Bluebird Care (South Bucks and Slough) provides personal care to younger and older adults, some who have a dementia, learning disabilities, mental health conditions and physical or sensory impairment. Based in the Burnham town centre since 2009, the service provided support to people in Buckinghamshire and Berkshire. At the time of our inspection, more than 200 people used the service and there were approximately 140 staff.

At our last inspection, the service was rated good.

At this inspection, the service was rated outstanding.

Why the service is rated outstanding:

People were protected from abuse and neglect. We found staff knew about risks to people and how to avoid potential harm. Risks related to people’s care were assessed, recorded and mitigated. We found appropriate numbers of staff were deployed to meet people’s needs and continuity of allocated care workers had improved. People’s medicines were safely managed.

There was good staff training and support. Staff received additional training in specialist areas, such as dementia, and became ‘champions’ who were enabled to teach other workers. People told us staff had the necessary knowledge, experience and skills to provide appropriate care for people. The service was compliant with the requirements of the Mental Capacity Act 2005 (MCA) and associated codes of practice. 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. There was collaborative working with various community healthcare professionals.

The service was very caring. There was extensive complimentary feedback from people who used the service, relative and friends, and community professionals we contacted. People and relatives were able to participate in care planning and reviews and some decisions were made by staff in people’s best interests. People’s privacy and dignity was respected when care was provided to them.

Care plans were person-centred and contained detailed information of how to support people in the right way. We saw there was a robust complaints system in place which included the ability for people to contact any office-based staff member or the management team. People and relatives told us they had no current concerns or complaints.

Outstanding care was provided to people because the service was well-led. All staff worked continuously as an effective team to improve care, ensure people were safe and increase the care in the home experience. The service received many local and industry awards for the exceptional care provided to people and for their community involvement. The service embraced innovation and continuous improvement in their care approach to enrich people’s lives. The service had an excellent workplace culture for staff.

Further information is in the detailed findings below.

We carried out this inspection on the 11 December 2014.This was an announced inspection. We gave the provider 48 hrs notice of our visits to make sure we could access the people and information we needed to.

When we inspected Bluebird Care (South Bucks and Slough) in November 2013 we found they met all the regulations inspected.

Bluebird Care (South Bucks and Slough) provides care and support to approximately 160 adults and older people in their own homes. This includes adults with physical disabilities and older people living with dementia. Bluebird Care (South Bucks and Slough) does not provide services to children.

Bluebird Care (South Bucks and Slough) has a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 overall very positive about the standard of care they received. They received their care visit close to the time they expected it and it was the length they expected. However, when there was a change in their regular care worker, they did not always get the opportunity to meet them before- hand. They told us this could be frustrating as they had to go through what care they needed and how it was to be provided each time. People told us they liked the system of receiving a care programme each week, setting out their visits and the care staff who would provide it.

People told us the spoken English capability of some care staff provided them with a challenge as it was difficult to understand each other. This did not reflect on the care these staff provided and the provider had systems in place to identify where this was a problem and offered additional language support to the staff concerned.

People’s safety and well-being was protected. Staff received regular training and support to help them provide a high standard of care. People were involved in making decisions about their care and staff treated them with respect and maintained their dignity whilst personal care was being provided.

People were supported to eat and drink and to take their medicines. Staff received relevant training and support which enabled them to achieve this.

Staff were positive about the support they received from the provider and management team. Staff recognition schemes were in place to recognise exceptional levels of care practice. Feedback was sought from people who received care, from care staff and from people involved in the commissioning of care from the service. This was then analysed and used to inform decisions about the future operation of the service. This included enhanced information technology (IT) systems, for example to provide a real-time monitoring capacity to support care staff and those they supported with their care.

The provider worked with a range of local care, education and support organisations to promote the care sector as a career and to inform improvements to the way care was provided.

We spoke with 14 people who received care and support or to their relatives. All of them were very positive about the service they received. " Can't say enough for them" and "Would recommend to anyone" were two comments made. People told us the service was reliable, effective and met their needs in the way they wanted it to.

People told us they had the information they needed about the service, they said communication was good. People said they were treated with respect and because the service was flexible and responsive, it took account of their changing needs even in the short-term.

Staff told us they were well supported by training and supervision. They felt they had the skills and knowledge they needed and had opportunities to gain more as necessary. This meant they were able to meet people's care needs effectively and safely.

We found the service had policies and procedures in place, including staff training, to ensure people were safeguarded from abuse. In the event abuse was seen or suspected, appropriate action was taken.

The service had effective systems in place to regularly monitor and assess the quality of service people received. Where people raised concerns, these had been addressed and changes made to improve the quality of care service provided.