This inspection took place on 16 November 2017. When we last visited the home on 29 September 2015 the service was meeting the regulations we looked at and was rated Good overall and in all five key questions. At this inspection we found the service remained Good.

Bluebird Care Sutton is a domiciliary care service that provides care and support to adults of all ages, in their own homes. The service provides help with people's personal care needs in Sutton and the surrounding areas. This includes people with physical disabilities and dementia care needs. At the time of the inspection they were providing personal care for 96 people.

The service had a manager who was in the process of applying for registration with the Care Quality Commission (CQC). The previous registered manager left the post recently. 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.

The service was safe. Risk assessments were completed to enable people to receive care with a minimum of risk to themselves or the care staff. Robust recruitment procedures were followed to ensure as far as possible only suitable staff were employed. Staff were trained to safeguard and protect people. They were aware of their responsibility to report concerns.

People were cared for and supported by staff who had received training to support people to meet their needs. The registered manager had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005. People were supported to eat and drink enough to ensure they maintained a balanced diet and referrals to other health professionals were made when required.

People were cared for and supported by staff who knew them well. Staff treated people with dignity and respect. People's views were actively sought and they were involved in making decisions about their care and support.

People and their relatives were involved in the planning and review of their care. Care plans were reviewed on a regular basis and also when there was a change in care needs. People were given information about how to make a complaint and the people we spoke with knew how to go about making a complaint and were confident that they would be responded to appropriately by the provider. We saw evidence the manager responded to complaints received in a timely manner.

There was a positive culture within the staff team and staff spoke positively about their work. Staff were complimentary about the management team and how they were supported to carry out their work. The manager and other senior staff were committed to providing a good service for people. There were quality assurance systems in place to help ensure any areas for improvement were identified and action taken to continuously improve the quality of the service provided. People told us they were regularly asked for their views about the quality of the service they received.

This was an announced inspection and took place on 29 September 2015.

At our previous visit in February 2015 we judged the service was meeting all the regulations we looked at.

Bluebird Care Sutton provides domiciliary care and support to 122 people living in their own homes in the Sutton area with a range of needs including older people, dementia, physical and mental health needs.

The service did not have a registered manager in post at the time of this inspection. A new manager was appointed in September 2015 and has applied to the Care Quality Commission to become a 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 told us they felt safe with the care and support they received in their homes. There were arrangements in place to help safeguard people from the risk of abuse. The provider had appropriate policies and procedures in place to inform people who used the service, their relatives and staff how to report potential or suspected abuse.

People had risk assessments and risk management plans to reduce the likelihood of harm. Staff knew how to use the information to keep people safe.

The manager ensured there were safe recruitment procedures to help protect people from the risks of being cared for by staff assessed to be unfit or unsuitable.

Staff received training in areas of their work identified as essential by the provider. We saw documented evidence of this. This meant that staff had the knowledge and skills to carry out their work with people effectively.

Appropriate arrangements were in place in relation to administering and the recording of medicines which helped to ensure they were given to people safely.

Staff had a good understanding of their responsibilities in relation to the Mental Capacity Act 2005. They supported people to make choices and decisions about their care.

People had a varied nutritious diet. They were supported to have a balanced diet, food they enjoyed and were enabled to eat and drink well and stay healthy.

People were involved in planning their care and their views were sought when decisions needed to be made about how they were cared for. The service involved them in discussions about any changes that needed to be made to keep them safe and promote their wellbeing.

Staff respected people’s privacy and treated them with respect and dignity.

People said they felt the service responded to their needs and individual preferences. Staff supported people according to their personalised care plans, including supporting them to access community-based activities.

The provider encouraged people to raise any concerns they had and responded to them in a timely manner. People were aware of the complaints policy.

People gave positive feedback about the management of the service. The manager and the staff were approachable and fully engaged with providing good quality care for people who used the service. The provider had systems in place to continually monitor the quality of the service and people were asked for their opinions via surveys. Action plans were developed where required to address areas for improvements.

At our previous inspection in August 2014 we found that care and treatment was not always planned and delivered in a way that was intended to ensure people’s safety and welfare. We also found that people were cared for by staff who were not being supported to deliver care and treatment safely and to an appropriate standard.

At this inspection we spoke with the new manager who is in the process of registering with the Care Quality Commission; with six people who use the service and two staff. We considered our inspection findings to answer the questions we had asked previously: Is the service effective and is the service responsive?

Was the service effective?

We found that people were supported by staff who had received effective supervision, appraisal and training and this helped to ensure they were able to meet the specific needs of people using the service.

We were told by the manager that a review of all staff supervision had taken place since the last inspection. We were told the supervision policy in place at the last inspection was implemented effectively. The manager told us staff supervision was carried out monthly. The staff supervision records we saw for staff evidenced this. Staff told us they received regular supervision and they said they found it supportive and useful in their work with people for whom they provided care and support.

