This inspection was carried out on 15 and 17 November 2016 and was announced. Twenty four hours’ notice of the inspection was given to make sure that people who wanted to speak to us were available during the inspection.

Bluebird Care (Canterbury and Thanet) provides care and support to a wide range of people living in their own homes including, children, older people, people living with dementia, and people with physical disabilities. The support hours varied from 24 hours a day to a half hour call and from one call to four calls a day, with some people requiring two members of staff at each call. At the time of the inspection 53 people were receiving care and support from the service.

A registered manager was leading the service, supported by the provider. 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 and associated Regulations about how the service is run.

People told us that staff were “very caring” and “fantastic”. One person’s relative told us, “Nothing's too much trouble for the staff who visit my relative”. Everyone we visited told us the service they received from Bluebird Care helped them to stay at home, which was where they wanted to be. People had been asked about their care preferences at the end of their life and staff had worked with community nurses and hospice staff to support people who wanted to remain at home.

Staff and the provider shared a commitment to treat people with dignity and respect at all times and support them to be as independent as possible. It was their philosophy to 'do with, not do for'. People told us staff demonstrated these values when they provided their care and support. Staff went ‘the extra mile’ to provide compassionate care to people and support them when they were upset or worried.

The registered manager and other senior staff supported staff to provide a good standard of care and held them accountable for their practice. Staff were clear about their roles and responsibilities and were highly motivated to provide the support and care that each person wanted. Checks on the quality of the service people received were completed every month to make sure they were of the standard the people and the provider required. Action was taken quickly to address any shortfalls found.

People told us they had regular carers who knew them well, and provided their care in the way they wanted. People's age and personality had been considered when deciding which staff provided people’s care. Staff worked as a team and provided cover for sickness or holidays.

Recruitment systems were robust. Checks, including criminal records checks had been completed to make sure staff were honest, trustworthy and reliable. Staff had completed the training and development they needed to provide safe and effective care to people and held recognised qualifications in care. Plans were in place to regularly refresh staff’s skills and further develop them in their role. Senior staff met regularly with staff to discuss their role and practice.

Staff knew the signs of possible abuse and the registered manager had raised any concerns they had with the local authority safeguarding team. People's care was planned and reviewed with them to keep them safe and help them be as independent as possible. Possible risks to people had been identified and action had been agreed with people to keep them safe, while supporting them to be independent.

Assessments of people's needs had been completed to identify any changes. Detailed guidance was provided to staff about how to meet people's needs as soon as they began to use the service. People's care plans had been reviewed with people and their relatives and changed when people's needs changed.

Accurate records were maintained about the care and

The inspection was carried out by one Inspector over eight hours. We spoke with staff and looked at records. We telephoned people that used the service and members of staff working in the community. We collated all of the information in order to judge compliance with the regulations. They helped answer our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Is the service safe?

The service was safe. Practices in the service protected people using the service, staff and visitors from the risk of harm. One person told us, “I feel very safe, I never have any troubles with them, I trust them all”.

Systems were in place to make sure that managers and staff learned from complaints, whistleblowing and investigations. This reduced the risks to people and helped the service continually improve.

People using the service were protected from infection because the provider had processes in place to assess the risks to them and manage these effectively.

Each person had a care plan detailing their care and support needs. These had been re-written since our last inspection and contained guidance for staff to follow to provide effective care and reduce risks to make sure people were as safe as possible.

Is the service effective?

The service was effective. People told us that they were happy with the care that had been delivered and that their care needs were met. One person we spoke with told us, “I would give the service 9/10”. People and their relatives told us that staff arrived on time and stayed for the agreed length of time. One person told us, “If they finish early they sit and chat to my relative”. Another person told us “They are usually on time but if they are 10 minutes late they leave 10 minutes later”. Everyone we spoke with said that they were informed if the staff would be late arriving at their home.

