This was an announced inspection that took place on 17 and 19 May 2017.

Bluebird Care (Richmond and Twickenham) is a domiciliary care agency registered to provide personal care to people living in their own homes. They provide care, support and assistance, shopping and companionship. The organisation is a franchise and most of the people who use the agency, pay for the service privately

There was a registered manager in post. 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 and associated Regulations about how the service is run.

At our last inspection in June 2015 we found that the service was overall good and rated good for the five key questions of safe, effective, caring, responsive and well-led.

The agency had been highly successful in incorporating new technology to drive up the standard and quality of the service people received. The impact of this was people said they were very satisfied with the service the agency provided. The agency maintained very good communication with people using the service and normally they were given notice of any changes to staff and the timing of their care, unless it was unavoidable short notice. The impact of this was that people were kept up to date and informed about changes to their care very quickly. The agency staff carried out the tasks that had been agreed with people to their satisfaction. People also said that staff were thoughtful and really cared. People generally thought the service provided was safe, effective, caring, responsive and well led.

The management team had been outstanding in the way they successfully promoted and championed equality and diversity by providing excellent support to staff that challenged stigma and discrimination. Staff were knowledgeable about the people they gave support to and the way people liked to receive support. When required they also worked well as a team, for instance when calls that required two members of staff. People said the care and support provided by staff was delivered in a professional and friendly way that was focussed on the individual. Their attitude made them approachable and accessible to people using the service and their relatives and they had appropriate skills to carry out their tasks well.

The records we looked at including those for people using the service and staff were kept up to date and covered all aspects of the care and support people received, their choices and identified that their needs were met. Information was clearly recorded, fully completed, and regularly reviewed enabling staff to perform their duties to a high standard.

People told us they found the manager, management team and organisation were accessible, supportive, responsive, encouraged feedback and selected and provided good staff that were well trained and provided a quality service. Staff said that they received good support and training from the manager and organisation, the organisation was a great place to work and they got a lot of satisfaction from the job they did. They said the management team was approachable, generally receptive to their ideas and there were opportunities for career advancement.

People using the service were encouraged to discuss health and other needs with staff and had agreed information passed on to GP’s and other community based health professionals, as appropriate. People were protected by staff from nutrition and hydration associated risks by them giving advice about healthy food options and balanced diets whilst still making sure people’s meal likes, dislikes and preferences were met.

The agency staff were familiar with the Mental Capacity Act and their responsibilities regarding it.

The manager, management team, office staff and organisation frequently monitored and assessed

Our inspection team was made up of an inspector who answered our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

We saw that the agency had a policy and procedure for treating people with dignity and respect that staff had been trained in. People and their relatives told us they were treated with dignity and respect. People said they received the care they needed, felt safe and staff were very supportive. One person said "I feel safe with the service I get and person who provides it".

We saw that the safeguarding procedures in place were robust, staff had received suitable training in them, knew how to operate them and they understood how to safeguard people. Areas or circumstances of concern specific to individual people or their homes were identified during the assessment process and recorded in the sample of ten care plans we looked at.

The organisation had systems that ensured the manager and staff learnt from accidents and incidents, listened to people's concerns, complaints, whistleblowing and investigations. This reduced risks to people and helped the service to improve. This meant that people and their rights were safeguarded.

People’s individual care and support needs were taken into account by the manager when making decisions regarding the required staff numbers, qualifications, skills and experience. An emphasis was put on continuity once an appropriate carer or carers were identified by the agency and people using the service. This was reflected in the staff rota and ensured that people’s needs were met.

No staff were currently subject to disciplinary action and policies and procedures were in place to make sure that unsafe practice was identified and people were protected. There were no current safeguarding alerts.

Is the service effective?

The agency assessed people’s health and care support needs with them and they were supported to contribute as much as they wished to their care plans. Any specialist care and support required such as diet, mobility or equipment needs were included in the sample of the support plans we saw, that had been signed identifying that people had been involved in producing them. People's relatives were also involved and consulted as appropriate. People and their relatives said "We have been fully involved in the care planning" and "Very happy with the service, carers turn up on time, carry out the tasks and stay for as long as they are supposed to".

