Bluebird Harrow and Brent is a domiciliary care agency registered to provide personal care to people in their own homes. The service provides support to people of all ages and different abilities. At the time of this assessment, they supported 134 people who received personal care. The Care Quality Commission (CQC) only inspect the service received by people provided with 'personal care'; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. We conducted this assessment to follow up on concerns we identified at the last inspection. These included breaches of Regulations relating to safe care and treatment and good governance. The last rating for this service was requires improvement (published 9 December 2022). At this assessment we found improvements had been made and the provider was no longer in breach of regulations. Assessment activity started on 2 December 2024 and ended on 18 December 2024. There was a registered manager in post. A registered manager is a person who has registered with the CQC to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. We assessed quality statements from the safe, effective, responsive and well-led key questions. The overall rating for the service is good. People received care and support that met their needs. Effective systems were in place to help protect people from the risk of harm. There was comprehensive information about how to manage potential risks to help keep people safe. Staff were recruited safely and trained appropriately to help ensure they were competent for their role. People’s care and support plans reflected their range of needs. Staff told us they were well supported by management. Management emphasised their commitment to continuously driving improvements to help ensure people received safe and effective care and support.
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Bluebird Care (Brent) was rated Requires Improvement overall following an August 2022 inspection prompted by two serious injury incidents, with breaches of Regulation 12 (unsafe moving and handling risk assessments) and Regulation 17 (ineffective governance and incident learning systems). Strengths included caring, dignified staff practice, safe recruitment, robust safeguarding awareness, and good medicines management.
Concerns (6)
criticalCare planning: “Risk assessments and the related moving and handling care plans did not contain the sling size, when the hoist was last serviced, hoist type, or what checks needed to be completed.”
criticalIncident learning: “Staff could not remember having any discussions in relation to lessons learnt following recent incidents of falls. We did not see any evidence to support how any lessons learnt were effectively cascaded.”
criticalGovernance: “The provider did not have effective systems and processes to identify where quality was compromised and to respond appropriately and without delay.”
moderateStaff competency: “Two out of six records we reviewed showed that these competencies were not completed properly to ensure staff had been assessed on various aspects of moving and handling and medicines administration.”
moderateMissed or late visits: “We reviewed an incident log of January 2022 and noted there was one missed visit and 48 late visits... the same conclusion for subsequent months.”
minorCommunication with families: “One person was registered blind but the care plan instructed staff to show their ID badge to the person on arrival. The care plan was also not available in a format that was understood by the person.”
Strengths
· People were protected from the risk of harm and abuse with effective safeguarding policies and staff awareness of reporting responsibilities.
· Medicines administration records were completed appropriately and regularly audited, with staff receiving medicines training.
· Staff recruitment was safe, with employment history, references, and DBS checks completed before commencement.
· People received person-centred care and were matched with care workers based on language, religion and culture.
· People were treated with dignity, respect and kindness, with strong feedback from relatives and service users.
Quality-Statement breakdown (22)
safe: Assessing risk, safety monitoring and managementRequires improvement
safe: Learning lessons when things go wrongRequires improvement
safe: Using medicines safelyGood
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Staffing and recruitmentGood
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 experienceRequires improvement
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Supporting people to live healthier lives, access healthcare services and supportGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
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
responsive: Meeting people's communication needsRequires improvement
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportNot rated
well-led: Managers and staff being clear about their roles, quality performance, risks and regulatory requirements; continuous learningRequires improvement
well-led: How the provider understands and acts on the duty of candourGood
well-led: Promoting a positive culture; engaging and involving people using the serviceGood