The manager told us since the last inspection staff training was improved with further training offered to all staff. We inspected staff files and the records we saw evidenced staff had completed all the necessary basic training deemed by the provider as being necessary for them to do their jobs effectively. Certificated evidence that we saw supported this. Staff confirmed that access to training had been improved significantly.

Was the service responsive?

People told us their care plans were reviewed recently and they were central to the process. They said they were asked how they would like their care to be given. One person said, “My care plan was reviewed with me quite recently and I was asked how I wanted the support to be given, I signed the care plan in agreement with it, I am very happy with the care I receive.” Another person told us, “Yes they came to see me at the end of last year, and went through everything with me and we agreed the care that I am now receiving. I am very happy with the support I get thank you.”

At this inspection we spoke with the manager who told us about a new IT and software package had been implemented that has helped improve the timeliness of care calls made by staff to people who use the service. They said that communication between staff and the office had also improved. We were told that people were now better informed if their care and support was to be late. People agreed with this, one person said, “Our calls are usually on time and if not the office tells us when they are going to be late.” Another person said, “We do get a telephone call now from the office if they are going to be late and that’s much better than it used to be.” All of the people we spoke with said that they were informed if their care worker was going to be late.

When we visited the offices of this service, the acting manager told us that approximately 95 people were using the service. We spoke with sixteen people, the acting manager, the operational manager, two staff and two relatives. We reviewed six people's care plans and five staff files.

We considered our inspection findings to answer questions we always ask; is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Was the service safe?

People who use the services were treated with respect and dignity by staff. They told us they liked their care worker to wear their badges and uniforms as it helped them to feel safe; one person said, “Yes my care worker wears their uniform. When they first came here they did not have their badge and I was unhappy about that because I could not be sure who they were. But since then they have their badge on and I now know the person anyway”. Other people told us it helped them to feel safe, “to know who the people were who were knocking on their doors”.

Recruitment practice was safe and thorough. The acting manager ensured that staff were appropriately qualified to meet the care needs of people who used the services. Risk assessments were undertaken by the agency to minimise the risks both to the person using the service and to care workers. This helped to ensure that people’s needs were met safely.

Was the service effective?

People who use the service had their care and support needs assessed, together with risk assessments and they were involved in their care and support planning. We inspected six people’s care files. They included essential information about the person’s needs and any risks to them as well as the care that had been agreed with them.

We found that staff had not received regular and appropriate training or supervision and were therefore not able to ensure they were able to meet the specific needs of people using the service.

Was the service caring?

People who use the services were supported by staff in a polite and respectful way. All sixteen of the people we talked with said their care workers treated them well and respected their privacy. One person said, “My care worker does what has been agreed in my care plan and then sometimes if there is time and I ask her to do some other little thing, she does it for me”. Another person said, “Oh yes they are polite and they do what has been agreed with me before, I’m quite happy”.

People who use the services told us they had discussed their care plans with the office and that they were able to discuss relevant issues and make decisions about what they wanted to do. This reflected the caring service ethos that we found on the day of the inspection.

Was the service responsive?

People who use the services were able to ask for changes in their care and support as their needs changed. Care plans had been reviewed regularly. We spoke with sixteen people who received care and support from this agency and eleven people told us that they were not kept informed if their care worker was late. One person said, “Our calls are often not on time and we are only informed very occasionally when they are going to be late”. Another person said, “Although we are satisfied with what our carers do when they come, they are sometimes late”. Only three people out of the sixteen people we spoke with said that they were informed if their care worker was going to be late.

All the people we spoke with knew how to make a complaint. There was an appropriate complaints procedure in place and although no complaints had been made since the last inspection staff indicated that they would be supportive of anyone who needed to complain. People can therefore be assured that complaints would be investigated and action taken as necessary.

Is the service well-led?

The acting manager and the operational manager carried out regular checks to assess and monitor the quality of services provided and took appropriate action to address any issues or concerns raised about service quality.

The views of people who use the services, their representatives and staff were listened to. People told us that they were asked for their feedback on the services they received and that they filled out a customer satisfaction survey. Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the agency. This helped to ensure that people received a good quality service.

People told us that they were very happy with the care and support they received from Bluebird Care Sutton. One person said, “Absolutely good care, we are very happy with what they provide for us”. Another person said, “They are really good, much better than other agencies I’ve had”.

People told us that they had been assessed before a service was provided and that they had a care plan that set out the care and support they received. People said that they felt safe with their care workers and that staff always wore their uniforms and identity badges.

People said that their care workers were reliable, kind and courteous and always respectful. All the people we spoke to were happy with the services they received. They all knew how to make a complaint but people we spoke to said they had never needed to do so.

People told us that they had been provided with enough information about the services offered by Bluebird Care Sutton to make a decision as to whether they wanted to use them or not. They also told us that they had been assessed before a service was provided and that they had a care plan that set out the care and support they received. People said that they felt safe with their care workers and that they always wore their uniforms and identity badges.

People said that their care workers were reliable, kind and courteous, always respectful but not always on time. All the people we spoke to were happy with the services they received. They all knew how to make a complaint but people we spoke to said they had never needed to do so.