The inspection was carried out on 4 October 2016. The inspection was announced.

Bluebird Care is registered as a domiciliary care agency with an office base in Sevenoaks, providing personal care and support to people in their own homes. These included older people, some living with dementia, as well as people with physical or learning disabilities. The service is able to provide a range of visits to people, from one visit a day, up to several visits per day together with providing a ‘live in’ service if required. The service is a privately owned franchise and the provider was involved in the day to day management of the service. At the time of the inspection the service was providing support to 90 people, this included personal care being provided to 39 of these people. The support provided aimed to enable people to live as comfortably as possible.

There was a registered manager for the service, who was registered for both the Sevenoaks and the Lewisham offices of the service. 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 and associated Regulations about how the service is run.

The feedback we received from people was excellent. Those people who used the service expressed satisfaction and spoke very highly of the registered manager and staff. For example, one person said, “They look after me very well, and I would not be without their support”.

The safety of people who used the service was taken very seriously and the registered manager and staff were well aware of their responsibility to protect people’s health and wellbeing. There were systems in place to ensure that risks to people’s safety and wellbeing were identified and addressed. Risks had been identified for individual people and their circumstances and measures had been put in place to control and reduce risks, helping to keep people safe.

People’s home environment was checked for hazards before support was commenced to ensure the safety of people and staff. Most people either managed their own medicines or their family members helped them. Some people required staff assistance with their medicines. The registered manager checked that staff were safe to administer people’s medicines by carrying out regular competency assessments. The registered manager ensured that staff had a full understanding of people’s care needs and had the skills and knowledge to meet people’s needs. People received consistent support from support staff who knew them well. People felt safe and secure when receiving care.

People had positive relationships with their support staff and were confident in the service. There was a strong emphasis on key principles of care such as compassion, respect and dignity. People who used the service felt they were treated with kindness and said their privacy and dignity was always respected. People received a service that was based on their personal needs and wishes. Changes in people’s needs were quickly identified and their care package amended to meet their changing needs. The service was flexible and responded very positively to people’s requests. People who used the service felt able to make requests and express their opinions and views.

The provider had a robust recruitment process in place to make sure new staff were suitable to work with people in their own homes. Staff were supported to gain the skills necessary to be able to support people in their own homes. Staff had the relevant induction and training updates to feel confident in their role. Support and the opportunity to develop was given through regular one to one supervision, observational assessments and annual appraisals.

Staff presented a caring approach as did the staff working in the office who supported the delivery of care. People were happy with the st

We spoke with eight people using the service and/or their relatives and found that people said they were treated with dignity and respect and that they were involved in decisions regarding their care support.

One person we spoke with told us that the service “was absolutely amazing, with dedicated, responsive and helpful staff”. Another told us that there was “a great consistency of staff”.

We looked at the risk assessments and care plans of nine people using the service and found that risk assessments were comprehensive and care plans were detailed and developed with the person and/or their relatives indicating their preferences for how care was provided.

We found that the provider had systems in place to audit the care it provided and that feedback from the people using the service was mainly positive and complementary. One person told us that they “were very happy with the service and care staff”.

We looked at seven staff files and found that the provider had effective recruitment and selection procedures in place and that staff were skilled and experienced in providing the level of care required.

We found that the provider liaised with other professionals involved in people’s care and complied with the local authority safeguarding policies and procedures.

People received a good quality of care and support. Assessments reflected each person’s needs and preferences. We saw that people were involved in their care and families were encouraged to be involved where the person wished it.

We saw care records that provided clear direction for staff. These had been developed for each individual and described their wishes and preferences in relation to how their care was provided. Staff supported people as they wished and ensured each person was at the centre of their care.

People we spoke with told us they were confident to talk to staff if they had any concerns. People told us they felt safe with the staff who visited them.

We spoke with five people who used the service and their relatives, all of whom were complimentary. One person told us they “couldn't speak highly enough of the service”. Another person said the staff were “excellent, caring and lovely”.

People told us they felt they were listened to when their care was planned. One person told us they “feel like staff listen to us”. A relative told us “all the staff and the managers have a great deal of time for us”.

We saw that staff were respectful and caring and responded to people’s needs. People’s dignity was promoted at all times. Staff we spoke with were knowledgeable about people’s support needs.

The service had a good quality assurance system in place. Complaints and concerns were listened to, recorded and acted upon immediately.