About the service:

Bluebird Care (Mid Staffs) is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to people with a learning disability, older people, people with physical disabilities, people who have dementia, people that have sensory impairment and younger adults. At the time of the inspection there were 61 people receiving personal care and support from the service.

People’s experience of using this service:

Care and support was tailored to meet the needs of individuals and delivered to ensure flexibility, choice and continuity of care. People were supported safely with their personal care by staff that knew them well. People were supported to be independent and their choices and preferences were respected and known to staff. Staff were caring, kind and respectful. People’s privacy and dignity was promoted.

People had support plans and risk assessments in place to meet their individual needs. Staff supported people with their individual preferences and people’s needs were met.

Lessons were learnt when things went wrong and systems were improved if needed. The managers were responsive and approachable to people that used the service and to the staff. The registered manager had a clear understanding of their responsibilities of their registration with us.

Rating at last inspection:

At the last inspection the service was rated as; Good (report published 06 July 2016)

Why we inspected:

This was a scheduled inspection based on the previous rating.

Follow up:

We will continue to monitor the service through the information we receive.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

We inspected this service on 25, 26 and 31 May 2016. This was an announced inspection and we telephoned 48 hours’ prior to our inspection in order to arrange home visits with people who use the service. Our last inspection took place in May 2014 and the provider was found to be meeting the legal requirements we looked at.

Bluebird Care (Mid Staffs) provides personal care and support to people living in their own homes in Cannock and the surrounding areas. At the time of our visit, 64 people were receiving a regulated service. There was a registered manager at 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.

Improvements were needed to ensure people’s feedback on the service was used to make changes where needed.

People told us they felt safe with staff. Staff recognised their responsibilities to protect people from abuse and were confident the manager would take action if they raised any concerns. Risks to people were assessed and managed to keep people safe whilst promoting their independence. People received their medicine as prescribed and were supported to apply any creams they needed. People’s needs and preferences were met when they were supported with their dietary needs and staff ensured people were referred to health professionals when their needs changed.

There were sufficient staff to meet people’s needs and checks were made to confirm staff were suitable to work with people in their own homes. Staff received an induction and training to gain the skills and knowledge to support people. Staff felt valued and supported by the management team.

People received personalised care and were happy with how the staff supported them. People told us the staff were kind and caring and looked forward to their visits. Staff gained people’s consent before providing care and support and understood their responsibilities to support people to make their own decisions. Staff treated people in a caring way, respected their privacy and promoted their independence.

People knew how to raise a complaint and felt confident their concerns would be acted on. The manager and provider carried out checks to monitor and improve people’s care.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask;

Is the service safe?

Care records contained detailed risk assessments which had been carried out for each element of care planned. Actions to reduce any risk identified were documented. Risk assessments balanced risk with the rights of people to maintain their independence. People told us that staff took care of them and made sure they were safe.

Staff were clear about their role and responsibilities in relation to consent. Before people received any care or treatment they were asked for their consent. Consent forms were completed and signed by people who received a service and documented in the care record.

Care plans were clear about people's ability to consent for themselves. We saw that, where appropriate, mental capacity assessments had been carried out.

The provider had appropriate systems in place with regard to safeguarding adults. The provider responded appropriately to any allegation of abuse and investigations were robust. Staff received safeguarding training at induction and had annual updates.

Is the service effective?

Care records were well written and reflected the needs and wishes of the people who received a service. People told us they were fully involved in developing their care plan. Daily records demonstrated that care staff delivered care in line with the care plan. Care plans contained sufficient information for staff to carry out the care required.

The minutes from staff meetings demonstrated that staff received updates, information and guidance aimed at improving care. There was evidence that incidents, complaints and feedback were discussed. Any appropriate lessons were learned and necessary actions were monitored through supervision.

Is the service caring?

We talked with nine people and the relatives of five others who used the service. All the people we spoke with said the service was good or very good. People we spoke with described the service as: "Kind and Caring", "Absolutely fabulous", "Professional, with a sense of humour".

Feedback from the annual survey and care reviews were generally very positive.

Is the service responsive?

All the people we spoke with said that they had been asked for their views about the service they received. Issues raised in surveys and reviews were discussed at staff meetings and supervision. People told us they were confident that any issue raised or complaint made would be thoroughly investigated and acted upon.

Policies and procedures were up to date and reflected national legislation and guidance.

Is the service well-led?

Staff told us they felt well supported by their supervisors and the registered manager. They told us that they were treated fairly and that issues they raised were dealt with appropriately.

Staff had good access to a wide range of training relevant to their role. All staff received a comprehensive induction programme prior to working alone.

There were systems and processes in place to monitor the quality of the service. These included analysis of incidents and complaints, satisfaction surveys and supervision visits to observe care staff delivering care.

This inspection was part of our scheduled inspection programme. We told the service we were visiting one day in advance. This was to make sure that staff we needed to speak with were available. As part of this inspection we spoke with senior staff, care workers and spoke with 14 people or their relatives to gain their views of the service.

People were satisfied with the care they received. Comments included: "All very good"; "I am very pleased with the service" and "They know me and how I like my care".

People were involved in decisions about their care and were provided with care that met their individual needs. Plans of care identified people's specific preferences and gave clear details about how they wanted their care provided.

People usually had regular care workers and the service was provided at a time that suited them. People told us that their care was not rushed.

Care staff were trained to identify signs of abuse and knew how to act upon concerns about people's welfare.

The service's recruitment procedures were making sure that care staff had the appropriate employment checks and were suitable to work with vulnerable people.

People's views about their care were sought by the service. These views were acted upon to improve the service that people received. Systems were in place to monitor and check the quality of care people received.