People’s health and care needs were assessed with them and /or their representatives. We found that people’s care plans had been re-written with them and their representatives since our last inspection and reflected their current needs.

Is the service caring?

The service was caring. People and their relatives told us they were supported by kind and caring staff. One person’s relative told us, ‘My relative is a very private person. The staff have brought them out of their shell and now they chat and joke together”. People we spoke with said they felt staff respected their privacy and dignity and staff were polite and caring.

Is the service responsive?

The service was responsive. People told us that they were happy with the service. Some people told us that they had raised concerns with the service about specific issues and they had been addressed immediately.

We found that people’s planned care had changed when they required it or as their needs changed. Emergency and contingency plans were in place and available to staff to support them to respond quickly to changes such as staff illness and changes in people’s health needs.

Is the service well-led?

The service was well led. There was a clear management structure in place quality assurance processes were in place. Staff told us they were clear about their roles and responsibilities and that they felt supported by the management team. Systems were in place to ask people who used the service, relatives and staff for their views about the service. Regular, unannounced spot checks were completed to assess the quality of the care being provided to each person.

We visited the office and spoke with two members of the management team and six staff. We spoke to the registered manager on the phone. We later spoke by telephone with ten people who used the service and six relatives.

People felt they were able to make their own decisions and choices regarding their day to day care and support. People confirmed that they had given their consent and been involved in discussions about their care, sometimes with a family member, when the service had first started.

Most people said they were satisfied with the care and support they received. One person said, "I think Bluebird Care are very good, much better than the last agency I used. “ Another person said, "They are efficient and caring, nothing is too much trouble”.

Two people told us that when there had been a few concerns when they first started to use the service. They had contacted the office and immediate action was taken to rectify the issues.

We found that care plans contained information about some of the support and care that people needed but lacked detail about people's specific needs like the risk of developing pressure areas or when people had specific medical conditions like diabetes

People knew about their care plan or confirmed that staff had talked about the care and support they required. Care was delivered by a regular team of care workers to ensure people had continuity. One person said, "I know most of them, I usually get the same staff”.

People said that they felt safe when care staff were in their homes. Policies and procedures were in place to safeguard people from harm and abuse. Everyone we spoke with said they felt safe when care staff were in their homes. People said that they trusted the care staff and said that their privacy and dignity was always respected.

Checks were made on staff, as part of the recruitment process, to make sure that people were safe and supported by appropriate people.

People said they had been asked for their views and feedback on the service provided. One person said, "They visit regularly and go through it all, the care plan and whether the staff wear their gloves etc." People told us they felt confident that any concerns would be addressed. There were systems in place to monitor the quality of the service.

There were 55 people using the service when we completed our inspection and 40 staff members. We spoke with three people who use the service and three of their relatives, the manager and staff. Everyone we spoke to said that they were satisfied with the service they received from Bluebird Care (Canterbury and Thanet). One person told us, “I can’t fault them”. Another person said “My relative gets excellent care all of the time”.

People’s needs were assessed before a service was provided and people were involved in planning their care and support on an on going basis.

People knew when staff would call on them and who was coming. They told us that they felt safe with staff and were treated with respect and dignity.

Everyone we spoke to said that the service they received was good. One person said, “I would give them top marks”.

One staff member told us, “The best thing about this service is that we get the time we need to meet peoples needs and are not rushed to get to the next person”.

You can see our judgements on the front page of this report.

We spoke to people who use the service and their carers over the telephone.

People told us that there were happy with the care and support they received. They told us they were involved in their plan of care and were aware of their records

People who use the service told us they received care from regular staff that were trained to do their jobs well. They said they felt safe with the staff who came to support them and staff were polite and caring. They said the staff were flexible and reliable.

People did not have any complaints but felt if they did these would be dealt with. Safety checks were carried out on staff before they were allowed to work with people.

People told us that the service carried out checks to make sure they were satisfied with the care being provided. Comments from the people using the services, relatives, health care professionals and staff were very positive