Bluebird Care Sefton was rated Requires Improvement overall following a February 2015 inspection, with Safe, Caring and Responsive rated Good but Effective and Well-Led requiring improvement due to inconsistent staff supervision, gaps in training (including MCA and safeguarding), and irregular quality auditing. A breach of Regulation 18 was identified regarding staff support arrangements, though no formal enforcement action was taken at this stage.
Concerns (8)
criticalSupervision / appraisal: “staff were provided with supervision but this was on a sporadic basis for some staff rather than on a regular scheduled basis.”
moderateStaff training: “training matrix showed no recorded staff training in topics such as adult safeguarding, mental capacity, food hygiene and infection control.”
moderateGovernance: “the last audit had been carried out 18 months ago.”
moderateGovernance: “clear inconsistency in how the system of spot checks was applied. For some people we saw no evidence that any spot checks had been carried out.”
moderateConsent / capacity: “the manager and care staff had not been provided with training in the Mental Capacity Act.”
moderateLeadership: “There was no registered manager at the service at the time of our inspection.”
minorSafeguarding: “they were not clear on the limitations of their role in investigating without the instruction of the local safeguarding authority.”
minorRecord keeping: “We found this required more detail about the medication which staff were administering.”
Strengths
· People who used the service consistently reported feeling safe, with comments including 'Yes, I've felt safe with anybody they've sent.'
· Staff had a good knowledge of people's needs and preferences; support plans were individualised and person-centred.
· Sufficient staffing numbers with travel time factored into schedules, ensuring staff were not rushed during visits.
· Robust pre-employment checks including DBS checks carried out prior to new staff starting.
· Complaints procedure was in place, complaints were investigated and responded to appropriately.
Quality-Statement breakdown (14)
safe: Safeguarding systems and abuse prevention proceduresGood
safe: Risk assessment and managementGood
safe: Staffing levels and recruitmentGood
effective: Staff training and inductionRequires improvement
effective: Staff supervision and appraisalRequires improvement
effective: Mental Capacity Act awareness and practiceRequires improvement
effective: Working with health and social care professionalsGood
caring: Staff attitude and person-centred approachGood
caring: Involvement of people in their care planningGood
responsive: Individualised care planning and flexibilityGood
responsive: Complaints handlingGood
well-led: Quality assurance and audit systemsRequires improvement
well-led: Registered manager in postRequires improvement
well-led: Staff support and consistency of management oversightRequires improvement
Bluebird Care Sefton was rated Good across all five key questions at its announced inspection on 11–12 August 2016, having successfully addressed a previous breach of regulation relating to staff training and supervision. The service demonstrated strong person-centred care, safe medication management, robust recruitment, and effective governance with no missed visits recorded.
Concerns (1)
minorComplaints handling: “Only one person told us they had raised a concern and felt it had not been addressed, we raised this with the registered manager who was going to look into this concern.”
Strengths
· All people spoken with said they felt safe and staff were on time for calls with no missed visits recorded
· Robust recruitment practices in place with DBS checks completed before staff commenced duties
· Medication administration procedures were detailed, with training, competency checks and accurate MAR records
· Previous breach of regulation regarding staff training and supervision had been fully remediated
· Regular quality assurance audits conducted monthly with action plans for any shortfalls identified
Bluebird Care Sefton received a Good rating across all five key questions at its April 2019 inspection, demonstrating reliable, person-centred homecare for 124–125 people with strong governance and staff support. One recommendation was made regarding safeguarding referral practices to ensure all potential abuse types were identified and reported to the appropriate authority.
Concerns (1)
moderateSafeguarding: “When we checked records on incidents we felt that there had been some that may have warranted further investigation by the local safeguarding authority.”
Strengths
· People reported feeling safe and trusted staff, with no safeguarding incidents since the last inspection over two years prior.
· No missed visits reported; new IT system introduced to monitor and programme staff visits in real time.
· Medicines safely managed in line with NICE guidance, with regular audits and competency checks.
· Staff well-trained, supported through regular supervision, and matched to people based on skills and attributes.
· High satisfaction rate of 95% in annual surveys; complaints thoroughly investigated and responded to openly.