Review of compliance. Brico Limited t/a Bluebird Care (Guildford) Bluebird Care (Guildford) South East. Region:

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1 Review of compliance Brico Limited t/a Bluebird Care (Guildford) Bluebird Care (Guildford) Region: Location address: Type of service: South East Unit 15, Westminster Court Hipley Street Old Woking Surrey GU22 9LG Domiciliary care service Date of Publication: March 2012 Overview of the service: Bluebird Care (Guildford and Waverley) is a local service specialised in the provision of care at home. The service is based in Old Woking, Surrey and operates across the Guildford, Woking and Waverley local authority areas. It offers a wide range of support for people in their homes ranging from companionship and domestic support through to comprehensive and complex Page 1 of 19

2 personal care packages. The service provides care visits ranging from as short as 15 minutes to 24 hours a day. Page 2 of 19

3 Summary of our findings for the essential standards of quality and safety Our current overall judgement Bluebird Care (Guildford) was meeting all the essential standards of quality and safety. The summary below describes why we carried out this review, what we found and any action required. Why we carried out this review We carried out this review as part of our routine schedule of planned reviews. How we carried out this review We reviewed all the information we hold about this provider, carried out a visit on 30 November 2011, talked to staff and talked to people who use services. What people told us People said they were involved in decisions and the agency supported them with their needs, provided the service they wished to receive and treated them with respect and dignity. One person said "I feel in control, staff respect me by asking me first before they do things". Another said "I am given time, not rushed". People said that they had discussed their support and preferred routines with staff. Two people said they liked the way staff encouraged them to do what they can for themselves". People told us they were very happy with the care and support received One person said "the staff and the care they provided was excellent People told us they felt safe receiving a service from the agency and had no concerns. They felt that staff that supported them had the skills and experience required. They were pleased the agency took time to introduce a new member of staff to them and ensured they were suitable. A family member said that the manager is very receptive to comments and strives to resolve any issues as soon as possible. What we found about the standards we reviewed and how well Bluebird Care (Guildford) was meeting them Outcome 01: People should be treated with respect, involved in discussions about their care and treatment and able to influence how the service is run Page 3 of 19

4 People were involved in decisions about their care and support. Their privacy and dignity was respected and their independence encouraged Overall, we found that Bluebird Care (Guildford) was meeting this essential standard. Outcome 04: People should get safe and appropriate care that meets their needs and supports their rights People who use the service experience effective, safe and appropriate care, treatment and support that meet their needs. Overall, we found that Bluebird Care (Guildford) was meeting this essential standard. Outcome 07: People should be protected from abuse and staff should respect their human rights People's safety is supported by staff who had received training to meet their needs and know how to recognise abuse. Overall, we found that Bluebird Care (Guildford) was meeting this essential standard. Outcome 12: People should be cared for by staff who are properly qualified and able to do their job People were protected by safe recruitment procedures. Overall, we found that Bluebird Care (Guildford) was meeting this essential standard. Outcome 14: Staff should be properly trained and supervised, and have the chance to develop and improve their skills People had their needs met by staff that were properly supported to provide care. Overall, we found that Bluebird Care (Guildford) was meeting this essential standard Outcome 16: The service should have quality checking systems to manage risks and assure the health, welfare and safety of people who receive care People benefit from the assessment and the monitoring of the quality of care within the service which informs the management of areas for improvement and development. Overall, we found that Bluebird Care (Guildford) was meeting this essential standard Other information Please see previous reports for more information about previous reviews. Page 4 of 19

5 What we found for each essential standard of quality and safety we reviewed Page 5 of 19

6 The following pages detail our findings and our regulatory judgement for each essential standard and outcome that we reviewed, linked to specific regulated activities where appropriate. We will have reached one of the following judgements for each essential standard. Compliant means that people who use services are experiencing the outcomes relating to the essential standard. A minor concern means that people who use services are safe but are not always experiencing the outcomes relating to this essential standard. A moderate concern means that people who use services are safe but are not always experiencing the outcomes relating to this essential standard and there is an impact on their health and wellbeing because of this. A major concern means that people who use services are not experiencing the outcomes relating to this essential standard and are not protected from unsafe or inappropriate care, treatment and support. Where we identify compliance, no further action is taken. Where we have concerns, the most appropriate action is taken to ensure that the necessary improvements are made. Where there are a number of concerns, we may look at them together to decide the level of action to take. More information about each of the outcomes can be found in the Guidance about compliance: Essential standards of quality and safety Page 6 of 19

