Bluebird Care West Dorset

Bluebird Care West Dorset is a domiciliary care agency providing personal care and support to people in their own houses and flats. The service provides support to people in the Purbecks and West Dorset. At the time of our inspection there were 34 people receiving personal care and support.

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.

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.

People’s experience of using this service and what we found

Right Support

At our last inspection, although no impact or harm, risk assessments for people’s care and support were not detailed enough to keep them safe. Improvements had now been made and risks to people’s safety and wellbeing had been identified, assessed and actions to mitigate were in place. Instructions for staff to follow were clear.

Staff knew people well and risk assessments covered all aspects of their daily care and support. Clear instructions for staff contributed to safe working practices. People told us they were happy with the service they received from Bluebird Care West Dorset.

There were enough staff to meet the needs of the service. Recruitment processes were in place to ensure staff had the necessary checks before starting work with the service. However, we found some gaps in employment history had not been explored, the manager and provider acted immediately to obtain the missing information.

People were protected from avoidable harm by a staff team who knew how to raise safeguarding concerns both within the service and outside. Staff told us they were confident their concerns would be acted upon by the management team.

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. Staff told us they promoted independence every day for people. People told us they felt respected by the staff and the service.

Right Care

People received their medicines as prescribed. Medicines management within the service was monitored and staff had received training including assessment of their competency. The manager was in the process of providing guidance for medicines people only needed to take occasionally. An electronic care planning and medicines system supported safety, as changes to medicine regimes were made without delay.

People were protected from the risk of avoidable infection. Staff had received training in infection prevention and control. The service had an annual statement which detailed their procedure to ensure safety. This included the provision of person protective equipment (PPE) for staff. The policy and guidance were in line with government and best practice guidance.

Accidents and incidents were recorded, analysed for themes and trends. Quarterly reviews of events looked for patterns and lessons learned. Governance systems were in place and supported oversight of the service. Leadership was visible and staff knew their roles and responsibilities. A range of audits supported quality assurance and were multi-layered.

Right Culture

The registered manager understood their statutory responsibilities and had made notifications to CQC as required by law. Staff felt appreciated by the service, there were various ways the service showed thanks to their staff. The provider was passionate about their team and supporting staff to give the best care they could to people. Staff felt involved and regular team meetings ensured training reminders and updates could be communicated.

Bluebird Care West Dorset sought to involve themselves in their local community, which included charitable work and the allocation of grants to support local causes. The service worked well with external health and social care professionals, and we received positive feedback on joint working.

The service actively sought feedback on the service it provides, and results of an annual survey were positive. The management team of Bluebird Care West Dorset was said to be approachable, visible, and supportive.

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 overall, with a rating of requires improvement in the safe key question. This was because people’s risk assessments were not robust enough to keep them safe (published 18 September 2018).

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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 remained as good based on the findings of this inspection.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults and younger disabled adults. There were 63 people who received personal care from this service at the time of the inspection.

There was a registered manager in place. 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.

This was the first inspection of this service.

Improvements were required to ensure all risks were consistently managed to reduce any risks to people’s safety.

The registered manager and provider were aware of their responsibilities to submit notifications to CQC. A notification is the means by which providers tell us important information that affects the running of the service and the care people receive. We had not been notified about one allegation of abuse as required that had been reported to the local authority. The registered manager told us they would ensure all required notifications were made in the future.

Staff were aware of the Mental Capacity Act 2005 and staff had received training in this area. Assessments of capacity and best interest decisions were not always recorded. We have made a recommendation about the assessment of people's capacity to make specific decisions and arrangements for best interests.

People's needs were assessed and their care was planned to meet their needs and preferences. People received care from staff that were caring, kind and compassionate. People and their relatives spoke very highly of staff.

People told us they felt safe. All staff were clear about how to report any concerns and were confident that any concerns raised would be responded to. The registered manager knew how and when they should escalate concerns following the local authorities safeguarding protocols.

The registered provider had a system in place to ensure people received their medicines as prescribed.

People received care from staff who had the right knowledge and skills to meet their needs. Staff told us there was good communication with the management of the service and they felt supported to carry out their roles.

Staff treated people with dignity and respect and asked for people’s consent before providing care.

Staff supported people to maintain their independence where possible.

The provider had processes in place to monitor the delivery of the service. People's views were obtained through surveys, one-to-one meetings, meetings with people's families and social workers.

The provider had a process in place to enable them to respond to people and their concerns, investigate them and had taken action to address their concerns.

Staff were knowledgeable about people's needs and told us they left drinks and snacks for people where required.

People, staff and their relatives told us the service was well managed and told us the registered manager would respond to any concerns.

Staff told us that they seek the guidance from healthcare professionals as required. They told us they would speak with people's families and inform the management team if they had any concerns about people's health or care needs.

There were systems in place to monitor incidents and accidents. Further improvements were required to ensure all incidents were recorded to identify all actions and continuous learning and lessons learnt to drive improvements within the service. We have made a recommendation about monitoring incidents and identifying lessons learnt.

The service worked in partnership with other agencies.

You can see what action we told the provider to take at the back of the full version of the report.