The inspection was carried out on 19 and 20 June 2017 and was announced. The service was given two working days’ notice because the location provides a domiciliary care service and we wanted to make sure someone would be available to speak with us. Telephone calls were carried out on 22 and 23 June 2017 to obtain feedback from people using the service and their relatives.

Bluebird Care (Hounslow) provides domiciliary care services for adults with a wide range of needs. The service offers support to people who require help with day to day routines, including personal care, meal preparation, shopping, housework and supporting people out into the community. At the time of inspection there were 26 people receiving personal care.

The service is required to have 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 registered manager had been in post since October 2016.

Safeguarding procedures were in place and staff reported any concerns. One issue in relation to needing to notify the local authority of a safeguarding scenario was discussed with the registered manager during the inspection. They took appropriate action to address the concern at the time of the inspection.

Risks were identified and assessed and action plans put in place to minimise them.

Recruitment procedures were in place and being followed to ensure only suitable staff were employed. There were enough staff employed to meet people’s needs.

People received the care and support they needed to manage their medicines.

Infection control was being managed by the service.

Staff received training and supervision to provide them with the skills and knowledge to care for people effectively.

Staff respected people’s rights to make choices about the care and support they received. Staff knew to report any deterioration in people’s capacity to make decisions for themselves.

Staff supported people with preparing meals if they required it and listened to people’s wishes.

Procedures were in place to ensure people received any assistance they required to gain healthcare input.

People were happy with the care and support they received and staff were kind and treated people with dignity and respect. Staff took the time people needed to meet their care and support needs.

People were assessed and were involved with their care records so their wishes were identified and included. Staff read the care records so they knew and understood the care each person needed.

Procedures for raising complaints were in place and people felt able to raise any concerns so they could be addressed.

People were happy with the service they received, were being listened to and had their needs met. People and staff all said they were happy to recommend the service to others.

Care assistants felt well supported by the registered manager and office staff and felt able to contact them to discuss any matters.

Systems for monitoring the service were in place and being followed. The registered manager was receptive and acted promptly to improve monitoring processes for incidents and accidents.

We carried out an announced comprehensive inspection of this service on 9 July 2014. A breach of legal requirements was found. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the planning of care and treatment. We undertook this focused inspection on 27 February 2015 to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Bluebird Care (Hounslow) on our website at www.cqc.org.uk

Prior to people using the service, assessments were being carried out and recorded for their needs. Care plans for people’s identified needs were up to date and reflected each person’s needs clearly, to provide staff with the information they required to respond to people’s needs.

Bluebird Care (Hounslow) provides domiciliary care services for adults with a wide range of needs. The service offers support to people who require help with day to day routines, including personal care, meal preparation, shopping, housework and supporting people out into the community. At the time of inspection there were 34 people receiving personal care.

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008 and to pilot a new inspection process being introduced by CQC which looks at the overall quality of the service.

This was an announced inspection carried out on 9 July 2014 and the provider was given 48 hours notice of the inspection. The previous inspection was carried out on 28 November 2013 and the service was meeting the regulations we checked at that time.

Bluebird Care (Hounslow) provides domiciliary care services for adults with a wide range of needs. The service offers support to people who require help with day to day routines, including personal care, meal preparation, shopping, housework and supporting people out into the community. At the time of inspection there were 21 people receiving personal care.

Bluebird Care (Hounslow) is a franchise that operates under a licence from Bluebird Care Franchises Ltd. The service has a registered manager in post.  A registered manager is a person who has registered with the Care Quality Commission to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

People and their relatives expressed their satisfaction with the care and support provided by the service and said they felt safe.

Staff were aware of people’s needs and how these were to be met, including reacting appropriately to any changes in a person’s condition so this could be addressed promptly. Staff understood safeguarding and whistleblowing procedures and were clear about the process to follow to report any concerns.

Staff recruitment procedures were in place and being followed, so people received care from suitable staff. Systems were in place to manage emergencies and to provide continuity of care to people.

People using the service, relatives and care workers felt the management of the service was good and the manager was approachable and supportive. Systems were in place to monitor the quality of the service and to encourage people to express any concerns, so these could be addressed.

Most of the documentation had been completed and kept up to date; however we found some information had not been fully recorded, which could place people at risk of not receiving appropriate care.

This was a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010. You can see what action we told the provider to take at the back of the full version of the report.

We spoke with people using the service, relatives and staff.

People using the service were involved in discussions about the care and support they required and had opportunities to modify the service they received at regular reviews and at other times as required. People were treated with dignity and respect.

Care plans were person centred to reflect individual needs and preferences and records were updated to reflect changes in the care package.

The provider had procedures to ensure continuity of care and the safety and welfare of people using the service, and staff had the necessary training and contacts to manage risks and emergencies.

The provider had suitable and up to date policies and procedures in place to safeguard people using the service from harm or abuse and staff had received appropriate training in this regard.

Staff had appropriate training and support and had regular supervision and appraisals.

The provider had a variety of systems to monitor the quality of service provided and feedback from people using the service indicated a very high level of satisfaction with the care they received. People were contacted regularly to obtain feedback on their care.

One person using the service told us, "They’ve been lovely with me – I’m very lucky. They really are caring", while another said, "I couldn’t ask for anything more - they’re first class.”