Is the service caring?

People told us that the carers were kind, professional and supportive. They carried out their tasks with patience and encouraged people to give their opinions if they thought their care needs had changed. People said, "They are really good, I've been with them four years and wouldn't stay with them if they weren't” and "There was an initial problem with timing of visits but I contacted the office and that has now changed".

People and their relatives completed an annual satisfaction survey and the agency operated spot checks. Where shortfalls or concerns were raised these were addressed by the manager and organisation.

We saw in the support plans we sampled that people’s preferences, needs and wishes had been recorded and that care and support had been provided in accordance with this information and changed when needs changed.

Is the service responsive?

People told us that staff and the agency were responsive to their needs, care support provided met them and this was changed to reflect any change in their requirements. We saw this in the sample of care plans we looked at. People also said they knew how to make a complaint if they were unhappy and who to although this had not been necessary.

Is the service well-led?

People told us that the organisation was accessible, manager and staff listened to their needs, opinions and acted upon them. The service worked well with other agencies and services to make sure people received linked support as required. This was demonstrated by the relationship between the agency and community based health services.

Appropriate notifications were made to the Care Quality Commission.

During our visit we spoke with the care manager, employment specialist and the owner of the service. Following our visit an Expert by Experience carried out a telephone survey with some people who used the service. We also contacted staff by telephone to gain feedback.

We saw there were clear procedures for the assessment of people when they initially contacted the service to identify their care needs.

People we spoke with said that the information they received when they first started using the service was good.

We saw that the care plans and risk assessments were up to date but some care plans did not reflect the support needs of people using the service. The daily records were also task focused and did not record the experience of the person receiving care.

One person said "They give me total respect" and several people said they felt that the care workers had becomes friends.

We saw that some staff had not received appropriate training to provide support for a person with specific care needs.

We contacted a number of people who use the service and their representatives. We asked them about their experiences. They told us that they were happy with the service they received. They said that care workers turned up on time, were reliable and were friendly. One person said that the service was ''fantastic''. Another person told us that having the care workers supporting them had changed their life for the better.

We met some of the care workers employed by the organisation. They told us that they liked working for Bluebird. They said that they had good support and that the manager was always available to offer them advice and training. Some of the staff told us that they had worked for other agencies in the past and that they felt this one was much better at providing personalised care for people who use the service and support for staff.

This was an announced inspection and took place on 29 May and 02 June 2015.

Bluebird Care (Richmond and Twickenham) is a domiciliary care agency registered to provide personal care to people living in their own homes. They provide care, support and assistance, shopping and companionship. The organisation is a franchise and most of the people who use the service, pay for the service privately.

There was a registered manager in post. 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 and associated Regulations about how the service is run.

At the last inspection in May 2014 the agency met the regulations we inspected against. At this inspection the agency met the regulations.

People said the agency provided a good service and that they were satisfied with it and way it was provided. They were positive about the choice and quality of the service provided. They thought the service provided was safe, effective and that staff were caring, responsive and well led.

The records contained clearly recorded, fully completed, up to date and regularly reviewed information that enabled staff to perform their duties. They covered all aspects of the care and support people received.

Staff we spoke with were knowledgeable about the people they supported, the care they needed and received support from the agency to meet people’s needs. They had appropriate skills and provided care and support in a professional, friendly and supportive way that was focussed on the individual. The staff said and we found that they were well trained. They told us the organisation was flexible, good to work for and they enjoyed their work. There was a thorough recruitment process and enough staff provided to meet people’s needs.

People were encouraged to discuss health and other needs with staff if appropriate. Any health information of concern was passed on to the person’s GP’s and other community based health professionals, with their permission. People were protected from nutrition and hydration associated risks with balanced diets that also met their likes, dislikes and preferences.

People told us the manager, office and field staff were approachable, responsive, encouraged feedback from them and consistently monitored and assessed the quality of the service provided.