This announced comprehensive inspection took place on 4 and 5 September 2018. Bluebird Care Exmouth is a domiciliary care agency. It provides personal care to older adults and younger disabled adults in Exmouth, Budleigh Salterton, Clyst St Mary and surrounding areas. The provider is W & S Flint Services Limited, a husband and wife team who run three branches of the agency in the Devon area. This was the first inspection since the location was registered in September 2017. At the time of the inspection the branch provided personal care to 26 people and employed 23 care staff, known as Devon Bluebirds.

The service had a registered manager. 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 relatives praised staff as exceptionally caring and compassionate. People were partners in their care. Their views, experience and contributions were sought and valued. The agency had a strong, visible person-centred culture. People were at the heart of everything they did, they were made to feel valued and that they mattered. The service went that extra mile to exceed people's expectations of the service. For example, they held a monthly wellbeing programme to get people out socialising, having new experiences and taking some exercise. Feedback showed wellbeing events significantly improved people's physical and emotional

wellbeing and reduced their risk of isolation.

People were supported in innovative ways, to be proactively involved in making decisions about their care, treatment and support. For example, the provider undertook a 'Talk Care' campaign to promote a conversation about care that was positive, informative, open-minded and inclusive. They made a series of informative short videos of conversations with health and social care representatives to highlight key things people needed to know about care. These included the importance of planning ahead for care, options for care, and simple explanations about lasting power of attorney, making wills, benefits and paying for care. These were posted on social media and provider’s website, which enabled people and families to be better informed about care options and what was important in planning their care.

The service had embraced the possibilities of using technology in innovative ways to improve the quality of people's care and to enable them to stay living at home for longer. They worked with a specialist provider to pilot exploring the possibilities of using sensor technology to assist families to support and monitor a person's wellbeing. For example, data about frequent trips to the bathroom highlighted early signs of a urine infection for one person. This led to them being seen earlier by their GP and antibiotic treatment started, which helped them recover more quickly. An electronic computer record system meant staff could read new people's care records before they visited, and follow up any health concerns. The system quickly highlighted when a person's needs changed, so their care needs could be reviewed. Other benefits included health professionals and relatives being able to access parts of the system, with the person's consent.

The service worked in partnership with local health and social care providers to respond to the changing needs of local people. For example, they worked with their local NHS to pilot providing temporary night support to people in Exeter, East and Mid Devon. This enabled people to be discharged home from hospital as soon as possible, enabled the ambulance service to prevent people being admitted to hospital at night and to support people dying at home. The pilot was so successful, the service was expanded in May 2018 to provide five night care staff seve