This inspection took place on 15, 16, 20 and 21 March 2018 and was announced. The provider was given short notice of our intention to inspect the service. This is in line with our current methodology for inspecting domiciliary care agencies to make sure the registered manager would be available.

At our previous inspection in October and November 2016 we rated the service as ‘Requires Improvement’ and identified one breach which related to safe care and treatment. Following the previous inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the key questions in Safe and Well Led to at least Good.

Bluebird Care (Calderdale and Bradford South) 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 people over the age of 18 years. Not everyone using the agency 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. At the time of our inspection 71 people were receiving personal care.

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.

The majority of people and relatives we spoke with were happy with the care and support provided by staff. They said staff usually arrived on time and stayed the full length of the call. However, three people/relatives told us the timing of calls was a problem and staff did not always stay the full length of the call. The provider agreed to look into these concerns.

People and relatives told us staff were kind and caring. People’s privacy and dignity was respected. Medicines management was safe, although further guidance was needed in relation to ‘as required’ medicines. Safeguarding procedures were in place to protect people from abuse. People were aware of the complaints procedure and knew how to raise concerns.

People were supported to have maximum 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 told us they had been involved in the care planning process. Care records were personalised and showed the support the person required from staff at each call. Risk assessments showed any identified risks had been assessed and mitigated. People’s nutritional needs were met and they were supported to access healthcare support as and when needed.

Staff received the induction, training and support they required to meet people’s needs. Staff told us communication was good. Recruitment checks were completed before staff started working in the service.

The company directors and registered manager provided consistent leadership and management. Action had been taken to strengthen and develop the governance systems to improve the overall quality of service delivery. This process was in the early stages and the company directors recognised these systems needed to be fully embedded to ensure all issues were fully identified and addressed.

We inspected Bluebird Care Calderdale and Bradford South on 27 October and 4 November 2016. The visit was made at short notice to make sure the registered manager would be available.

Bluebird Care Calderdale and Bradford South is registered as a domiciliary care agency and provides a range of services including personal care in the Halifax, Brighouse, Elland and South Bradford area of West Yorkshire. At the time of inspection the agency was providing care and support to approximately one hundred and twenty 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.

We found staff received training to protect people from harm and they were knowledgeable about reporting any suspected harm. There were a sufficient number of staff employed for operational purposes although the recruitment procedures designed to ensure only people suitable to work in the caring profession were not always being followed.

Where risks to people’s health, safety and welfare had been identified appropriate risk assessments were in place with actions taken to mitigate these. However, we found some shortfalls in the medication recording systems.

The people we spoke with and their relatives told us the service was generally reliable and staff usually arrived at the same time each day and stayed for the correct amount of time. However, some people felt the service could be improved by office based staff communicating more effectively as phone calls were not always returned in a timely manner.

Some people also raised concerns about the electronic system used by the agency to record visits, care documentation and daily records as they had difficulty accessing information at times. We therefore asked the provider to review the systems in place to ensure everyone who used the service had easy access to all their care records.

The staff we spoke with were able to describe how individual people preferred their care and support delivered and the importance of treating people with respect in their own homes. Staff told us the training provided by the agency was very good and they received the training and support required to carry out their roles effectively.

The registered manager demonstrated a good understanding of their responsibilities under the Mental Capacity Act 2005 (MCA) and staff demonstrated good knowledge of the people they supported and their capacity to make decisions.

There was a complaints procedure available which enabled people to raise any concerns or complaints about the care or support they received.

There was a quality assurance monitoring system in place that was designed to continually monitor and identify shortfalls in service provision. However, we found the shortfalls in the service highlighted in the body of this report had not always been identified through the quality assurance process.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we asked the provider to take at the end of this report.

During our inspection, we spoke with the registered manager, five support workers, six people who used the service and one relative.

One person we spoke with said; “I’m very happy with the girls that come. I’ve never had any problems and they help me in any way they can.” Another person told us; “They go above and beyond. I love them like family and they do all they can to make sure I’m happy.”

All of the people we spoke with who used the service told us they knew their support workers and said they were always ‘very caring’ and they ‘helped out wherever they could’.

The five support workers we spoke with told us Bluebird Care was a good organisation to work for, where they knew a good service was provided and where they felt they were supported by their managers. Three of the five support workers we spoke with told us they feel Bluebird Care would benefit from employing more staff as they sometimes feel ‘like there isn’t enough time to do everything’ or to ‘get from one call to another’.

There were procedures in place to protect people from abuse.

There were effective systems in place to ensure people who used the service had given consent to their care and treatment. We saw that each person using the service had been required to sign and date a ‘Consent Form’.

We found that records were maintained and kept up to date, including any changes following care plan reviews.

We did not talk to people using the service because we were concerned about how people's care needs were documented. The manager told us that since our last visit on the 13th November 2012, they have adopted a new approach to care planning. We looked at four sets of care records and found they provided a detailed explanation of how people wanted their care to be provided. Appropriate risk assessments were also in place.

People who use the service did not make any specific comments about the essential standard we reviewed.

People who use the service did not make any specific comments about the essential standard we reviewed.

We spoke to two people who use the service and they told us that staff are very helpful, always listen and make changes for any requests that are made.

A relative of a person who uses the service told us that this was his first experience of dealing with an agency providing home care and he had been worried about the standard of care they would provide. However, his initial meeting with the manager had put his mind at ease and he was delighted with the care and support provided.

We spoke to the relatives of two people who use the service and they told us that they were involved in the care planning process and review meetings.

People who use the service told us that they were very happy with the care being provided. They also told us that that they would speak to staff if they had any concerns and staff responded well to any requests that were made.

One person told us that the care manager had visited her to review her care plans twice within the last year. Another person told us that her care plans had also been reviewed within the last year.

We spoke to the Local Authority, who told us they do not have any specific concerns relating to this provider.

People who use the service told us they have been provided with contact phone numbers. One person told us that on one occasion there was no answer but the provider rang her back very quickly.

One person told us that that care staff would stay behind to do additional work when requested.

We spoke to the relatives of people who use the service and they told us that care staff always wear identification badges.

People who use the service and their relatives told us they did not have any concerns about the care they receive and would speak to the care manager if they had any concerns.

We spoke with six care workers, three people who use the service and three of their relatives. All the people using the service or their relative spoke highly of the care provided. People had experience of other care agencies and told us the care provided by Blubird was much better. They told us they were involved in making decisions and care staff were respectful towards them. One relative commented that they have asked care staff to wear protective covers on their shoes to prevent their carpet from becoming dirty but not all the care staff did this. However, this did not reflect the views of other people we spoke with.

People who use the service or their relative told us they had received information from the agency prior to care being delivered and it included information on how to raise a complaint.

People were happy that on most occasions they had a regular set of care workers; they liked the continuity of care. They also told us all the care tasks were carried out and they felt safe.

Most of the care workers told us they felt supported by the manager and other colleagues from the agency. They told us they could raise concerns and they would be dealt with. However, nearly all care staff told us they would like more information in the care plan which provided details about how the person would like to receive their care.