7 Outcome 01: Respecting and involving people who use services What the outcome says This is what people who use services should expect. People who use services: * Understand the care, treatment and support choices available to them. * Can express their views, so far as they are able to do so, and are involved in making decisions about their care, treatment and support. * Have their privacy, dignity and independence respected. * Have their views and experiences taken into account in the way the service is provided and delivered. What we found The provider is compliant with Outcome 01: Respecting and involving people who use services Our findings What people who use the service experienced and told us People said they were involved in decisions and the agency Bluebird Care (Guildford) supported them with their needs, provided the service they wished to receive and treated them with respect and dignity. The manager from the agency had visited them before they started receiving care so they had been able to express their views about the care and support they needed. People told us they felt supported to make decisions for themselves and were encouraged to be independent. They all confirmed that staff treated them with respect and dignity. Other evidence When talking to staff they showed their commitment to making sure that people were always treated as individuals and were encouraged to express their views about their care. They explained on a day to day basis how they maintained people's privacy, dignity and independence whilst support was provided. People were involved in decisions about their care and support. Their privacy and dignity was respected and their independence encouraged Page 7 of 19

8 Overall, we found that Bluebird Care (Guildford) was meeting this essential standard. Page 8 of 19

9 Outcome 04: Care and welfare of people who use services What the outcome says This is what people who use services should expect. People who use services: * Experience effective, safe and appropriate care, treatment and support that meets their needs and protects their rights. What we found The provider is compliant with Outcome 04: Care and welfare of people who use services Our findings What people who use the service experienced and told us People told us they were very happy with the care and support received and everyone was aware of their care plan. People said they had no concern with regard to the quality of care and were very complimentary about the quality of the staff and the support offered. One person said "the staff and the care they provide was excellent. Other evidence We looked at the records for five people who used the service. Each person had a care plan in place, which is guidance for staff on the support and care needs for each individual person. We saw that these care plans set out the actions to be taken by staff and gave information on how to support people with their individual needs. They were also reviewed regularly. Where people had more than one visit a day, the care plan was divided into the individual visits so that staff were aware of the different support needs at different times of the day. The care plans were regularly updated and changes were noted within the care plans viewed. Risk assessments were in place in all the care files seen. The risk assessments seen detailed and clearly showed the actions needed to minimise risks. The risk assessments covered both the home of the person using the service and the tasks staff would carry out when providing care. Page 9 of 19

10 People who use the service experience effective, safe and appropriate care, treatment and support that meet their needs. Overall, we found that Bluebird Care (Guildford) was meeting this essential standard. Page 10 of 19

11 Outcome 07: Safeguarding people who use services from abuse What the outcome says This is what people who use services should expect. People who use services: * Are protected from abuse, or the risk of abuse, and their human rights are respected and upheld. What we found The provider is compliant with Outcome 07: Safeguarding people who use services from abuse Our findings What people who use the service experienced and told us People told us they felt safe receiving a service from the agency and had no concerns. Other evidence Staff spoken with showed knowledge of safeguarding people from abuse and how and where to report any suspicions or concerns. Evidence was seen at the time of the site visit that all staff had a Police check. The purpose of the check is to show that someone has not done anything in the past that might make them not suitable to work with vulnerable people. Staff had received training on how to keep people safe. This gave them the knowledge and the skills to do their jobs well and protect people from abuse. Training has yet to be delivered to all staff in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguarding (safeguards to protect loss of freedom and rights) but training had been planned. The manager was able to locate a copy of the local safeguarding protocols during the site visit (procedures to follow to protect vulnerable people from abuse) issued by Surrey Council available for staff. People's safety is supported by staff who had received training to meet their needs and know how to recognise abuse. Page 11 of 19

12 Overall, we found that Bluebird Care (Guildford) was meeting this essential standard. Page 12 of 19

13 Outcome 12: Requirements relating to workers What the outcome says This is what people who use services should expect. People who use services: * Are safe and their health and welfare needs are met by staff who are fit, appropriately qualified and are physically and mentally able to do their job. What we found The provider is compliant with Outcome 12: Requirements relating to workers Our findings What people who use the service experienced and told us People told us they received care and support from a small team of staff and were happy with the care received and had no concerns relating to workers. Other evidence Staff told us and documentation seen on staff files viewed confirmed a robust recruitment process. Evidence showed that staff had completed an application form, supplied and received references, attended an interview and had a Criminal Record Bureau (CRB) check. All staff spoken with confirmed that they had attended a full induction training program and had shadowed the manager or experienced staff before working alone. People were protected by safe recruitment procedures. Overall, we found that Bluebird Care (Guildford) was meeting this essential standard. Page 13 of 19

14 Outcome 14: Supporting staff What the outcome says This is what people who use services should expect. People who use services: * Are safe and their health and welfare needs are met by competent staff. What we found The provider is compliant with Outcome 14: Supporting staff Our findings What people who use the service experienced and told us People told us they felt staff were kind and caring. They said they were happy with the service provided. When asked people who use the service stated that they felt that staff that supported them had the skills and experience required and that the agency took time to introduce a new member of staff to them and ensured they were suitable. Other evidence Staff spoken with demonstrated through discussion skills to carry out their role. Records viewed showed that staff had received training in core courses namely, safeguarding adults, manual handling, First Aid and fire. Many of the staff had a NVQ (National Vocational Qualification) in care at various levels. Training updates had been carried out in line with current guidance as recommended by Skills for Care a government training agency. Staff said they felt supported by the training to carry out their role. Staff confirmed they undertake a 12 week period of weekly supervision including unannounced spot checks. At the end of this they have a probation appraisal to review their performance and identify any additional training needs. Supervisions were seen recorded and they continue following the initial period six times a year. Members of staff had a full in house induction when they started working. A foundation induction programme that follows the element of national guidance for care homes issued by Skills for Care (a national government training agency) was also in place. Page 14 of 19

