We inspected Bluebird (Cheshire East) on 21, 22 and 23 September 2016. As this was a domiciliary care agency service, we contacted the registered manager 48 hours before the inspection. This was so that we could ensure that staff were available at the office. At the last inspection in January 2014 we found the service met all the regulations we looked at.

Bluebird Care (Cheshire East) is registered to provide personal care to children and adults who live in their own homes. The offices for the service are located in Crewe. At the time of the inspection 38 people were in receipt of personal care.

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 were very positive and complimentary about the support they received from Bluebird Care (Cheshire East). They found the service to be very reliable and responsive to their needs. Comments included “I can’t speak too highly of them, they are excellent,” “They care greatly” and “I am indeed happy with the way they treat me.”

People told us that they felt safe and we found that people were protected from harm and abuse. Staff were trained in safeguarding procedures and understood their responsibilities to report any concerns of this nature. Two staff members were uncertain where they could report safeguarding concerns to outside of their organisation. The registered manager addressed this immediately and ensured that all staff had a copy of the service’s safeguarding process flow chart with contact details.

We found that there were sufficient staff to meet the needs of the people supported by the service. The service was focused on the recruitment of new staff and the manager told us that additional care packages would not be accepted unless they had the staff to cover these. People told us that their care calls were never missed, and that staff always arrived to support them as expected.

All new employees were appropriately checked through robust recruitment processes.

People who required support with taking their prescribed medicine were provided with this. We saw that medicine administration records (MAR) had been written and printed by staff. However we found in a few cases, the information written on the MARs did not always reflect the current medication requirements, although people were receiving their medication as required. The registered manager took immediate action to address these issues.

Staff were skilled and knowledgeable. We found that staff completed an induction prior to starting work in the service and received regular and on-going training. Staff told us that they felt supported, they received regular supervision and appraisals.

Staff had an understanding of the Mental Capacity Act (MCA). Staff ensured that they obtained consent from people prior to carrying out any support tasks. The registered manager told us that all of the people they supported at the current time had the capacity to make decisions about their care.

We found that people were well cared for and treated with compassion. Staff supported people in a caring manner. They knew the people they were supporting well and understood their requirements for care. People told us that were treated with dignity and respect.

People received personalised care and the service was responsive to people’s changing needs. Assessments and care plans were in place. They provided sufficient information and were regularly reviewed. The care plans and risk assessments provided some person centred information but this was an area that the service had already identified for further improvement.

The service had a complaints policy and procedure that was included in people's care records.

We spoke with a range of people about the agency. They included the registered manager, staff, relatives and people who received a service. This helped us to gain a balanced overview of what people experienced using Bluebird Care Agency.

Standards we looked at took account of the care and welfare of people using the service and what they experienced. We looked at how complaints were managed and responded to. We also looked at what quality assurance systems the agency used to monitor and develop its service provision.

People we spoke with were positive about the service they received. One person told us, “It is a good service for me. There have been times when different staff arrive, but that’s been sorted out now”. Another person said, “Staff do an excellent job. Always pleasant and cheerful”. We spoke with a member of the staff team. They told us it was well managed. They felt supported and they liked the work they undertook.

People told us they had received a visit from senior staff before the service commenced. This was to introduce themselves and carry out an initial assessment. People told us their needs had been discussed and they had agreed with the support to be provided. One relative spoken with said, “If we need any more information or support they are always at the end of the phone”.

We found that people received the care that had been planned and agreed. We spoke with three people who used the service and they told us that the staff were kind and caring and supported them well. One person said "They always ask me what I want" and "I get a schedule of staff so I know who to expect." Another person told us "I'm very satisfied. I'm very happy with my carers X, Y and Z (named staff members)."

We spoke with three members of staff who told us that they liked working for the service and that they felt well supported in their roles. We found that staff received appropriate training for their roles and that some training such as moving and handling was delivered “on the job” and was individually tailored to each person who used the service.

We found that the provider had effective systems in place to monitor and improve the quality of the service that was provided.

We received wholly positive comments during the home visits we carried out, they included:

“Could not manage without them”.

“They never rush me and always treat me with respect; we have lots of laughs”.

“My carer is very, very helpful”, “best carers that have ever been in the house”.

“My carers are comfortable and I like them in the house”.

”The carers do not rush me and are very respectful”.

We also looked at a sample of the customer survey forms that have recently been sent out, the following are some of the comments we read:

“I can’t think of any way Bluebird Care could make the service better for me”.

“The service is excellent, I have no complaints”.