This announced inspection took place on 22 and 28 August 2018.

At our last inspection of 17 December 2015, the service was rated ‘Good’ across all domains.

Bluebird Care Merton is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults and younger disabled adults.

Not everyone using Bluebird Care Merton receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. At the time of our inspection 57 people were receiving care.

At the time of our inspection the director was awaiting interview for their CQC registration as 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.

At this inspection we found that the provider was in breach of the regulations relating to good governance. You can see the action we have told the provider to take about these breaches at the back of the full version of this report.

We found that developments were needed to ensure quality assurance systems were appropriately managed and improvements to the service made in a timely manner. Audits conducted of incidents and complaints were not effective in identifying patterns and trends. Care plans for people using the service were not always regularly reviewed. Feedback from people and relative satisfaction surveys was not analysed to support improvements across the service. People were not always supported to express their wishes in relation to end of life care preferences.

People and their relatives were not always satisfied with staff attending their calls on time, and expressed concerns with how office staff communicated with them. The director had highlighted this as an area for development and had focused on office team development through team meetings and supervisions.

People were supported by staff that knew how to safeguard them, and appropriate checks had been carried out to ensure staff were safe to work with people. Staff were aware of their responsibilities in relation to infection prevention and control. Incidents and accidents were appropriately investigated as and when they occurred. People’s risk assessments and administration of medicines were comprehensively assessed and managed to ensure that people received the support they required.

Staff received regular supervision and appraisal to support them in their roles. People were supported to eat balanced meals of their choice. Where people needed to access healthcare professionals the service supported them to do so. People are supported to have maximum choice and control of their lives and staff support them in the least restrictive way possible; the policies and systems in the service support this practice. Staff sought people’s consent when delivering care. People’s needs were assessed in line with best practice guidance.

People felt that staff were caring and attentive to their needs. People’s privacy and dignity was respected, and staff were considerate of people’s needs when supporting with personal care. People’s care plans, and staff support reflected that people were supported to be as independent in tasks as possible.

People’s care plans were comprehensive in detailing people’s preferences in how they wanted their care needs to be met. Complaints were appropriately investigated and responded to in a timely manner.

Staff recognised that the director had made improvements to communications between staff in the field and in the office. A new quality and training manager had been recruited to focus

This This was an announced inspection and took place on 17 December 2015. 

At our previous visit in January 2015 we judged the service was meeting all the regulations we looked at.

Bluebird Care Merton provides domiciliary care and support to 78 people living in their own homes in the Merton area with a range of needs including older people, dementia, physical and mental health needs.

The service had a registered manager in post at the time of this inspection.

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 told us they were happy with the care they received. This was also the view of relatives we spoke with about the care and support provided for people in their homes. There were arrangements in place to help safeguard people from the risk of abuse. The provider had appropriate policies and procedures in place to inform people who used the service, their relatives and staff how to report potential or suspected abuse. 

People had risk assessments and risk management plans to reduce the likelihood of harm. Staff knew how to use the information to keep people safe.

The registered manager ensured there were safe recruitment procedures to help protect people from the risks of being cared for by staff assessed to be unfit or unsuitable.

People told us staff had the knowledge and skills to carry out their work effectively. Staff received training in areas of their work identified as essential by the registered manager. We saw documented evidence of this. 

Appropriate arrangements were in place in relation to administering and the recording of medicines which helped to ensure they were given to people safely.

Staff had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005. They supported people to make choices and decisions about their care.

People had a varied nutritious diet.

They were supported to have a balanced diet, food they enjoyed and

were enabled to eat and drink

well and stay healthy.

People said they thought the staff were caring and compassionate towards them. They told us they were involved in planning their care and their views were sought when decisions needed to be made about how they were cared for. The service involved them in discussions about any changes that needed to be made to keep them safe and promote their wellbeing.

We were told by people that staff always wore their uniforms and identity badges. They said that staff respected their privacy and treated them with respect and dignity. 