15 The manager told us and staff confirmed she spent time working with care staff on a regular basis. The agency also holds staff meetings, which were recorded and kept on file. Staff spoken with consistently reported high levels of satisfaction about the employer and manager. People had their needs met by staff that were properly supported to provide care. Overall, we found that Bluebird Care (Guildford) was meeting this essential standard Page 15 of 19

16 Outcome 16: Assessing and monitoring the quality of service provision What the outcome says This is what people who use services should expect. People who use services: * Benefit from safe quality care, treatment and support, due to effective decision making and the management of risks to their health, welfare and safety. What we found The provider is compliant with Outcome 16: Assessing and monitoring the quality of service provision Our findings What people who use the service experienced and told us People that we spoke with confirmed that they were happy with the support the agency provided. People said they are encouraged to voice their opinion about the care they received. A family member said that the manager is very receptive to comments and strives to resolve any issues as soon as possible. Other evidence The manager stated that information received from staff, people who use the service and their families was used to improve their care provision. The agency carries out regular reviews to ensure people are happy with the service, and the manager provides their care on occasions to ensure staff are meeting their needs. Staff received regular supervision and contact with the manager. The manager stated that complaints / concerns were used to make changes to improve the quality of care. On evidence seen at the time of the site visit the service had other means of monitoring the quality of care by carrying out audits, health and safety, and risk assessments. At present surveys have been developed but have not yet been sent out. The agency has only been operational for five months and intended to send out surveys next month to people who use the service, families and other interested parties. The manager is very much involved with the day to day running and engages with everyone involved with the care and support of the people who use the service. Page 16 of 19

17 As an ongoing process the provider carried out an audit of the service to measure compliance with the outcomes of the Care Quality Commissions Essential Standards of Quality and Safety. People benefit from the assessment and the monitoring of the quality of care within the service which informs the management of areas for improvement and development. Overall, we found that Bluebird Care (Guildford) was meeting this essential standard Page 17 of 19

18 What is a review of compliance? By law, providers of certain adult social care and health care services have a legal responsibility to make sure they are meeting essential standards of quality and safety. These are the standards everyone should be able to expect when they receive care. The Care Quality Commission (CQC) has written guidance about what people who use services should experience when providers are meeting essential standards, called Guidance about compliance: Essential standards of quality and safety. CQC licenses services if they meet essential standards and will constantly monitor whether they continue to do so. We formally review services when we receive information that is of concern and as a result decide we need to check whether a service is still meeting one or more of the essential standards. We also formally review them at least every two years to check whether a service is meeting all of the essential standards in each of their locations. Our reviews include checking all available information and intelligence we hold about a provider. We may seek further information by contacting people who use services, public representative groups and organisations such as other regulators. We may also ask for further information from the provider and carry out a visit with direct observations of care. When making our judgements about whether services are meeting essential standards, we decide whether we need to take further regulatory action. This might include discussions with the provider about how they could improve. We only use this approach where issues can be resolved quickly, easily and where there is no immediate risk of serious harm to people. Where we have concerns that providers are not meeting essential standards, or where we judge that they are not going to keep meeting them, we may also set improvement actions or compliance actions, or take enforcement action: Improvement actions: These are actions a provider should take so that they maintain continuous compliance with essential standards. Where a provider is complying with essential standards, but we are concerned that they will not be able to maintain this, we ask them to send us a report describing the improvements they will make to enable them to do so. Compliance actions: These are actions a provider must take so that they achieve compliance with the essential standards. Where a provider is not meeting the essential standards but people are not at immediate risk of serious harm, we ask them to send us a report that says what they will do to make sure they comply. We monitor the implementation of action plans in these reports and, if necessary, take further action to make sure that essential standards are met. Enforcement action: These are actions we take using the criminal and/or civil procedures in the Health and Social Care Act 2008 and relevant regulations. These enforcement powers are set out in the law and mean that we can take swift, targeted action where services are failing people. Page 18 of 19

19 Information for the reader Document purpose Author Audience Further copies from Copyright Review of compliance report Care Quality Commission The general public / Copyright (2010) Care Quality Commission (CQC). This publication may be reproduced in whole or in part, free of charge, in any format or medium provided that it is not used for commercial gain. This consent is subject to the material being reproduced accurately and on proviso that it is not used in a derogatory manner or misleading context. The material should be acknowledged as CQC copyright, with the title and date of publication of the document specified. Care Quality Commission Website Telephone address Postal address Care Quality Commission Citygate Gallowgate Newcastle upon Tyne NE1 4PA Page 19 of 19

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