This comprehensive inspection took place on 31 October, 2 November and the 8 November 2018 and was announced. At the last comprehensive inspection in August 20165 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 40 people in the City of Bristol. Not everyone using Bluebird Care (Bristol )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 consider any wider social care provided.

The service had two very experienced managers in post. Both of whom had worked for the provider at their other location for a number of years. As part of the provider’s restructuring plans they had both transferred to the Bristol branch in the last six months. This was after the previous registered manager had left. One of whom was in the process of applying to be registered with us. 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.

There was also a care manager who took management responsibility for matters related to the care needs of people who used 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. Each manager had clear roles and lines of responsibility. The team and people we spoke with were very positive about the managers. Staff told us “They seem to work really well together” and “They just gel together”.

People continued to receive safe care and support from staff who understood their responsibilities to manage risks and report concerns. This was where there were any issues relating to people's safety. Medicines were managed safely. Care calls were closely checked and monitored to ensure people did not experience missed visits.

People, their relatives and healthcare professionals told us they were exceptionally happy with the care and support provided by Bluebird Care Bristol. People were at the heart of the service at Bluebird Care Bristol.

The service worked hard to build and create a person-centred culture throughout all levels of the service. The managers and managing director led their team by example, showing strong, inclusive and creative leadership. The leadership team focused constantly on improving the service and creating positive outcomes for people.

The service played a key role in the community, taking part In and funding and facilitating schemes, events and initiatives. These all aimed at creating awareness and engaging people and staff creatively in stimulating meaningful activities and events.

There was a real emphasis on partnership working with other organisations to reach positive outcomes for people. There was excellent feedback from professionals who worked with the service about the quality and responsiveness of the care provided. Bluebird Care Bristol worked in partnership with other professionals to help people stay in their own homes when could have been at risk of being admitted to hospital.

People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People and relatives all told us staff were exceptionally caring and suppo

This inspection took place on 16 June 2016. The inspection was announced, which meant the provider knew we would be visiting. This was because we wanted to make sure the provider, or someone who could act on their behalf, would be able to support the inspection. Bluebird Care was last inspected on 11 June 2014 and was meeting all legal requirements

Bluebird Care provides personal care to people living in the Bristol area. At the time of this inspection they were providing care to people for 30 people.

There was a registered manager in post. 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 feedback we received from people and their relatives was positive. They spoke highly of the registered manager and the staff team. Comments included, “I trust all of the staff, they are good and very patient” “ and “We have a good rapport with the coordinator and the team and things always get done.”

People were safe with the staff that supported them. Robust recruitment procedures were in place and staff received training and understood their responsibilities for keeping people safe from avoidable harm and abuse. Staff had received training and understood their responsibilities for supporting people with taking medicines when needed.

People were treated with kindness and respect. Staff spoke knowledgably about the people they provided personal care for. People and their relatives were confident that staff knew how to meet their needs. People were encouraged to provide feedback about the care they received. Feedback was acted upon and actions taken to improve the quality of the service.

People were supported to access healthcare services when needed. Staff worked well with other health professionals and we saw they acted upon recommendations made.

Staff were well supported by the management team. Care staff told us the service was well-led and they were managed well. They had opportunities to speak with the directors who staff said, were approachable.

This inspection was undertaken by an Adult Social Care Inspector. We looked at five standards during this inspection and set out to answer these key questions: Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. This is based on our visit to the office, telephone interviews with 11 people who used the service and discussions with staff. Please read the full report if you want to see the evidence supporting our summary.

Is the service caring?

People that we spoke with as part of our inspection were happy with the support they received. We heard a number of comments such as “perfectly happy” and “I’m really impressed”. People told us that they had built positive relationships with staff, particularly those that visited on a regular basis.

People had clear support plans in place which described the ways in which they required support and how this should be achieved.

Is the service responsive?

As part of our review of the quality monitoring systems within the service, we viewed a sample of complaints and how they had been responded to. We saw that complaints had been investigated appropriately and the outcome of these logged.

Staff told us that they felt comfortable in approaching the provider for any further training that they might need. When appropriate, a senior member of staff went out on visits to support care workers with any particular aspects of care that they needed further training on.

Is the service safe?

People who used the service were protected against the risks of abuse because staff had received safeguarding training and this was refreshed on a regular basis. Staff told us they felt able to identify and report any issues of concern.

There were systems in place to protect people from the risk of financial abuse, when staff supported people with shopping.

We viewed records that demonstrated issues of concern were shared with other agencies when necessary to ensure that they could be investigated appropriately.

Is the service effective?

People’s support was reviewed on a regular basis and this provided opportunity to ensure that support plans were current and reflective of people’s needs.

Quality monitoring systems were in place and these were being developed further to ensure that any issues with the performance of the agency were identified and acted upon. We heard that as a result of auditing care files, everyone’s files were being reviewed to ensure they contained all the information required.

Is the service well led?

At the time of our inspection, the registered manager had recently left and the provider was recruiting to the post. The company had recently had new directors and so it was going through a period of transition. However other senior members of staff remained within the organisation and this would help ensure some stability and continuity of care for people using the service.

People that we spoke with were happy with the care they received. One person told us "I am very happy, the staff are so pleasant and down to earth". Another person told us that staff were "excellent". We were told that staff arrived to appointments on time and that communication with the office was good.

There were systems in place to administer medicines safely and staff received training in this field. People's care plans were detailed and contained clear information about the support they required. Risk assessments were in place to help ensure that people were supported safely.

New staff were required to undertake relevant checks to ensure they were suitable for their role. An induction programme was in place to support staff in their work. Staff told us that this was effective and that they had opportunities to consolidate their learning by shadowing more experienced members of staff.

The provider gathered feedback from people that used the service as part of their quality monitoring. People told us that they felt able to approach staff with any queries or concerns and there were process in place for managing and recording complaints.