The inspection took place on 9 and 11 September 2016 and was announced.

Bluebird Care Limited is a domiciliary care service that provides personal care to people living in their own homes. They predominantly provide a service for older adults, some of whom may be living with dementia or may have a physical disability. The service does not provide nursing care. At the time of our inspection there were approximately 44 people using the service.

There was not 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. The former registered manager had left in April 2016. The former Head of Care had been appointed as manager and was applying to CQC to become the new registered manager.

Staff supported people to remain safe in their homes. There were sufficient staff to meet people’s needs and to manage risk safely. On-call and emergency arrangements worked well. There were effective systems in place to manage medicines and people were supported to take their prescribed medicines safely. The provider had a robust recruitment process which helped protect people from the risk of avoidable harm.

Staff were supported to develop their skills and knowledge. Staff sought consent before providing care and understood people’s rights to make choices about their service. People were supported to consume food and drink of their choice. Staff worked well with people and health care professionals, to ensure people maximised their health and wellbeing.

People were treated with dignity and respect by staff. Staff knew people well and had time to spend developing positive relationships with them. People received support that was personalised and responded flexibly to changes in their lives. Staff had detailed guidance to enable them to provide a consistent level of support. They were aware of how to make a complaint and felt that they were listened to by the registered manager.

Staff were enthusiastic about working for the service and worked well as a team. The director was working well with the new manager to manage change within the service. The provider promoted innovation and supported best practice. There were systems in place to check the quality of the service.

We spoke with three of the 21 people who used the service. We also spoke with one person's relative and three staff members. We looked at four people's care records. Other records viewed included staff training records and satisfaction questionnaires completed by the people who used the service.

We considered all the evidence we had gathered under the outcomes we had inspected to answer the questions we always ask; 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?

People’s care records contained risk assessments and care plans to ensure the care provided was safe and appropriate for their needs. We saw care plans were reviewed in conjunction with the people who used the service, and their relatives where appropriate, to ensure care was provided in accordance with their wishes.

The service had policies in place in relation to Adult Safeguarding, the Mental Capacity Act (2005) and Deprivation of Liberty Safeguards. Mental capacity assessments were completed when people lacked the ability to make decisions in relation to their care and treatment and we saw ‘best interest’ decisions had been documented. Staff had received training and demonstrated an understanding of the implications of the policies in relation to their work. This meant people’s rights were protected.

Is the service effective?

A full assessment was completed for each person prior to commencement of a service. Care plans were reviewed regularly and updated as necessary to ensure the care provided was appropriate to each person’s individual needs.

We saw there was a structured approach to training and regular meetings took place with appraisal of staff to ensure they were supported to ensure they were effective in their job roles.

Is the service caring?

When we talked to people who used the service and their relatives, they told us that staff were caring and understood people’s individual needs and preferences .

Is the service responsive?

Systems were in place to make sure that themes and trends from events such as accidents and incidents, complaints, and concerns were identified and lessons learnt to prevent recurrence. This reduced the risks to people and helped the service to continually improve.

Feedback on the service was sought from people and their relatives and we saw a number of examples of improvements which had been implemented as a result of this feedback. We were made aware of two incidents where people using the service had experienced care below the standard they expected. The service was able to demonstrate what action they had taken to learn from these and make changes to improve the service.

Most of the people we spoke with told us they had had no need to complain but if they raised a concern or issue of any kind they were confident their concerns would be addressed. They said staff were approachable and always listened to their views.

Is the service well led?

There were structures in place for clinical governance and quality assurance. We saw a planned approach to quality audits and evidence that action was taken as a result of these to improve the quality of the service provided.

Staff told us they felt well supported and were encouraged to provide standards of care they could be proud of. They had received the training they required to deliver safe and effective care. There were systems in place for the appraisal of staff performance and personal development planning.