About the service: Bluebird Care (Leicester) is a domiciliary care agency. It provides personal care to people living in their own homes. It currently provides a service to people with physical disabilities people with dementia and older adults. At the time of the inspection, 47 people were receiving support with personal care.

People’s experience of using this service:

• People were protected from the risk of harm. Staff had been trained in safeguarding people and understood how to assess, monitor and manage their safety. A range of risk assessments were completed, and preventative action was taken to reduce the risk of harm to people.

• People were supported with their medicines in a safe way. People’s nutritional needs were met, and they were supported with their health care needs when required. The service worked with other organisations to ensure that people received coordinated care and support.

• People were protected by safe recruitment process which ensured staff were suitable to work in care services. There were enough staff to meet people's needs. All staff received training for their role and ongoing support and supervision to work effectively. Some staff received specialist training for people with complex needs.

• 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. The provider followed the principles of the Mental Capacity Act, 2005 (MCA) in planning and delivering people's support. People's consent was obtained before they were supported.

• People were involved in their care as far as possible and care plans were regularly reviewed and updated as people’s needs changed. Where appropriate people’s relatives were involved in planning and reviewing people’s care.

• Staff were provided with clear guidance to follow in the care plan which included information about people’s preferences, daily routines and diverse cultural needs. Staff had a good understanding of people's needs and preferences and worked flexibly to ensure people’s care needs were met.

• People’s relatives were happy with staff who provided their relations personal care needs and all had developed positive trusting relationships.

• People and their relatives were encouraged to provide feedback about the service which was used to assess the quality of the service and to make any improvements. The provider had a process in place which ensured people could raise any complaints or concerns and people felt comfortable to do this should they need to. The provider had received many thank you cards and questionnaire feedback which included positive comments regarding the care staff provided.

• The registered manager and provider were aware of their legal responsibilities and provided leadership and supported staff and people who used the service. The registered manager and staff team were committed to the provider’s vision and values of providing good quality, person centred care.

• The provider’s quality assurance system to monitor and assess the quality of the service was used effectively to improve the service. Lessons were learnt when things went wrong, and improvements made to prevent re-occurrences. The provider worked in partnership with other agencies to meet people’s complex and diverse needs and people's health and well-being was continuously monitored at the service.

Rating at last inspection:

At the last inspection the service was rated as Good (April 2016).

Why we inspected:

This was a planned inspection.

Follow up:

We will continue to review information we receive about the service until the next scheduled inspection. If we receive any information of concern we may inspect sooner than scheduled.

This inspection took place on 14 April 2016 and was announced. We gave the provider 48 hours’ notice of our visit because the location provides a domiciliary care service and we needed to make sure that there would be someone at the office at the time of our visit.

Bluebird Care is registered to provide personal care. The registered location is situated in Leicester and provides care to people who live in their own homes in and around Leicester. The service caters for older people and younger adults with needs relating to dementia, learning disabilities or autistic spectrum disorders, physical disabilities, and sensory impairment. There were 33 people using this service at the time of our inspection.

At the time of our inspection the service did not 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 previous registered manager de-registered in January 2016. A manager was in post and was in the process of applying to the Care Quality Commission for registration.

People using the service and relatives said they thought the service provided safe care and that staff were good at managing risk. We looked at individual examples of how risk was managed. We saw that staff had the information and training they needed to keep people safe.

There were enough staff employed by the service to support people safely. For example, if people needed two staff to support them safely they were provided. Staff were safely recruited to help ensure they were suitable to work with the people using the service.

People told us they thought the staff were well-trained. The staff we spoke with were knowledgeable about the people they supported and how best to meet their needs. Training records showed that staff had completed a wide range of courses to give them the skills and knowledge they needed to support people effectively.

People were supported to choose the food they liked. Staff knew what people’s favourite foods were and how they liked them served and this information was available in their care plans. If people were on particular diets or had any allergies staff were made aware of these.

Staff supported people to maintain good health and access healthcare service when they needed to. Staff gave us examples of how they monitored people’s well-being and told us what they would do if they had concerns. This included liaising with healthcare professionals and accompanying people to GP appointments where appropriate.

People using the service and relatives told us that having mostly the same staff made the service more caring for them. They said this ‘continuity of care’ helped staff develop positive caring relationships with the people using the service. Staff got to know people by taking an interest in their lives, hobbies and interests.

People told us that staff actively involved them in making decisions about their care and support.

They said that staff always treated then with respect and dignity and documented people’s care and support needs in a respectful manner.

People’s preferences as to how they wanted their care and support provided were recorded in their care plans. This meant staff had the information they needed to ensure people received personalised care in line with their wishes. Care plans were reviewed regularly and updated so staff were aware of people’s changing needs.

People said they knew how to make a complaint if they needed to. The provider’s complaints policy was in the service user guide and told people what to do if they wanted to complain.

People using the service, relatives and staff told us they would recommend the service to others.

They told us the provider and manager listened to them and