We undertook an announced inspection of Bluebird Care (Gravesham and Dartford) on the 21 July 2016. Bluebird Care (Gravesham and Dartford) is registered to provide the regulated activity personal care and provides personal care, housework and assistance with medicines in people’s homes.

At our last inspection on 6 January 2014 the service met the regulations inspected.

There was a registered manager in post. 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 using the service and relatives told us that they were satisfied with the care and services provided. People told us they were safe when cared for by care workers. People and relatives also spoke positively about care workers and management at the service.

Systems and processes were in place to help protect people from the risk of harm and care workers demonstrated that they were aware of these. Care workers had received training in safeguarding adults and knew how to recognise and report any concerns or allegations of abuse.

Risk assessments had been carried out and care workers were aware of potential risks to people and how to protect people from harm.

There were appropriate arrangements in place in respect of medicines. Care workers had received medicines training and policies and procedures were in place. Medicines Administration Records (MARs) were completed correctly and the service had an effective medicines audit in place.

People told us their care workers turned up on time and they mostly received the same care worker on and had consistency in the level of care they received. This was also confirmed by relatives we spoke with. The service had a system in place to monitor care workers punctuality.

People and relatives told us that they were confident that care workers had the necessary knowledge and skills they needed to carry out their roles and responsibilities. Care workers spoke positively about their experiences working for the service and said that they received support from management and morale amongst staff was positive.

Care workers had a good understanding of and were aware of the importance of treating people with respect and dignity. Feedback from relatives indicated that positive relationships had developed between people using the service and their care worker and people were treated with dignity and respect.

People received care that was responsive to their needs. People's daily routines were reflected in their care plans and the service encouraged and prompted people's independence. Care plans included information about people's preferences.

The service had a complaints procedure and there was a record of complaints received. People and relatives spoke positively about the service and told us they thought it was well managed.

There was a clear management structure in place with a team of care workers, office staff, the registered manager, the operations manager and the provider.

Staff were informed of changes occurring within the service through regular staff meetings. Staff told us that they received up to date information and had an opportunity to share good practice and any concerns they had at these meetings.

Systems were in place to monitor and improve the quality of the service. We found the service had obtained feedback about the quality of the service people received through review meetings and satisfaction surveys. Records showed positive feedback had been provided about the service. The

service also undertook a range of checks and audits of the quality of the service and took action to improve the service as a result

We spoke with four people who use the service. They were all satisfied with the care and support they received and were happy with the way they were treated. One person told us, "They (staff) are fantastic. I wouldn't have continued to use them for so long if they weren't".

We saw that people's consent was obtained where possible before care and treatment was undertaken. We observed that the care given was safe and appropriate and based on effective care planning and risk assessments. This meant that people's individual needs were met and preferences were taken into account.

People were protected from abuse and cared for in a safe and inclusive environment. We also noted that people were cared for, or supported by, suitably qualified, skilled and experienced staff. In addition, the provider had an effective system to regularly assess and monitor the quality of service that people received.

This inspection was to follow up on the findings from our previous inspection of 10 May 2012. The purpose of the visit was to assess if action had been taken in regards to concerns, which had been highlighted at the last inspection.

We found that the provider had taken action to address the identified concerns around record keeping so that people were protected from the risks of unsafe or inappropriate care.

We arranged to speak with people who used the service and their relatives over the telephone. They told us that they were happy with the care and support that was provided by the service. Two people told us they were so pleased with the care that they would recommend the service to others.

People praised the staff who visited them and described them as “Very helpful” “Always very nice, always smiling” and “Kind”. Comments included “The staff do what I want them to” and “The staff always go that extra mile to make sure I am ok”. The people we spoke with told us staff were on time and always stayed for the agreed amount of time.

People told us that they were visited by regular care staff who understood their needs. People said they were kept involved with their care. They confirmed that they had copies of their care plans at home and were involved in reviews of their care by the service.

People praised the communication from the main office and said that the service was “Very efficient” and “Accommodating”. One person explained “The service is very accommodating…I have had to request an extra visit and they sorted this out very quickly”.