This comprehensive inspection took place on 23, 25 and 29 January 2018 and was announced. At the last comprehensive inspection in November 2015 the service was rated as Good.

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older adults and younger disabled adults. At the time of the inspection the service was supporting 85 people in the City of London and the London Borough of Westminster, of which 75 were privately funded. Not everyone using Bluebird Care (Westminster) receives regulated activity; 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.

There was a registered manager in post at the time of our inspection. 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.

The provider had involved the whole staff team in driving improvement and had invested in staff and systems which created an open and positive culture throughout the service. Staff were committed, praised the level of support they received and spoke positively about their opportunities to progress within the organisation.

People using the service and their relatives were confident they would be listened to and felt the management team were approachable and felt comfortable getting in touch.

Staff treated people in a way that respected their privacy and dignity and promoted their independence. Two members of staff had been recognised for their outstanding work in supporting people living with dementia.

People and their relatives told us staff were kind and compassionate, knew how to provide the care and support they required whilst also going the extra mile for them. Regular care assistants knew the people they supported and showed concern for people’s health and welfare.

The provider was passionate and worked with other agencies with the aim to create a dementia friendly community. People were supported to access events, follow their interests and maintain relationships with friends and family to increase their health and well-being.

People were involved in planning how they were cared for and supported. An initial assessment was completed from which care plans and risk assessments were developed. Records were accessible to staff and relatives on digital devices so the latest information could be seen. Care was personalised to meet people’s individual needs and preferences and was reviewed if there were any significant changes.

Risks to people were identified during an initial assessment with detailed guidance and control measures in place to enable staff to support people safely.

People using the service and their relatives told us they felt safe using the service and staff had a good understanding of how to identify and report any concerns. Staff were confident that any concerns would be investigated and dealt with.

People who required support with their medicines received them safely and all staff had completed training in the safe administration of medicines, which included observations and competency assessments. Alerts were set up on the software used that informed the office if people’s medicines had not been given by a specific time.

People’s nutritional needs and preferences were recorded in their care plans and staff were aware of the level of support required. Care assistants told us they notified the office if they had any concerns about people’s health and we saw evidence of this in people’s care records. We also saw people were supported to maintain their health and well-be

Bluebird Care (Westminster) is a domiciliary care agency that provides care and support to people living in their own homes. The inspection was announced and we informed the provider 48 hours before the inspection that we would be coming, in order to ensure that staff would be available at the service. At the time of the inspection 25 people were receiving personal care, and this was the first inspection since the service registered on 19 July 2015.

There was a registered manager at 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 2008 and associated Regulations about how the service is run.

People and their relatives told us they felt safe with care staff. All of the care staff we spoke with understood their role and responsibilities in relation to keeping people safe and protecting them from abuse. Care staff understood how to raise any safeguarding concerns. Risks were assessed and individual risk management plans were implemented, to enable people to maintain their independence as much as possible while ensuring their safety.

Staff had received training about how to support people with their medicines needs if required, in accordance with people’s wishes and assessed needs.

The provider employed sufficient skilled and experienced staff to meet people’s needs. Rigorous pre-employment checks were conducted before care staff were appointed, in order to ascertain whether staff were suitable to provide care and support for people who used the service.

Staff received appropriate training, supervision and support to effectively meet people’s needs. This included training and guidance in relation to seeking people’s consent before providing personal care and supporting people to make their own choices and decisions.

Care plans showed that people’s healthcare needs had been identified and care staff supported people to attend medical appointments, where necessary.

People and their relatives told us they received kind and compassionate care, and were treated with respect. Staff described how they promoted people’s dignity and protected their entitlement for privacy and confidentiality.

The provider supported staff to understand the emotional and social needs of people living with dementia and was actively involved in achieving positive local outcomes to improve the quality of life for people living with dementia and their informal carers.

The service responded to people’s needs and provided personalised care. Care staff knew people well and were able to describe how they would respond to people’s needs and wishes. The provider actively sought feedback from people and their relatives, and made positive changes as a result of people’s views and suggestions.

People received a well-led service. The management team had a clear vision about the values of the service and the standard of care and support people should consistently receive. This was understood by care staff, who felt the management team encouraged and supported good practice. Systems were in place to continually monitor the quality of the service and any areas that required improvement were promptly attended to.