This announced inspection took place between the 11 and 16 January 2019. At our last inspection in October 2015 we rated the service good. This is the service's first inspection at its current address. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

Bluebird Care, Newmarket and Fenland is a domiciliary (home care) care agency. It provides personal care to people living in their own houses and flats. This also includes a ‘live-in’ care service where staff cared for people in the person’s home for most of the day. Bluebird Care, Newmarket and Fenland provides a service to younger adults, older people, people living with dementia, people with a physical disability and people with sensory impairments. Not everyone using Bluebird Care, Newmarket and Fenland receives the regulated activity of personal care. 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 there were 106 people receiving the regulated activity of personal care.

A registered manager was not in post. They left in November 2018. A new manager had been in post for two weeks and had already applied to us to be registered.

People continued to receive a safe service. Staff had a good understanding of safeguarding systems and how to report any concerns. Staff continued to be recruited in a safe way with checks undertaken on their suitability. Only staff who successfully passed pre-employment checks were recruited. Sufficient staff were employed and they met people's needs safely including the safe administration and management of their medicines. Staff helped people to keep a clean environment in their homes. Risk assessments relating to the health, safety and welfare of people using the service were completed. Lessons were learned when things went wrong.

The service remained effective. Staff were supported to have the right skills to meet people's needs. Staff supported people to eat and drink well. People were enabled to access health care services. People were given choice and control over their lives and staff supported them in the least restrictive ways possible. The policies and systems in the service supported this practice. The registered manager worked with other organisations involved in people’s care to help ensure when they moved between services, they received consistent care.

The service remained caring. People received a service from staff who showed compassion, kindness and respect of people's dignity. Procedures and policies were in place to help people to access and use advocacy services. People were involved and had a say in how their care was provided. People were treated with fairness whatever their needs were and could be as independent as they wanted to be.

The service remained responsive. People received person-centred care that was based on their individual needs. Staff used technology to record their care visits to people. Monitoring of this helped identify the need for prompt deployment of additional staff resources. This helped improve the quality of people’s lives. Concerns were found and responded to effectively and this helped drive improvement. People, when needed, were supported with end of life care by staff who had the necessary knowledge and skills to do this with dignity. Procedures were in place to support people with their end of life care wishes when needed.

The service continued to be well-led. The operations' manager and the manager led by example and ensured the staff had skills relevant to their role. Staff worked as a team and promoted

The inspection took place on 18 September 2015 and was announced. The service received 48 hours’ notice of our intention to inspect the service. This is in line with our current methodology for inspecting domiciliary care agencies.

The service provides care and support to people in their own home. At the time of our inspection 88 people were receiving a service.

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.

Staff were trained in safeguarding people from abuse and they understood their responsibilities. Safeguarding concerns had been raised appropriately with the local authority and staff were confident about raising concerns if they had to.

Risks to people and staff were assessed and actions taken to minimise them.

Staffing levels were assessed and kept under review. There was a recruitment procedure in place which ensured that staff were safe to carry out this kind of work and had the required skills and experience.

Medicines were administered safely and records related to medicines were accurate.

Training and support was provided for staff to help them carry out their roles and increase their knowledge about the health conditions of the people they were caring for. There was a robust induction process which trained, monitored and supported staff during their first three months.

People gave their consent before care and treatment was provided and all except the newest staff had received training in the Mental Capacity Act (MCA) 2005. The MCA ensures that, where people lack capacity to make decisions for themselves, decisions are made in their best interests according to a structured process.

People were supported with their eating and drinking and staff helped to ensure that people had access to the food and drink they might need after staff had left for their next call. Staff also supported people with their day to day health needs and worked in partnership with other healthcare professionals.

Staff were caring and people were treated respectfully and their dignity was maintained.

People were involved in planning and reviewing their own care and were encouraged to provide feedback to enable the service to learn and grow.

Formal complaints were managed well. Informal complaints, gathered as a result of the regular feedback the service encouraged, were dealt with promptly and to the satisfaction of the people raising the issue, although some may have warranted a more formal response.

Staff understood their roles and were well supported and valued by the management team. The management team demonstrated a commitment to using innovative practices to improve the service.

Robust quality assurance systems were in place to monitor the delivery of the service.