including a thorough induction and regular refresher training. When required specialist trainers had been brought in to train on the management of some long term conditions. Staff said they felt they had been given the right training and support to care for people effectively. The registered manager and seniors provided regular supervision for staff. Supervision is a one to one meeting to consider the development needs and progress of staff. Staff also felt able to rely on each other for support and guidance.
Relatives praised the kind and caring attitude of the staff. Staff were committed to providing high-quality care which reflected people's preferences and upheld their dignity. Staff took time to understand how to communicate with people and ensured they built up rapport over time which helped to include people in decision making about their care. Staff were knowledgeable about how to support people when they experienced distress and followed good practice guidance in relation to positive behavioural support.
People received highly person-centred care which reflected their needs and preferences. Relatives told us the provider had been involved in reviews and updates about people and care was amended to reflect any changes to people's needs and preferences. Relatives had also been involved in recruitment, which had helped ensure families could identify staff they felt would be most appropriate. The provider had a complaints procedure which they followed when required. Relatives told us they had not felt the need to complain formally but any concerns they may have had been addressed in a timely way.
The provider remained committed to providing high-quality, person-centred care. Staff said they felt the service was well managed and they understood the aims and values of the organisation. Regular audits of care practices and records helped maintain consistency and quality of care. The registered manager addressed any concerns as they arose through supervision and other staffing procedures where necessary. Families told us they felt fully engaged with the service. The provider continued to work with partner organisations develop and improve care.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at the last inspection
The last rating for this service was good. Published (June 2017)
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Big Blue Door is registered to provide personal care for adults and children who have learning disabilities, in their own homes. On the day of our inspection there were two people using the service. We were not able to verbally communicate with these people during our inspection.
At the time of our inspection 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.
Staff had received training in safeguarding and knew their responsibilities to report any concerns. The service also had a whistleblowing policy in place.
Risks to people who used the service had been identified but we found risk assessments had not been put in place. We discussed this with the registered manager who told us they would action this as a matter of urgency. The day after our inspection the registered manager sent us the required risk assessments. These identified risks and how staff were to mitigate them to keep the person safe.
Recruitment systems and processes in place were robust. We saw references, identity checks and Disclosure and Barring Service checks were completed before staff were employed.
Medicines were managed safely in the service. Only staff members trained to do so were able to administer medicines to people. We have made a recommendation about the medicines policy in place in the service.
We saw accidents and incidents were recorded and retained in both an accident book and on an accident and incident sheet which the provider had developed, a copy of which was retained in the person’s home in their care records.
Staff told us they had access to personal protective equipment (PPE) such as gloves and aprons and confirmed they had received training in infection control. We have made a recommendation about the infection control policy in place.
All new staff members were expected to complete and induction when they commenced employment. Those who did not have a qualification in health and social care were expected to complete this during their employment. We saw staff completed further training in topics such as safeguarding, medication, autism, food hygiene, equality and diversity, challenging behaviour, disability awareness, communication and epilepsy awareness.
Staff members told us and records confirmed that staff members received supervisions and appraisals on a regular basis. All staff members told us they were able to discuss any training requirements they had.
We observed some carers undertaking tasks in people’s homes. We observed they were kind, caring and respectful in their interactions with people and respected people’s privacy and dignity when undertaking personal care tasks.
People’s independence was promoted on a daily basis. Staff encouraged people to undertake daily living skills such as washing their clothes, cleaning the house and cooking their meals.
Care plans in place for people contained detailed information to direct staff on how to meet people’s needs.
Staff meetings were held on a regular basis. Records we looked at confirmed staff were able to bring up topics or suggestions in these meeting.
There were quality assurance processes in place which included regular audits and checks on the operation of the service.
We have made a recommendation about the statement of purpose currently in place within the service.