People said they felt the service responded to their needs and individual preferences. Staff supported people according to their personalised care plans, including supporting them to access community-based activities.

People knew how to raise any concerns or complaints they might have and they said they felt comfortable in doing so. People were aware of the complaints policy.

People gave positive feedback about the management of the service. The registered manager and the staff were approachable and fully engaged with providing good quality care for people who used the service. The registered manager had systems in place to continually monitor the quality of the service and action plans were developed where required to address areas that needed improvements.

This was an announced inspection and took place on 16 January 2015. At our previous visit on 18 June 2013, we judged that the service was meeting all the regulations that we looked at.

Bluebird Care Merton is a domiciliary care agency providing personal care and support for 60 adults living at home in the Merton area. Fifty seven people who receive a service from Bluebird Care Merton are privately funded and three are funded by the Merton Clinical Commissioning Group (CCG). After the inspection visit we spoke on the telephone with ten privately funded people who used the service. We also spoke with two commissioners from the Merton CCG who commissioned and monitored the care provided to people who used the service.

The service had 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 told us they felt safe with the service they received at home. There were arrangements in place to help safeguard people from the risk of abuse. The provider had appropriate policies and procedures in place to inform people who used the service, their relatives and staff about how to report suspected abuse.

People had risk assessments and risk management plans to reduce the likelihood of risk. Staff knew how to use the information to keep people safe.

The registered manager ensured there were safe recruitment procedures to help protect people from the risks of being cared for by staff assessed to be unfit or unsuitable.

Staff received training in areas of their work identified as essential by the provider. We saw documented evidence of this.

Appropriate arrangements were in place in relation to administering and the recording of medicines which helped to ensure they were given to people safely.

People were involved in planning their care and their views were sought when decisions needed to be made about how they were cared for. The service involved them in discussions about any changes that needed to be made to keep them safe and promote their wellbeing.

Staff respected people’s privacy and treated them with respect and dignity.

People indicated that they felt that the service responded to their needs and individual preferences. Staff supported people according to their personalised care plans, including supporting them to access community-based activities.

The provider encouraged people to raise any concerns they had and responded to them in a timely manner. People were aware of the complaints policy.

People gave positive feedback about the management of the service. The registered manager and the staff were approachable and fully engaged with providing good quality care for people who used the service. The provider had systems in place to continually monitor the quality of the service and people were asked for their opinions via surveys. Action plans were developed where required to address areas for improvements.

All of the people who received services from Bluebird Care Merton were privately funded clients.

People told us that they had been provided with enough information about the services offered by Bluebird Care Merton to make a decision as to whether they wanted to use them or not. They also told us that they had been assessed before a service was provided and that they had a care plan that set out the care and support they had received. People said that they felt safe with their care workers and that they always wore their uniforms and identity badges.

People said that their care workers were reliable, kind and courteous, always respectful and generally on time. One person said, “I am very happy with Bluebird Care Merton they are very reliable, clean and tidy and they always ask if anything else needs doing, it’s an excellent service”. A relative of one of the service users fedback to Bluebird Care, “You have been efficient, flexible and honest, my mother is very happy with the service”.

People told us that the office always let them know if their care worker was going to be late. All the people we spoke to were happy with the services they received. They all knew how to make a complaint but the people we spoke to said they had never needed to do so.

People told us that they had been provided with enough information about the services offered by Bluebird Care Merton to make a decision as to whether they wanted to use them or not. They also told us that they had been assessed before a service was provided and that they had a care plan that set out the care and support they had received. People said that they felt safe with their care workers and that they always wore their uniforms and identity badges.

People said that their care workers were reliable, kind and courteous, always respectful and generally on time. They said that the office always let them know if their care worker was to be late. All the people we spoke to were happy with the services they received. They all knew how to make a complaint but the people we spoke to said they had never needed to do so.