Bluebird Care (Eastbourne & Wealden)

Updated 2 February 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two 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 houses and flats.

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 a registered manager in post.

Notice of inspection

We gave the service 24 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.

Inspection activity started on 25 November 2022 and ended on 1 December 2022. We visited the location’s office on the 25 November 2022.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We also used information provided by the local authority that had been in contact with the service. We used all this information to plan our inspection.

During the inspection

We spoke with 7 people who used the service and 6 of their relatives about their experience of the care provided. We met with the registered manager, spoke with 5 care workers and an agency worker. We spoke with the clinical lead district nurse, district nurse and the occupational therapist who were all involved in people’s care. We looked at written records, which included three people's care records and two staff files. A variety of records relating to the management of the service were reviewed.

Updated 2 February 2023

About the service

Bluebird Care (Eastbourne and Wealden) is a domiciliary care agency and provides personal care to people living in their own homes. Not everyone using Bluebird Care (Eastbourne and Wealden) received personal care. People that were being supported had a range of needs such as Dementia, physical disabilities and older people.

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 was supporting 25 people.

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

Safeguarding concerns had not been reported to the local authority to help protect people from harm or abuse. Staff knew how to look out for signs of abuse however, training had not been completed in some time and not all staff knew where to report concerns.

Risks to people were not well managed. Risk assessments were out of date and assessment tools were not appropriately used to help assess and monitor risk.

Medicines were not managed safely. Gaps were found in people’s electronic medicine administration records. Where medicines were discontinued by the GP records were not updated. People’s care plans were not kept up to date when changes had been made to their care calls. This left people at risk of not receiving their medicines as prescribed.

Staff were recruited safely. However, a high level of agency were being used in particular to cover live in care calls. We received mixed feedback regarding the agency workers. We were also concerned about how agency staff were monitored and where incidents had occurred, lessons had not been learnt. Staff had not received up to date training and not all supervisions had been carried out.

People had their needs assessed before receiving care. However, care plans were not regularly reviewed and kept up to date. People who were receiving care and support from district nurses did not have wound care plans in place. Guidance for staff was not clear as to what support people required. Positive behaviour support plans were not in place for people where incidents had occurred. Staff were not given the tools to help support people in a positive way.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

Quality assurance processes were not effective in identifying concerns found on the inspection. Audits had not always been carried out and where they had, issues were not picked up and addressed. Under the previous provider, there had been a lack of provider oversight at the service and the registered manager had not received much support. The provider had recently changed and had already been more visible in the service.

At the time of the inspection, the location did not 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.

People told us staff were kind and caring. People gave us examples of how staff promoted their independence and respected their privacy and dignity.

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 (published 17 May 2018).

Why we inspected

The inspection was prompted in part due to information we had received about the service.

Enforcement and Recommendations

We have identified breaches in relation to person-centred care, consent, safe care and treatment, safeguarding and good governance at this inspection.

Please see the action we have told the provider to take at the end of this report. Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

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.