This assessment took place on 28 January 2025 following an assessment at another of the provider’s services. Bluebird Care (Rother & Hastings) is a care at home agency that provides personal care to people living in their own homes. CQC only inspects where people are receiving the regulated activity personal care. This is help with tasks related to personal hygiene and eating. Where they do, we consider any wider social care provided. At the time of this inspection 40 people were receiving support with personal care. The service had a registered manager in place. People and relatives fed back positively regarding the registered manager and office staff, telling us the service was well managed with good levels of communication. Staff looked after people with care and compassion. We received many positive comments about care staff and people were very happy with the care they received, and the support care staff provided them. Telling us, “I really do not know what we would do without them” and “I am housebound, so I look forward to them visiting.” Staff were safely recruited and received an induction and training. All staff completed mandatory and further training to ensure they were able to meet people’s needs. Staff competencies and spot checks were caried out to monitor staff and ensure they were following best practice. Staff felt supported and told us they enjoyed their role. One told us, “I am proud to work for this company.” Governance systems and process were in place to continually review and improve. The registered manager had oversight of the day to day running of the service.
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Bluebird Care (Rother & Hastings) was rated Requires Improvement overall at its first CQC inspection, with safe and well-led domains falling short due to safeguarding escalation gaps, an unreported notifiable incident, incomplete risk assessments, and inadequate care plan audit frequency. Effective, caring and responsive domains were rated Good, reflecting well-trained and compassionate staff, no missed visits, strong person-centred care, and effective complaints handling.
Concerns (8)
criticalGovernance: “the registered manager had not informed the CQC of a notifiable incident”
moderateSafeguarding: “three staff failed to identify the local authority as their primary point of contact to raise safeguarding concerns beyond the service's management”
moderateIncident learning: “they could not recall completing an accident form and there was no completed accident form in the office”
moderateIncident learning: “the 'follow up' section within the accident and incident documentation had not always recorded what, if any, alterations to care and support had occurred”
moderateRecord keeping: “a person who had recently started using the service did not have clear guidance for staff about their behaviour which could be challenging”
moderateGovernance: “the registered manager told us they were currently auditing one care plan a month. This meant that a care plan may not receive an audit in excess of one year”
moderateCare planning: “one person who had recently started to use the service had not had appropriate risk assessments completed”
minorSupervision / appraisal: “senior staff were not having these discussions formalised or documented”
Strengths
· Medicines were managed safely with regular MAR audits and staff competency checks
· No missed or late visits; sufficient staffing levels maintained at all times
· Staff received comprehensive induction, regular training, supervision and appraisals
· People and relatives consistently praised staff as kind, compassionate, reliable and punctual
· Care plans were mostly detailed and person-centred, developed in partnership with people
Bluebird Care (Rother & Hastings) was rated Requires Improvement overall at this June 2018 announced inspection, driven by incomplete recruitment documentation and insufficiently robust staff-file auditing, despite no regulatory breaches. The service performed well across effective, caring and responsive domains, with particular strengths in end of life care, staff training, electronic monitoring, and consistently positive feedback from people, relatives and health professionals.
Concerns (3)
moderateRecord keeping: “Employment histories were in place but there were some unexplained gaps on each file viewed. Interview records were not routinely maintained to record if reasons for gaps had been explored.”
moderateGovernance: “Gaps in employment histories of recruited staff, or actions taken in regard to chasing second references needed better recording to support the thoroughness of the recruitment process.”
minorMedication management: “Staff were doing this for liquid medicines and ointments and needed to extend this to boxed medicines if and when they received them, this is an area for improvement.”
Strengths
· No missed calls and good continuity of staff; agency staff no longer used to cover shortfalls
· Strong safeguarding knowledge among staff with clear escalation processes internally and externally
· Robust electronic MAR monitoring enabling remote daily audit of medication administration
· Comprehensive staff training including specialist inputs (e.g. PEG, diabetes) and a purpose-built simulation suite
· Regular staff supervision approximately four times per year plus annual appraisal and competency observations
Quality-Statement breakdown (20)
safe: Recruitment and staffingRequires improvement
Bluebird Care (Rother & Hastings) was rated Good across all five key questions at this July 2019 inspection, representing an improvement from Requires Improvement in Safe and Well-Led at the previous inspection. The service demonstrated strong person-centred care, effective governance, safe recruitment and medicines management, and positive partnership working with health and social care professionals.
Strengths
· Staff knew people well, understood their needs, and were described as attentive, caring and cheerful by relatives.
· Safe recruitment processes were strengthened following previous inspection concerns, with gaps identified and addressed.
· Medicines were managed safely with staff competency assessed, PRN guidance in place, and clear MAR recording.
· Specialist training provided for staff supporting people with epilepsy, challenging behaviour and communication needs.
· Real-time electronic monitoring of care visits with outcome-based alerts for missed or incomplete visits.
Quality-Statement breakdown (23)
safe: Systems and processes to safeguard people from the risk of abuse; Learning lessons when things go wrongGood
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced diet
effective: Nutrition and hydration
Good
effective: Health needs and partnership workingGood
caring: Kindness, dignity and respectGood
caring: Involvement of people and relativesGood
caring: Independence and community presenceGood
responsive: Person-centred care planningGood
responsive: Accessible informationGood
responsive: Complaints handlingGood
responsive: End of life careGood
well-led: Governance and auditRequires improvement
well-led: Leadership and cultureGood
well-led: Engagement with people, relatives and professionalsGood
Good
effective: Supporting people to live healthier lives, access healthcare services and support; Staff working with other agenciesGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: Meeting people's communication needsGood
responsive: Supporting people to develop and maintain relationships to avoid social isolationGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirements; Continuous learning and improving careGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Engaging and involving people using the service, the public and staff, fully considering their equality characteristicsGood