The inspection site visit took place on 21 November 2017 and was announced. This service is a domiciliary care agency. It provides personal care to adults living in their own homes. Sixty people were receiving the regulated activity of ‘personal care’ at the time of our inspection visit.

At the last inspection in November 2015 the service was rated Good overall. At this inspection we found the quality of service had improved and was now rated Outstanding in the well-led key question, with a Good rating in all other key areas. This meant the service has been rated Good overall.

The registered manager had been registered with us since October 2010. 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 provider and the registered manager were innovative and demonstrated sustained improvements to the quality of care they delivered. They worked in partnership with other organisations to make sure they followed current best practice and high quality care. Systems ensured excellent standards of care were consistently maintained for people.

The provider encouraged people to provide feedback on how things were managed and to share their experiences of the service in creative ways. People were extremely positive about the care and support they received from staff who valued them as individuals.

The provider and the registered manager utilised a range of management tools to deliver person centred, quality care to people. They demonstrated they valued care staff and promoted their learning and development. There was an open culture at the service where staff felt well supported, able to raise any concerns and put forward suggestions for improvements. Staff opinion was listened to, and the registered manager acted on their suggestions. Staff enjoyed their work and were motivated to provide people with high standards of care.

People were protected from the risks of harm or abuse because staff were trained in safeguarding and understood their responsibilities to raise any concerns with the registered manager. The registered manager made sure there were enough suitably skilled, qualified and experienced staff to support people safely and effectively. Risks to people's health and wellbeing were managed.

Staff had the skill, experience and support to enable them to meet people’s needs effectively. The registered manager checked staff’s suitability to deliver care and support during the recruitment process.

Staff worked within the principles of the MCA and supported people to have maximum choice and control of their lives.

People were supported to eat and drink enough to maintain a balanced diet that met their needs and preferences. People were supported to maintain their health.

People, relatives and staff felt well cared for. People and their relatives were included in planning how they were cared for and supported. Staff understood people’s diverse needs and interests and supported them to enjoy their lives according to their preferences. Staff respected people’s right to privacy and supported people to maintain their independence.

People were involved in planning how they were cared for and supported. Care was planned to meet people’s individual needs and preferences and care plans were regularly reviewed. People knew how to complain and had the opportunity to share their views and opinions about the service they received.

Bluebird Care (Stratford and Warwick) is a domiciliary care agency which provides personal care and support to people in their own homes. At the time of our visit the service supported 97 people.

We visited the offices of Bluebird Care (Stratford & Warwick) on 25 November 2015. We told the provider before the visit we were coming so they could arrange for staff to be available to talk with us about the service.

The service has 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 and their relatives told us they felt safe using the service and care workers understood how to protect people from abuse. There were processes to minimise risks associated with people’s care to keep them safe. This included the completion of risk assessments and checks on care workers to ensure their suitability to work with people who used the service.

There were enough suitably trained care workers to deliver care and support to people. People had regular care workers who stayed the agreed length of time.

Staff understood the principles of the Mental Capacity Act (MCA), and care workers respected people’s decisions and gained people’s consent before they provided personal care. People’s records showed their families and other health professionals were involved when they did not have capacity to make their own decisions, and any decisions made were in their best interests.

Care workers received an induction and a programme of training to support them in meeting people’s needs effectively. People told us care workers were kind and caring and had the right skills and experience to provide the care and support they required. Care plans and risk assessments contained relevant information for care workers to help them provide the care people required.

People were supported with kindness and compassion. Staff treated people in a way that respected their dignity and promoted their independence.

People were involved in planning how they were cared for and supported. Care was planned to meet people’s individual needs and preferences and care plans were regularly reviewed.

People knew how to complain and were able to share their views and opinions about the service they received. Staff felt well supported by the registered manager and were confident they could raise any concerns or issues, knowing they would be listened to and acted on. The registered manager valued staff and promoted their development.

There were processes to monitor the quality of the service provided and understand the experiences of people who used the service. This was through regular communication with people and staff, returned surveys, spot checks on care workers and a programme of other checks and audits.

When we visited Bluebird Care (Stratford and Warwick), we spoke with the nominated individual, the registered manager, the team leader and a support worker. We spoke with the representative of one person who used the service during our visit. (People's representatives included family members and friends.) We read the care records for four people who used the service. We gathered evidence of people's experiences by telephoning two people who used the service and the representatives of six people, following our visit. We also telephoned two support workers following our visit.

People we spoke with were positive about the care they received. One person who used the service told us, “I am very happy with the services they provide.” A person’s representative told us, “We are all very pleased with the service.”

We found that staff treated people with respect and gained people’s consent before they supported them.

Staff demonstrated they understood people’s personal needs and the individual ways they communicated their needs.

We spoke with staff and found that they felt supported by their manager and felt able to raise any issues.

We found that there was a system for monitoring the quality of the service, which included customer satisfaction surveys.

We visited the service on 05 February 2013 and telephoned two people who use the service after our inspection visit.

We gathered evidence of people’s experiences through speaking with two people who use the service. We spoke with two members of staff who supported people.

People we spoke with told us that the care received matched the care that was discussed with them. They told us that they were involved in planning the care and that reviews were held to reassess their needs. We saw that people and family members had provided information on their care plan.

We saw that the care plans were person centred and reflected people’s needs. This meant that the care plan was based on the needs of the person. We saw that people’s needs were reassessed and where necessary the care plan was updated. We saw that people's like and dislikes were clear within their care plans.

People we spoke with told us that staff were friendly and supportive. We saw their were regular members of care staff who provided people's personal care. Continuity of staff should mean that people receive their care consistently as staff have an increased understanding of people's needs.

We spoke with staff about what they thought abuse was and they showed they had a good awareness of the importance of keeping people safe. They understood their responsibilities for reporting any concerns regarding abuse.

We saw records were kept up to date and stored securely.