About the service: Bluebird Care is a domiciliary care agency. It provides personal care to people living in their own homes. It provides a service to both older adults and younger disabled adults. At the time of the inspection they were providing care and support to 233 people.

People’s experience of using this service:

People did not always receive care and support from staff who understood their roles and responsibilities. This meant some staff had acted outside of their remit, which resulted in some care and support not being provided in a well-planned and directed way.

We recommended the provider looked at ways to improve staff knowledge of their roles and responsibility within the service.

There was not a registered manager in post. The new manager had applied to register with the Care Quality Commission (CQC). The registered manager and provider are legally responsible for how the service is run and for the quality and safety of the care provided.

People did not always receive care and support from a consistent team of staff. People also said staff were sometimes late and they were not always informed. The manager was working towards improving this experience for people.

People received care from staff who were kind and caring. Staff respected people’s privacy and dignity when providing personal care. However, some people said they sometimes received care and support from a male care worker when they had said they preferred not to. The manager was reinforcing the need for planners to be aware that some people did not want a male care worker to carry out personal care.

There were systems in place to monitor the quality of the service, ensure staff kept up to date with good practice and to seek people’s views. However, they had failed to identify the lack of consistency of care workers that some people had experienced. The manager had identified shortfalls and was working towards addressing the issues raised.

Some staff in a specific geographical area said they did not feel supported and involved in the running and development of the service. The provider was looking at ways to improve communication with staff in this area and support them to be more actively involved.

People told us they felt safe with the staff who supported them. Risk assessments were in place to identify any risk to people and staff. All staff understood how to ensure people were safe. There were enough staff to support people with their daily living.

Staff demonstrated a good understanding of people’s needs and received training relevant to the needs of the people they provided care and support for. Some people needed help to prepare and eat a healthy meal. Staff ensured peoples dietary preferences were followed, and a healthy meal provided.

Staff encouraged people to be involved in their care planning and reviews. People were supported to express an opinion about the care provided and any improvements that could be made.

Records showed the service responded to concerns and complaints and learnt from the issues raised.

The service continued to have strong links with the local community. They provided support and training in Dementia awareness to local businesses, schools and colleges.

Rating at last inspection: At our last inspection we rated the service Outstanding. The report was published June 2016.

Why we inspected: This was a planned inspection based on the rating at the last inspection. The service’s rating changed from Outstanding to Good overall.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

This inspection took place on 17, 18 and 22 February 2016. The provider was given 48 hours’ notice because the location provides a domiciliary care service and we needed to be sure the registered manager would be available for the inspection. It also allowed us to arrange to visit people receiving a service in their own homes.

Bluebird Care provides personal care to people living in the areas of Taunton, Mid Devon, Sedgemoor and West Somerset. At the time of this inspection they were providing personal care for 96 people. They also provided a domestic service to people living in their own homes.

This was the care provider’s first inspection since they re-registered at their new address. The inspection was carried out by one adult social care inspector.

People who received care and support from Bluebird Care said they were very happy with the service provided. Everybody said the staff went above and beyond what was expected of them. People told us they felt safe with all the staff who supported them. There were clear risk assessments which meant care was provided in a way that minimised risks. One person said, “I always feel safe they are all so nice.” Another person said, I really look forward to them coming and I have never felt unsafe.” Staff were aware of how to recognise and report any suspicions of abuse and all were confident that any concerns would be fully investigated.

The registered manager listened to what people said and made adjustments to their care and the organisation to reflect their comments. For example care workers worked in small geographical teams to ensure people received care and support from a regular team of staff whom they got to know well and trust.

People received care and support in line with their needs and wishes because adequate numbers of staff were employed. There were contingency plans in place if staff were unable to carry out their visits. Staff were well trained and had a good knowledge of the needs and preferences of people which enabled them to provide personalised care. One person said “They all know exactly how to look after me; they even know which TV channel I watch and make sure it is on before they leave.” A relative said, “They know how to look after [the person] and they make sure the exercises he needs are done every day.”

Care plans were personalised to each individual and contained information to assist staff to provide care in a manner that respected their wishes. For example the care provider provided support for one person who had an active life and interests such as shooting and boxing. The care provider had arranged for the person to have a male care worker with similar interests and had facilitated a weekend in London at a boxing match.

People said they received care and support from a consistent team of people they knew. One person said, “I have my team of girls and I have got to know them very well.” Staff said they had sufficient travel time between visits so they could spend extra time with people to have a chat and get to know them rather than just provide the care required.

The registered manager had a clear vision for the care provider which was to provide a service which was influenced by the needs and wishes of the people who used it. There was a commitment to providing high quality care which was tailored to people’s individual wishes. Their vision and values were communicated to staff through staff meetings, supervisions and a regular newsletter. People’s views were gathered by regular monitoring visits and phone calls and by satisfaction surveys.

The care provider worked within the local community to promote awareness of the effects of living with dementia. They took a key role in supporting organisations to develop dementia champions within their staff teams. Part of their role within the community was to provide training sessions in dementia awareness for groups, clubs, colleges and family members of people they provided support for.

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