This inspection took place on 5, 6 and 11December 2017 and was announced. A previous inspection, undertaken in November 2015, found there were no breaches of legal requirements and rated the service as ‘Good’ overall.

Bluebird care (South Northumberland) is a domiciliary care agency. It provides personal care to people living in their own houses and flats. It provides a service to older adults (including people who may be living with dementia), younger and disabled adults and people with a learning disability. At the time of the inspection the service was supporting 57people with a range of needs, 22 of whom were receiving support with personal care.

The service had a registered manager who had been registered since December 2013. 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 safe when being supported by staff and we found the service had in place safeguarding adults procedures. The registered manager was able to describe lessons learned from a recent minor information breach. Risk assessments had been undertaken with regard to staff working in people’s own homes. Accidents and incidents were monitored and reviewed.

Suitable recruitment procedures and checks were in place, to ensure staff had the right skills. People told us staff arrived on time and always stayed the full allocated period. Medicines were managed and recorded appropriately. People said staff always used personal protective equipment when delivering personal care.

The provider had a policy regarding equality and diversity and staff understood issues related to this area, and what it meant for people using the service. Staff told us they had access to a range of training and updating and records confirmed this. They confirmed they had access to regular supervision and an annual appraisal. The registered manager described how technology was being used to enhance care delivery, especially the introduction of electronic care and medicine records which could be updated in real time.

CQC monitors the operation of the Mental Capacity Act 2005 (MCA). No one using the service was subject to any restrictions imposed by the Court of Protection. People were asked for their consent on a day to day basis or had signed consent forms. Where this was not possible there was evidence of best interest decisions being made. People were supported with food and drinks in their own home. Special monitoring of people with a higher risk of weight loss was undertaken.

People told us they were happy with the care provided and the approach of staff. Staff demonstrated a good understanding of people’s individual needs and preferences. People and relatives said they were always treated with respect and dignity. They told us they were regularly involved in care decisions. People were supported to maintain good health and wellbeing and access general practitioners and other health staff.

Care plans related appropriately to the individual needs of the person, although this was sometimes difficult to find amongst a range of more generalised information. People were supported to access activities or attend events in the community. Formal complaints in the last 12 months had been addressed appropriately.

The registered manager demonstrated that regular checks on people’s care and the running of the service were undertaken. People told us senior staff carried out spot checks and quality monitoring calls. Staff felt well supported by the registered manager, who they said was approachable and responsive. Records were up to date and well maintained. The service was meeting legal requirement related to its registration through the display of its current quality rating and ensuring t

Bluebird Care (Northumberland South) is a domiciliary care service providing personal care and support to people within their own homes, in the Northumberland area. Most people using the service were older persons. The service also delivered care and support to people living with dementia and to people with a learning disability. At the time of our inspection there were 33 people using the service.

This inspection took place on 3 and 4 September and was unannounced. This was our first inspection of the service since it was registered.

A manager was in post who had been registered with the CQC to manage the service since it was first registered. 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 spoke very highly of the staff who supported them, saying they felt safe in their presence. Appropriate systems were in place to protect people from abuse and there were channels available through which staff could raise concerns. Records showed that safeguarding matters had been handled appropriately and referred on to the appropriate local authority safeguarding team for further investigation.

The provider and registered manager enjoyed an open culture and staff told us they found them approachable and supportive. The provider had clear visions and values and he had future plans in place about how he wanted the business to develop. Both the provider and the registered manager were passionate about delivering an excellent standard of care and this was evident in their desire to continually improve. They had embraced technological advances in the domiciliary care sector and were in the process of embedding a sophisticated electronic system into the service. The registered manager had obtained qualifications and awards during her time at the service and she had applied what she had learnt into her management role and shared her knowledge with staff. The service had won acclaim and awards for their contribution to the care sector and the local community, and the provider had introduced staff award schemes which staff said made them feel valued.

People’s needs and risks that they were exposed to in their daily lives were assessed, documented and regularly reviewed. Staff supported people to manage health and safety risks within their own homes and refer matters on to third parties if necessary. Medicines were managed and administered safely. Recruitment processes were robust. Staffing levels were determined by people’s needs and the number of people using the service. We had no concerns about staffing numbers. Records related to staff training showed that this was up to date and staff received the support they needed to ensure they had the skills relevant to their roles and the varying care needs of the people using the service.

Supervisions of staff practice and annual appraisals took place regularly, as did staff meetings. Staff told us they felt supported by management and could approach them at any time, with any matters or concerns. CQC monitors the application of the Mental Capacity Act (2005). There was evidence to show the service understood their legal responsibility under this act and that they assessed people’s capacity when their care commenced and on an on-going basis if necessary. Decisions that needed to be made in people’s best interests’ had been appropriately taken.

Staff displayed caring attitudes and people told us about examples of care where the service had gone over and above their expectations, to fulfil their goals and ambitions. People were very complimentary about staff and said they were supported in a way which promoted and protected their privacy, dignity and independence. They said they enjoyed kind and positive relationships with staff and there was continuity of care which they appreciated. An equality and diversity policy was in place and the registered manager conducted learning sessions with staff to promote people’s right to equality and diversity. The provider had ‘gone the extra mile’ to ensure that the care they delivered was extremely personalised.

There was a complaint’s policy and procedure in place which people were made aware of at the point they started using the service. People’s views and those of their relatives were gathered through surveys and staff told us that they had the opportunity to feedback their views via staff meetings or supervision sessions. Care records were very person centred and demonstrated that the provider was responsive to people’s needs. People were supported to access the services of medical healthcare professionals if they needed such input to maintain their health and wellbeing.

The provider promoted social inclusion and had arranged themed events for people to attend if they so wished. People’s right to make choices and consent to their care was promoted and there was evidence that the service worked in partnership with other organisations and healthcare professionals, to obtain the best possible outcomes for people, when they transitioned between services.

Auditing and quality monitoring of the service delivered was carried out regularly and records showed that where any issues were identified, these were addressed promptly. Checks on staff practice were undertaken so the provider could be sure that staff retained and applied their skills. Records were stored appropriately and confidentially.