This inspection took place between the 12 and 19 June 2018 and was announced. This means the provider was given notice due to it being a domiciliary care service and we needed to ensure that the registered manager and staff would be available.

Bluebird Care is a domiciliary care service. It provides personal care to people living in their own houses and flats in the community and in some specialist housing. It provides a service mainly to older adults and some younger adults with specialist needs. The service supports people in Rye and the surrounding areas. The service also provides live in carers to give relatives a respite from their caring responsibilities. At the time of inspection 43 people were receiving the regulated activity of ‘personal care’.

The service had a registered manager in post. A registered manager is a person who is 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.

At our last inspection in 2017 we rated the domain of ‘Safe’ and ‘Well led’ as requires improvement. Three recommendations were made in relation to good practice regarding staff knowledge of escalating safeguarding concerns, accident reporting, and processing references for new staff. At this inspection we found that the provider had made improvements in these areas.

We found that a safe recruitment process was in place to check the suitability of staff but minor improvements were needed to ensure the completion of some documentation. We have made a recommendation regarding staff recruitment records.

Medication was managed safely but auditing could be improved by extending the practice of dating liquid and ointment medicines to boxed medicines and this is an area for improvement.

A range of audits had been developed to inform the registered manager and provider of where the service was operating well and areas that needed attention, the audit of staff records however, is an area for improvement..

Staff understood their responsibilities for the protection of vulnerable adults, and how to escalate suspicions and concerns both within and outside the organisation. Action had been taken to improve the accident /incident reporting process; peoples care records could be accessed remotely by office staff that monitored and audited records to alert them to any omissions in recording and reporting. The registered manager analysed accidents and incidents for patterns and trends, and reviewed actions taken.

There were enough staff to support people’s day to day needs, staff and people said they were never rushed; there was good continuity of staff and no missed calls. People and relatives spoke positively about the reliability and dedication of staff. A suitable system was in place for the assessment and management of risk to keep people safe. Guidance was provided to inform staff how to support people when they became over anxious to de-escalate their behaviour and reassure them.

Staff had been trained in infection control and prevention and implemented this in their daily practice. New staff received an induction to their role before working unsupervised; all staff received regular training updates to enhance their knowledge and skills. Staff felt well supported and found the registered manager and office team approachable. Arrangements were in place for regular staff supervision and annual appraisal of their performance and development.

People referred to the service were assessed before a decision was made to accept the care package to ensure this could be met, the assessment took account of any additional support people may need regarding their sexual orientation, ethnicity, culture, or religion and this was recorded in the care plan to inform staff. Each person had a plan of care that was develop

This inspection took place between the 10 and 16 May 2017. We visited the office of Bluebird Care (Rother and Hastings) on 10 and 11 May 2017. This was an announced inspection. This means the provider was given notice due to it being a domiciliary care agency and we needed to ensure someone was available. The inspection involved a visit to the agency’s office and telephone conversations with people, their relatives and staff, between the beginning and end dates.

Bluebird Care (Rother and Hastings) is a domiciliary care agency based in Rye. This was the provider’s first inspection at this location since they registered with the Care Quality Commission (CQC) in May 2015. They provide support and care for predominately older people living in their own homes. People had been assessed at risk of falls and some had long term healthcare needs such as diabetes, multiple sclerosis and people were living with dementia type illnesses.

Bluebird Care (Rother and Hastings) were able to, in line with their franchise agreement, offer their services over a large geographical area in East Sussex. However at the time of our inspection most people lived within 15 miles of the provider’s office in Rye. At the time of our inspection 21 people were using the service. There was a registered manager in post, a registered manager is a person who has registered with the CQC to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

People spoke positively about the services provided. However we found some areas related to safety required improvement. We found an example where a staff member had not followed the provider’s policy in regard to reporting an accident. Completed accident and incident paperwork had not consistently recorded what corrective actions had been taken to reduce a reoccurrence. Staff were clear on what constituted abuse. However we found some staff were unable to identify who they should escalate a safeguarding concern to. Although staff records related to recruitment were predominately complete and assured the provider staff were suitable to work in care, one staff member did not have all previous employment references in place.

All people, their relatives and staff told us they considered the service was well led. However we found some shortfalls in areas where the leadership of the service was accountable. We found examples where people’s care records did not provide an accurate reflection of the support staff were providing to people. Although this had not impacted on care delivery, care records should document the specific care being provided. Senior staff were not having their supervision documented which meant it would be more difficult to set and track defined objectives. The providers electronic scheduling and care call monitoring software had the potential to allow staff to ‘tag’ into the same call as another staff member. This increased the risk that aspects of care delivery may be overlooked.

Medicines were managed safely and in accordance with current regulations and guidance. There were systems in place to ensure that medicines records were audited and reviewed to check for errors or omissions.

There were enough staff to meet people's care needs and care staff had regular training, supervision and appraisal to support them. Staff gave positive feedback about the quality of the training they completed and people who use the service said staff were well trained and knowledgeable.

People's care and support needs were assessed and routinely reviewed. Care plans were developed to detail how these needs should be met. People and their relatives told us they felt involved in their care. Most people’s care plans were detailed and provided clear guidance to staff to be able to provide individualised care. People knew how to make a complaint or raise concerns with the senior staff or the registered manager. There was an appropriate complaints system in place.