Bluebird Care (Stockport)

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

During our assessment of this key question, we found concerns around staff recruitment, gaps in staff training and supervision and the quality of care plan risk assessments. This has resulted in breaches of regulations related to safe care and treatment and staffing. You can find more details of our concerns in the evidence category findings below. There were systems in place to ensure people were safe and protected from avoidable harm, however not all of the processes were effective, and we found gaps in people's risk assessments. The safeguarding policy was not up to date. Staff training in safeguarding, moving and handling and medicines administration was not always up to date. People received their medicines as required, however, information on how to apply creams was not identified. There were enough staff to meet people's needs, however, staff did not always attend people's support calls as scheduled. Staff supervision was not planned and frequent. Staff recruitment was not always robust. Staff knew how to keep people safe, and people told us they felt safe with the staff who supported them. Following the on-site inspection, the provider told us about a number of improvements made to ensure people’s safety.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

People told us they felt safe. One person said: “I feel very safe with the carers.” Another person told us: ”Oh yes, we really do feel very safe and comfortable with the care.” One relative told us, ”I do feel that [person] in safe in their [staff] capable hands.”

Staff knew how to keep people safe and protected from harm and who to contact if they had any concerns. One staff member told us, “It would depend on individual, for example, if somebody was chatty and suddenly become withdrawn. If anyone isn’t their usual self I can see it.” Another staff member told us: “If I had any concerns I would speak to the office.” Staff were provided with safeguarding training, however not all staff training was up to date.

There were systems and processes in place to ensure people were safe and protected from avoidable harm, however not all of the processes were effective. For example, there were no risk assessments in place for people who were new to the service. Environmental risk assessments were not always routinely being completed. Staff had a good understanding of how to keep people safe and were provided with training, however not all staff had their safeguarding training up to date. The safeguarding policy was also not up to date and contained generic information. Following the on-site inspection the provider told us a number of people’s risk assessments had been updated.

People told us they were involved in managing their risks. One person said, “It is all going well and I’m in charge.” Another person told us, “I have trouble walking and most of the time I make myself walk; they [staff] stand by my side to steady me.” One relative told us, “Yes, they [staff] are good. [Person’s] mobility is not great, and they are good with [person].” However, one relative told us: “I asked a carer about their training, and they said we just do it online and most carers don’t speak English. I’m more worried about [person] and about their safety now.”

Staff had a good understanding on how to keep people safe and manage their risks well. One staff member told us how they contacted the office as they noticed there were changes to a person’s skin; they said, “I called the office to get the district nurse to come out.”

There were processes and procedures in place to support staff in keeping people safe, and manage and mitigate identified risks. However, these had not always been effective, for example, some of the provider’s policy were generic and out of date and there were no risk assessments in place for people new to the service. Environmental risk assessments were not routinely being done. The manager told us for one person there were challenges with their environment; there was some historical documentation around this issue from 2022 but there had been no updates about the ongoing challenges the person was facing since that time. Not all of the staff had their training up to date, for example in the area of moving and handling and medicines administration, which could put people at risk of receiving unsafe care. There was limited evidence of face-to-face staff training. Following our on-site assessment the provider told us they were in the process of updating people’s care plans and risk assessments.

We did not look at Safe environments during this assessment. The score for this quality statement is based on the previous rating for Safe.

People told us there were enough staff to meet their needs. One person said, “I have a steady team as far as possible unless someone is away on holiday or off sick.” Another person told us, ”I generally get the same staff, but now and then it’s someone new.” Most people told staff were trained well. One person said, ”Oh yes,[staff] they know what they are doing.” Another person told us, ”The regulars [staff] are well trained and then they send someone who has just started and they are being trained, but there are always 2 staff.” Some people’s relatives had concerns about the quality of staff training. One relative commented, “I asked the carer about [their] training, and [they] said we just do it online.” Another relative told us, "They [staff] have not had proper training and do not seem to know or understand the first thing about dementia. Apparently the only training they [staff] receive is online and is obviously nowhere near thorough enough.” People told us they didn’t always receive care on time. One person told us, “We asked for an early call as we know there is a leeway either side of this, but they [staff] never turn up before 10:30 am so they are always on their own all morning.” Another person said, ”We are happy with the carers, but we never know when they are supposed to be coming; that’s all a bit of pot luck really.” One relative told us, “We like to keep routine. Some days it’s 8:00 am when the carers arrive and somedays it could be 10:00 am. We like consistency. I have told them, but nothing happens really.” Following our on- site assessment, the provider had taken active steps to review staff training and competencies, including regular checks of staff competencies.

Staff spoke positively about the training provided. One staff member told us, ”Training is brilliant, there is a training room upstairs which is very good.” Another staff member told us:” Yes, I had a safeguarding training but I don’t remember when.” The provider told us they were keen to invest in staff training and the nominated individual told us they were going to retain some responsibility for the training delivery in the future.

There were enough staff employed to meet people’s needs. However people did not always received support visits at the time they were scheduled for. There was evidence staff received training, however a number of staff had their training out of date and the majority of training was delivered online. There was some evidence staff completed Mental Capacity Act training, however not all of the staff had their training up to date. Staff skills and competencies were assessed, however this was not completed regularly. There was some evidence of staff receiving supervision and appraisal, however this was infrequent. Records in staff files were not suitably maintained and did not consistently demonstrate recruitment processes were robust; the applicant’s work history and employment gaps had not always been explored. Staff understood their roles and responsibilities.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

People received support with their medicines as required. One person told us,” They [staff] check my medicines sheet every morning with my tablets to make sure it tallies; they are very good, and they really help me.”

There was evidence staff received training in medicines administration, however some staff training was of date and needed refreshing, and assessments of staff competencies in administering medicines were not completed regularly. Following our on-site assessment, the provider had reviewed staff training and the frequency of staff competency checks including supporting people with managing and administering their medicines.

There were policies and procedures in place to support the safe management and administration of people’s medicines, however, these were not always effective. Staff training in medicines was out of date for some staff and assessments of their competence to administer medicines were not completed regularly. Information regarding people’s medicines was not always detailed and personalised, for example, protocols for medicines taken ‘as required’ [PRN]. Information about how people’s creams were to be applied was not always clear; there were no evidence of body maps being completed when people were receiving support with the application of creams and/or ointments. Following our on-site assessment, the provider had reviewed medicines administration processes, to better ensure the safe administration of these.