This inspection of Bluebird Care (Norwich and North Norfolk) took place between 14 May 2018 and 13 August 2018. Our visit to the office was announced to make sure staff were available.

At our previous inspection in August 2016, we found concerns in relation to the level of detail of guidance for staff in people’s care plans and the culture and communication between some office staff and people and care staff. We found that there had been an improvement in the quality of information in people’s care plans and these provided clear guidance to staff. The registered manager had taken steps with the introduction of new systems and processes to help drive improvement in communication between the office staff and people using the service. Following the most recent satisfaction survey the registered manager recognised further action was still needed to improve communication for some people; this was being fully reviewed.

Bluebird Care (Norwich and North Norfolk) is a domiciliary care agency that provides personal care to people living in their own houses and flats in the community. It provides a service to older adults. At the time of our visit 95 people were using the service.

Not everyone using Bluebird Care (Norwich and North Norfolk) receives a 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.

There was a registered manager at this agency who was supported by a deputy manager and other senior staff.

The registered manager had implemented an effective quality assurance system to monitor the standards of the service. The registered manager used feedback from people using the service, staff and others to drive continuous improvement.

Staff knew how to respond to possible harm and how to reduce risks to people. Lessons were learnt about accidents and incidents and these were shared with staff members to ensure changes were made to staff practise to reduce further occurrences. There were enough staff who had been recruited properly to make sure they were suitable to work with people. Medicines were administered safely. Staff used personal protective equipment to reduce the risk of cross infection to people.

People were cared for by staff who had received the appropriate training and had the skills and support to carry out their roles. Staff members understood and complied with the principles of the Mental Capacity Act 2005 (MCA). People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible. People received support with meals, if this was needed.

Staff were caring, kind and treated people with respect. People were listened to and were involved in their care and what they did on a day to day basis. People’s right to privacy was maintained by the actions and care given by staff members.

There was enough information for staff to contact health care professionals if needed and staff followed the advice professionals gave them. People’s personal and health care needs were met and care records guided staff in how to do this.

A complaints system was in place and there was information available so people knew who to speak with if they had concerns. Staff had guidance to care for people at the end of their lives if this became necessary.

Further information is in the detailed findings below

This announced inspection was carried out on 16 August 2016. Bluebird Care (Norwich & North Norfolk) provides support and personal care to people living in their own homes in Norwich and North Norfolk. On the day of the inspection there were 83 people using the service who received personal care.

The service did not have a registered manager in place at the time of our inspection and has not had one since May 2016. A new care manager had been recruited who would be applying to become the 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 supported by staff who understood the risks people could face and knew how to make people feel safe. People were supported in a way that protected them from risks whilst maintaining their independence.

People were usually supported by a regular staff member or group of staff who they knew. People who required support to take their medicines received assistance to do so when this was needed.

People were provided with the care and support they required by staff who were trained and supported to do so. People’s human right to make decisions for themselves was respected and they provided consent to their care when needed.

People were supported to consume a sufficient amount of food and fluids that promoted their wellbeing. People received support from staff who understood their health needs.

People were treated with respect by staff who demonstrated kindness and understanding. People were involved in determining their care and support. They were shown respect and treated with dignity in the way they wished to be.

People could not rely on their plan of care containing all the required information to ensure their care and support was delivered as needed. People felt able to express any issues of concerns and these were responded to.

People used a service that did not have the benefits of consistent direction and management. Improvements were needed to the systems used to monitor the quality of the service.

Most of the people we spoke with were very satisfied with the service. One person said, “They can’t be faulted. The service is excellent.” Another person told us, “The staff are excellent, there’s nothing wrong with the staff”.

People said they received the care and support they needed although staff sometimes were late getting to them and the office did not always ring to let them know this. We were also told by some people that they would prefer to have fewer different staff to visit them. One person said, “…each week it seems like a new face appears”. People had a copy of their care plan at home and they confirmed that reviews took place and any necessary changes to their care were made. We also saw that referrals were made to other providers of care and support as necessary and they were involved as required in the person’s care.

The service had robust recruitment processes in place and good records were kept. We saw that staff were supported with appropriate training and regular supervision. Staff told us that they felt well supported in their role.

The service regularly monitored the quality of the service and we saw the results of the most recent satisfaction survey, including the action plan that had been developed as a result of the findings. People also told us they knew how to complain and felt confident they would be listened to. Complaint records were seen and showed that the service acted promptly to resolve any concerns people had.

Records were kept in good order and were stored securely. Computers were password protected and security locks fitted to all the main office doors. The service was able to access all the records we requested quickly and information within those records was easy to find. Entries in records were legible and clearly written.

People we spoke with told us they were very satisfied with the service. They described the care they received and how they had been involved in deciding on their care package and any changes that needed to be made to it. They said that the office staff were helpful, very efficient and easy to talk to.

People spoke positively about the staff, whom they described as “Very friendly” and “Incredibly helpful”. They described how staff provided the care and support that had been agreed and that they could request changes to their care package as necessary. People confirmed they were fully consulted and felt in control of the arrangements for their care and support.

People said they knew how to complain if they were dissatisfied with the service. One person told us, “I can’t fault them. I have no complaints at all and would ring them up and tell them”. Everyone we spoke with agreed that they felt able to ring the office at any time if they wanted to change their care package or if they had concerns. One person told us, “I hope they end up with a good report as they deserve it”.

People told us they were very satisfied with the service and the care and support they received. They said they were involved in the planning and review of their care package and that their views and opinions were always listened to. People said that staff were kind and very good. Very positive comments were made about the punctuality of staff and the good arrangements in place if staff were running late.

People using the service said they felt safe with the staff who visit them. They said that staff understood and respected the security arrangements they had in place so that they did not feel vulnerable. People told us that they knew how to complain if they were dissatisfied and they were confident they would be listened to and that action would be taken.

People said that their views and opinions were sought on a regular basis. They confirmed they had recently been asked to complete a quality questionnaire so that the service could review how well it was doing and how it could improve. The people we spoke with had been happy to send in their views and were confident they would be acted on.