Our inspection of Bluebird Care, Bradford North, took place between 13 to 17 March 2017 and was announced. At our previous inspection in February 2016 the service was found to be in breach of legal requirements regarding medicines management and good governance. At this inspection we saw improvements had been made and the service was no longer in breach.

Bluebird Care (Bradford North) provides a wide range of home care services and support to older people who live across the Bradford local authority area. Their headquarters are located within the town centre of Shipley. On the day of our inspection 57 people were receiving the regulated activity of personal care.

A registered manager was in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are 'registered persons'. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People we spoke with told us they felt safe with the care and support provided by the service. Staff had received safeguarding training and understood how to keep people safe. Risk assessments were in place and appropriate to people's needs. Accidents and incidents were monitored and appropriate actions taken as a result.

Medicines were safely managed and any issues dealt with promptly.

Most people we spoke with were positive about the service and told us staff generally arrived when they should and stayed for the correct amount of time. People particularly commented on the accessibility and responsiveness of the management team.

Sufficient staff were employed to ensure people received a reliable and consistent service. Robust recruitment procedures were in place and staff received appropriate training to allow them to provide effective care and support.

The service was acting within the legal framework of the Mental Capacity Act (MCA). People told us they were supported to make choices about their care and support and information about supporting people's choice was documented in people's care records.

People told us staff were kind and caring and supported them to maintain as much independence as possible. Staff knew people well and most staff told us they supported the same people which allowed them to build good relationships and maintain consistency. This was confirmed by people we spoke with.

Electronic care records contained information on people's likes, dislikes and preferences. However, further detail would enhance the personalisation of these.

Complaints were taken seriously by the service. Any complaints received were documented and investigated to provide people with an outcome. Complaints were analysed for lessons learned.

People's health care needs were met and we saw liaison took place with a variety of health care professionals such as GPs, district nurses and social workers.

Robust systems were in place to assess and monitor the quality of the service. A range of tools were used to drive improvements.

People and staff were mostly positive about the management of the service and told us they were approachable, responsive and caring. The management team was pro-active and open to ways of improving the service.

People were involved in the running of the service through meetings, reviews, surveys, social gatherings and a regular newsletter. Most people told us they listened to by the service. Staff attended regular meetings and completed an annual survey.

Bluebird Care (Bradford North) provides a wide range of home care services and support to older people who live across the Bradford local authority area. Their headquarters are located within the town centre of Shipley.

A registered manager was in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

People and their relatives all spoke positively about the service. They said Bluebird Care (Bradford North) provided them with effective and responsive care that met their needs. They said that generally the service was reliable and staff arrived at the same time each day and stayed for the correct amount of time.

All the people we spoke with told us they felt safe from abuse whilst using the service. They said staff treated them well and managed risks to their health and safety appropriately. Staff demonstrated a good awareness of safeguarding and how to act to keep people safe.

Although people who used the service provided good positive feedback about the service, we found a number of issues with care records and medication documentation. This meant that we could not evidence a consistent and high quality service in these areas. The provider was transitioning from paper based records to computerised record keeping. During this transition period we found a number of people did not have up-to-date care records or risk assessments.

The service had recently reduced the number of care packages it provided, to ensure it could continue to meet people’s needs. At the time of the inspection we found there were sufficient staff employed to ensure people received a reliable and consistent service. Safe recruitment practices were in place.

Medicines were not consistently managed in a safe way. We found a number of gaps on Medication Administration Records (MAR) where we could not confirm people had received their medicines as prescribed and care records did not always reflect the medicines people were taking.

Staff received a range of face to face training and support from a recognised training provider to help ensure they had the correct skills and knowledge to care for people. People told us that staff undertook tasks carefully and competently. Most people told us they received care from a consistent group of staff, although a number of people said this wasn’t always the case and they would prefer a smaller group of staff to visit their homes.

The service was acting within the legal framework of the Mental Capacity Act (MCA). People told us they were supported to make choices about their care and support.

People told us that staff were consistently kind and caring and always treated them well. People said they felt listened to by staff and management. Wherever possible the service promoted people’s independence to help them do more for themselves.

Care records contained information on people’s likes, dislikes and preferences for example with regards to mealtime choices. This demonstrated staff had taken the time to understand the people they were caring for.

We saw evidence the service liaised with external health professionals such as GP’s, and district nurses to help ensure people’s healthcare needs were met by the service. Feedback from health professionals about the service was positive.

People told us complaints were appropriately managed by the service.

People and staff all spoke positively about the way the service was managed. They said the management were responsive in answering the phone or getting back to them regarding any queries or concerns.

Some systems were in place to assess and monitor the quality of the service. However this was not consistently so. We found records of daily care and medication r

People, who use the service and their relatives, told us that they very satisfied with the quality of services. They had no concerns or problems with the level of service provided and the staff were very good and dedicated to their work.

Bluebird Care (Bradford North) is a home care service which provides personal care in people’s own homes. This includes help with washing and dressing, mobilising around their homes and supporting people to access the local community. At the time of the inspection, the service provided care to 102 adults. The service had a registered manager in post.

The overall feedback about the quality of the service was positive from people who used the service and their relatives. For example, people told us that staff delivered effective care, were friendly and treated them well. People said they felt safe when staff were in their home.

There were two areas where people felt improvements were required. Firstly, they said that they would like more continuity of care staff, so that they could build up good relationships with familiar carers who understood their needs. Secondly, although people told us staff were usually on time, and never missed calls, they told us that when they were late, they were not contacted by the service. We saw the provider had identified these problems and was working through an action plan to address them.

Staff understood how to keep people safe and how to identify and act on allegations of abuse. Staff understood how the Mental Capacity Act (MCA) was applied to ensure decisions made for people without capacity were made in their best interest.

People’s needs were assessed when they started using the service and this was used to produce clear support plans to allow staff to deliver effective care. People’s likes and preferences had been recorded and there was evidence people were involved in their care planning and review.

Staff had received a range of training to allow them to do their role effectively. This included induction training based on national standards as well as regular training updates in areas such as manual handling and safeguarding.

People said staff were kind and considerate. People said that all the care staff were of a satisfactory standard but some were better than others. People said that it was difficult to develop strong relationships with staff due to the lack of continuity of carers.

People and their relatives were involved in the planning and review of care through regular care plan reviews.

Management had identified the key challenges which faced the organisation. We found these had been identified through quality assurance systems such as spot checks and surveys. An action plan was in place to address these challenges which were consistent with what we found during the inspection.

There were currently only limited systems in place to monitor the timeliness of care calls. There was no analysis of late calls to look for themes and trends, and late calls were not identified if staff failed to ring the office.