This announced inspection took place on the 7 and 8 August 2018.

Bluebird Care is a domiciliary care agency which provides personal care to older people who live in their own homes in Rugby and South Leicestershire. At the time of our inspection there were three people using the service.

At the time of our inspection the service did not have 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. An acting manager was in post and was in the process of applying to the Care Quality Commission for registration.

The provider had not fully met all the conditions of their registration. The provider had moved to new premises and had not submitted the relevant notification and applications. They were operating from an unregistered location.

People using the service and relatives said they thought the service provided safe care. We looked at individual examples of how risk was managed. We saw that staff had the information and training they needed to keep people safe.

There were enough staff employed by the service to support people safely. Staff were safely recruited to help ensure they were suitable to work with the people using the service.

People told us they thought the staff were well-trained. Staff we spoke with were understood the needs of the people they supported. They found the training they received useful in helping them carry out their role. Training records showed that staff had completed a wide range of courses to give them the skills and knowledge they needed to support people effectively.

Staff knew people’s likes and dislikes. Staff spent time getting to know people and their preferences.

Staff supported people to maintain good health and access healthcare service when they needed to.

People using the service and relatives told us they appreciated a consistent staff team. Staff were given time to get to know people by taking an interest in their lives, hobbies and interests.

People told us that staff involved them in making decisions about their care and support. Staff had an understanding of the Mental Capacity Act. The provider was aware that care plans lack detail regarding people's ability to make decisions, and they were making improvements to the forms.

People said that staff always treated then with respect and dignity staff received training to enable them to provide care in a dignified manner.

Although people’s preferences as to how they wanted their care and support provided was recorded in their care plans it was not very detailed and the care plans had not been updated. However, the provider and acting manager had made contact with people to ensure the care they received remained appropriate. Staff had been provided with information they needed to ensure people received personalised care in line with their wishes. The provider was taking steps to update the care plans.

People said they knew how to make a complaint if they needed to. The provider’s complaints policy was in the service user guide and told people what to do if they wanted to complain. People felt able to contact the office staff if they experienced a problem.

People using the service told us they would recommend the service to others.

We carried out the inspection on 23 May 2017. The registered manager was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be available.

The service is a domiciliary care agency that provides personal care to people in their own homes. At the time of our inspection nine people used the service.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. People were supported by staff who understood their responsibilities to keep them safe and to report any concerns they may have. The provider had not consistently followed safe recruitment practices.

Risks associated with people’s care were assessed and managed to protect people from harm. People could be assured that staff would arrive on time to provide the care that they needed.

People’s medicines were administered safely by staff who were appropriately trained and competent to do so.

Staff had received training and guidance to meet the needs of the people who used the service. Staff told us that they felt supported. Their competence to do their role was regularly assessed.

People were supported in line with the requirements of the Mental Capacity Act 2005.

People’s health needs were met and when necessary, outside health professionals were contacted for support. People were supported to have enough to eat and drink

People’s independence was promoted and they were encouraged to make choices. Staff treated people with kindness and compassion. Dignity and respect for people was promoted.

Staff had a clear understanding of their role and how to support people who used the service. The care needs of people had been assessed and people contributed to the planning and review of their care.

People were encouraged to give feedback about the service they received. They felt confident that any concerns that they might have would be addressed. People and staff felt that the registered manager was approachable.

Staff were clear on their role and the expectations of them. Staff felt supported.

Systems were in place to monitor the quality of the service being provided and to drive improvement. However, these had not identified where recruitment practices had not been robustly followed.

The registered manager had not always reported events that occurred within the service to CQC as required. The previous inspection report rating was not clearly on display at the service or on the provider’s website in order to inform the public of the service rating.

We carried out the inspection on 1 April 2016. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure that someone would be available.

The service is a domiciliary care agency that provides personal care to people in their own homes. At the time of our inspection 14 people used the service.

The service had 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.’

People told us that they felt safe in their own homes. The registered manager had assessed the risks associated with providing care in the home environment. Staff understood their responsibility to make checks within people’s home and of equipment to keep themselves and people safe.

Staff understood how to keep people safe and report concerns if needed. The registered manger had ensured that all staff had undergone relevant employment checks.

People received their medicines as required and medicines were managed safely. Staff were not always kept informed of changes around people’s medicines.

People made decisions about their care and the support they received. People were involved and their opinions sought and respected. The registered manager understood their responsibility to ensure people were supported in line with the Mental Capacity Act (MCA) and Deprivation of Liberty Safeguards (DoLS).

Staff had not received regular refresher training to ensure that their skills and knowledge were current.

Staff did not always feel supported by the registered manager. Staff did not receive regular supervision from the registered manager and formal checks of competency to carry out their role were not completed.

The registered manager had assessed the care needs of people using the service. Staff had a clear understanding of their role and how to support people who used the service as individuals. People’s needs were kept under review and plans were changed to reflect changing needs.

People were supported to maintain their health and wellbeing. People’s health needs were met and when necessary, outside health professionals were contacted for support. People were supported to have sufficient to eat and drink.

Staff knew people well and treated them with kindness and compassion. People received a consistent level of support.

People who used the service and their relatives felt they could talk to the registered manager and had confidence concerns would be acted upon.

The registered manager had not implemented effective systems for gathering information about the service, identifying areas of concern and to drive improvement.

We spoke with three people who used the service or their representatives. A person told us that they were “delighted with them, it’s what we wanted” and that their relative was treated with respect. A person who used the service told us they were happy with the service and all the “staff were very good and they liked them all”.

Another person told us that staff were punctual and “I enjoy their visits. They help me to be as independent as possible. I feel safe and in control”.

People told us they could contact the agency at any time and that any issues or concerns would be resolved. Staff told us they were well supported and they received the training they needed.

We found that the agency regularly monitored and reviewed the service they provided to ensure that people were supported safely.

We spoke with two people who used the service and their representatives. People said they were very satisfied with the service they received.

One person told us that their carers were "absolutely wonderful, great all of them". A relative of a person who used the service told us that their relative was living with dementia and could become very anxious. They said that the "carers have worked wonders, they are very good and very patient". They also told us that the service was flexible and had been able to offer extra care at short notice following an accident.

People told us that they could contact the service at any time and that they would quickly resolve any concerns or issues. Staff told us they were well supported and received all the training they required.

We telephoned six people to gather their thoughts of the service being provided. Two were receiving direct care from the service and four were relatives of people receiving care. We were also able to talk to four members of staff over the telephone.

People told us that overall, they were satisfied with the care and support they received. One person told us, Bluebird are excellent, we couldn’t be happier with the support.” Another person explained, “they’re doing a good job at the moment”.

We were told that people felt safe with the care workers who supported them. One person explained, “she is safe and that’s a relief for me.” Another person told us, I feel safe with them, they always check I’ve got my frame and my lifeline.”

People told us that they were treated with respect and they were happy with the care workers who supported them. One person explained, “I am more than satisfied, they are absolutely brilliant”. Another person told us, “the timings haven’t always been right, but we understand that they can’t always fit them in”. A third person told us, “they always show me the greatest of respect”.