This inspection took place on 16 December 2016. This was an announced inspection and the provider was given 48 hours' notice. This was to ensure that someone would be available at the office to provide us with the necessary information to carry out an inspection. When we last inspected this service on 3 June 2014 we found the service met all the regulations we looked at.

Bluebird Care Camden & Hampstead is a domiciliary care agency based in North London which provides home based care for elderly people, some of whom are living with dementia. At the time of the inspection there were 33 people using the service.

There was a registered manager at the service. 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.

The registered provider and registered manager continually strived to improve the service and implemented an action plan which identified areas for improvement and actions were put in place accordingly. The registered provider had developed strong links with the local community. They worked alongside other social care organisations to promote social care causes and make improvements.

People were extremely satisfied with the quality of the service they received and praised the caring and compassionate nature of the care staff. The provider supported staff to understand the emotional and social needs of people living with dementia and was actively involved in achieving positive local outcomes to improve the quality of life for people living with dementia.

People, relatives and particularly staff praised the supportive and responsive management structure in place at the service. The registered manager and registered provider enabled an open culture that encouraged learning and the discussion of ideas and improvements through regular staff meetings.

Robust quality assurance processes and procedures were in place to monitor the quality and safety of people's care. The delivery of care was recorded on the services electronic care records system which enabled immediate management oversight of the completion of care tasks on a real time basis. Any issues were promptly picked up by office staff and dealt with through the instant electronic feedback system which was confirmed in records seen.

People and relatives told us they felt safe. Procedures and policies relating to safeguarding people from harm were in place and accessible to staff. All staff had completed training in safeguarding adults and demonstrated an understanding of the different types of abuse to look out for and how to raise safeguarding concerns.

Detailed risk assessments were in place for people using the service and were reviewed and updated regularly. Risk assessments explained the signs to look for when presented with a possible risk and the least restrictive ways of mitigating the risk based on the individual needs of the person.

Medicines were managed safely and effectively and there were regular medication audits in place. Staff had completed medication training and the service had a clear medication policy in place which was accessible to staff.

The provider employed sufficient skilled and experienced staff to meet people's needs. We saw evidence of a comprehensive staff induction and on-going training programme. Staff were recruited with necessary pre-employment checks carried out. Staff received regular supervisions and annual appraisals.

Care plans were person centred and reflected what was important to the person. Care needs were regularly reviewed and updated to meet the changing needs of people who used the service.

People and their relatives told us they received kind and compassionate care and were treated with respect.

All staff had received training o