This inspection was started on Tuesday 14 August and was announced. We gave the provider 48 hours’ notice of the inspection to ensure that the provider, registered manager and other office staff were available. On 14 and 15 August 2018 we made telephone calls to people who used the service or their relatives and asked them for their views and experiences of Bluebird Care South Gloucestershire.

The inspection was carried out by one adult social care inspector and an expert by experience. An expert by experience is someone who has personal experience of using or caring for someone who uses this type of service.

At the time of this inspection the service were providing a service to 100 people in their own homes, had 33 care staff and five live-in care staff, six office staff as well as the registered manager and provider. Services were provided to people whose care and support had been arranged on a private basis or was commissioned by South Gloucestershire Council. The geographical area the service covered was within a 10 mile radius of the market town of Chipping Sodbury, South Gloucestershire. The service could be provided from a small number of hours per week up to a 24 hours live-in service.

The service was last inspected in January 2016 and at that time we gave an overall rating of Good. The provider has made significant improvements to the service since the last inspection.

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 2008 and associated Regulations about how the service is run.

Bluebird Care UK is a national franchise. A franchise is when a franchisee (the provider) has bought the rights to sell a specific company’s products in a particular area using the company’s name. Throughout the report we have referred to Bluebird Care (South Gloucestershire) as Bluebird Care.

Why we have rated this service as Outstanding.

The service was exceptionally caring. To ensure people received continuity of care, they were allocated to the least number of care staff. People had in the past raised concerns when this had not been the case and had been listened to. A new care coordinator had resulted in improved planning and better outcomes for people. Care staff knew the importance of developing good working relationships with the people they looked after and ensured they provided person centred care based on their specific needs. The feedback we received from people and their relatives was overwhelmingly positive.

The service went over and above to provide a person- centred service to each person. One example is their ‘Nobody is lonely at Christmas’ campaign where care staff had arranged for people to have a full Christmas meal with all the trimmings, when family and friends were unable to. Two of the care staff had received awards, one from the Bluebird Care Franchise office, 'Best carer in the South West' and the other ‘Best apprentice’, nominated by their external NVQ trainer.

The service was exceptionally responsive. The assessment, care planning and service delivery arrangements ensured each person was provided with a service that met their specific care and support needs. Their care plans were reviewed on a regular basis and changes made as and when required. Care staff would feedback to the office staff where people’s needs had changed so the service could then respond to these changes and support the person appropriately. People were provided with information about the service so they knew what to expect. These details included the provider’s complaints procedure so they would know how to raise any concerns they may have. The provider used feedback about the service to drive forward any improvements. Feedback from peopl

The inspection started on 13 January 2016 and was announced. We gave the provider 48 hours notice of the inspection to ensure that the people we needed to meet with were available. The service was last inspected in June 2014 and at that time there was no breaches of regulations.

At the time of this inspection the service was providing support to 69 people who lived in their own homes. Fifty-eight people were receiving a personal care service and the others received domestic assistance or companionship. The service was provided to people who lived in Thornbury and surrounding villages and Yate/Chipping Sodbury. The provider had plans in place to increase service provision and be able to deliver a service to people in the Kingswood area. All these areas are within South Gloucestershire. The service employed 36 care workers.

There was not a registered manager in post at the service however a care manager had been recruited who will apply to the Care Quality Commission to be registered. They had already commenced the process. 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.

The aim of the service was that people were looked after by the minimum number of care workers. This would ensure they received a consistent service. Due to expansion of the service and changes in where people being supported lived, this was not being achieved at the time of the inspection. Feedback from two people we spoke with during the inspection indicated this required improvement but this contradicted what others has said in the survey forms. The provider, manager and coordinator were already aware of some improvements and had a plan in place to review all care workers work schedules.

People were safe with the care staff who supported them. Care workers received training to ensure they were aware of safeguarding issues and were recruited following thorough recruitment procedures. Staff knew to report any concerns they had about a person’s welfare to the registered manager or directly to the local authority, CQC or the Police. Where risks were identified management plans were put in place to manage the risk with the aim of reducing or eliminating the risk. Where people were supported with their medicines this was safely managed.

People received the service they had agreed to receive when the service was set up. Care workers talked about the people they supported in a respectful manner and received the appropriate training to enable them to undertake their roles effectively. People received a service based on their individually assessed care and support needs. Where identified in the assessment process, people were provided with support to have sufficient food and drink. People were supported to access health care services if needed. Where appropriate care workers worked in conjunction with other health and social care providers.

People were treated with kindness and respect. Their preferences and choices were respected. They were encouraged to provide feedback about the service they received and to have a say about how their service was delivered. They were provided with a copy of their care plan and were told on a weekly basis which care workers were going to support them.

People and care workers said the service was well-led and well managed. There were no missed calls and people were not ‘let down’ by the service. Any feedback that was provided by people using the service, their families or the care workers was acted upon. Information received was used to drive forward improvements to service provision.

This inspection was undertaken by an Adult Social Care Inspector. We looked at five standards during this inspection and set out to answer these key questions: Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. This is based on our visit to the office, discussions with people who use the service and their relatives, and staff. Please read the full report if you want to see the evidence supporting our summary

Is the service caring?

People who we contacted as part of our inspection were positive about the care they received. We received comments such as "staff are very kind and caring" and "I am more than happy".

People confirmed that staff treated them with dignity and respect. Staff had clear ideas about what these terms meant and gave examples of how they would put them in to practice when providing care.

The support plans that people had in place were detailed and provided clear and consistent guidelines for staff to follow that would allow care to be delivered in a person centred way. It was clear that people had been involved in discussions about their care and people signed to give their agreement to the support plan.

Is the service responsive?

People's needs were reviewed regularly and the dates of these were recorded on file. This meant that staff were able to respond to any changes in the level of support that a person required. One person that we spoke with said that their plan was "always updated if my condition changes".

Where concerns arose that might indicate a person was at risk, appropriate action was taken in reporting the issues to the relevant authorities. Disciplinary procedures were followed if allegations were made against a member of staff.

The service kept a log of complaints and we saw that these were responded to appropriately. People who used the service could be assured that their concerns would be listened to and addressed.

Is the service safe?

People that we spoke with told us that they felt safe in the presence of staff. One person told us that staff contacted them if they had any concerns about their relative.

Staff received training in safeguarding vulnerable adults and told us they would feel confident in identifying and reporting concerns. There was guidance and policies in place for staff to follow in the event of identifying a safeguarding issue. Staff understood the term 'whistleblowing' and knew that they could report concerns to outside agencies if they needed to.

There were risk assessments in place to ensure that people were supported in a safe way. This included clear instructions for staff to support people with their moving and handling needs.

Is the service effective?

People’s packages of care were reviewed regularly to ensure that they were meeting the person’s needs. These reviews allowed people to give their opinions on the care they received and for the agency to make changes as required.

Staff received training and support to help ensure that they were able to carry out their roles effectively. Regular supervision and spot checks took place to monitor staff performance.

Is the service well led?

There was a registered manager in place at the time of our inspection. Staff that we spoke with told us they felt well supported and could approach senior staff with any issues or concerns.

A programme of quality monitoring was in place, which included gathering the views of people who used the service. We viewed some returned satisfaction surveys and noted that the responses were positive.