Bluewood Leicester is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community. It provides a service to older people, younger adults and children. The provider had changed the name of the location but had not applied to change their registration. Following our inspection visit the registration for this location was changed to Bluewood Healthcare. At the time of our inspection the registered manager informed us that there were a total of 120 people receiving care from the service.

At our last inspection in September 2015 we rated the service overall as ‘Good’.

At this inspection we rated the service overall as ‘Good’.

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 continued to receive safe care. Staff recruitment processes were followed and ensured that people were protected from being cared for by unsuitable staff. There were enough staff to provide care and support to people to meet their needs safely. Staff were trained in procedures to support and to protect people from abuse.

People continued to be protected from avoidable risks. A range of risks assessments were completed and preventative action was taken to reduce the risk of harm to people. Where people required support with their medicines, staff had been trained in the safe handling of medicine, which was supported by a policy and procedure. People were supported to maintain good health and nutrition.

People continued to receive effective care and support. Staff received induction and ongoing training for their role and understood their responsibilities to work effectively.

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. People continued to receive good care. They had developed positive relationship with the staff who understood their needs. Staff were kind, caring and treated people with dignity and respect.

People continued to receive care and support that was responsive to their individual needs. Care plans were personalised and provided staff with clear guidance as to how people wished to be supported. Following our inspection visit care plans were updated to include people’s diverse, cultural and lifestyles choices and support required to access the wider community. Care plans and relevant information was made available in accessible formats to help people understand the care and support agreed. Staff worked in a flexible way which promoted continuity of care so that they could meet people's needs in a person centred way.

People knew how to raise a concern or to make a complaint. The provider had a complaint policy and procedure and complaints received were investigated.

The provider and registered manager had not consistently met the regulatory responsibilities. They had not provided us with the key information about the service when required, which we took into account when making judgement about the service. The registered manager had not fully understood and met all the legal requirements with regards to their registration. This included accessing relevant support to maintain their knowledge as to changes in legislation and best practice. Following our inspection visit the registered manager took the necessary steps to ensure the service was registered correctly and assured us they would access training.

The registered manager ensured the management team provided people and staff with the support they needed. Effective systems were in place to monitor and improve the quality of the service provided through a range of audits and views sought from

As part of this inspection we spoke with six people who used the service and two family members, four care workers and four members of the management team. We looked at a number of records including people's personal records and records kept in relation to the management of the service.

We considered all the evidence we had gathered under the outcomes we inspected. We used the information to answer the five questions we always ask. This is a summary of what we found:

Is the service safe?

People told us that they felt safe with the care workers who supported them and that they were treated well. One person explained: “I feel as safe as houses with them.” A family member told us: “I know that she [their relative] is in safe hands.”

Care workers and members of the management team knew what to do if they suspected that someone had been abused. One care worker explained: “I would report it immediately to the office.”

Risk assessments were in place. Those checked on the day of our visit showed us that the risks associated with people’s care had been assessed and measures had been put into place to reduce that risk. This showed us that people’s health and welfare was, wherever possible, protected.

Personal protective equipment was available for care workers to use including disposable aprons and gloves. This ensured that care and support was provided safely and in line with the services infection control policy.

There was an appropriate recruitment process in place and care workers were not allowed to work in the community, until all the appropriate checks had been carried out. This safeguarded the people who used the service and ensured that only suitable people worked for it.

Is the service effective?

We spoke with people who used the service and they told us that they were satisfied with the care and support they received. One person explained: “They are very, very good, I couldn’t wish for better.”

People told us that the management team where effective and approachable and ensured that the best possible service was provided. One person told us: “The care coordinator is very good, she gives me a lot of confidence and If I have a problem, she does her best to sort it out.”

Care plans provided care workers with information about people’s care and support needs. However, not all of those seen during this visit included all the tasks that care workers were carrying out.

On speaking with both care workers and the management team it was clear that they understood the needs of the people they supported. This ensured that people’s needs were met.

Consent to the care and support that people received was obtained and weekly contact was made with everyone who used the service. This ensured that people remained happy and in agreement with the care and support they received.

Is the service caring?

People who used the service told us that they were very happy with the care and support they received. They told us that the care workers showed them respect at all times and they provided their care and support in a kind and dignified manner. One person told us: “They are very nice very helpful and very caring. They are like my daughter.”

A family member told us: “The carers are competent and caring. Very nice people.”

Is the service responsive?

The provider had an effective complaints procedure that ensured complaints were taken seriously and thoroughly investigated. Everyone using the service had been given a copy of the procedure so that they knew what to do if they were unhappy with the service they received. People who used the service told us that they knew what to do if they weren’t happy. One person told us: I would phone Bluewood, I have a blue folder with their number in.”

A complaints policy was in place and a copy of this had been given to everyone who used the service. This ensured that they, or their advocate, were informed as to what to do if they were unhappy about the service they received.

Is the service well-led?

A quality assurance system was in place and the management team regularly assessed the service provided. Annual quality surveys had been used. This provided the people who used the service with the opportunity to share their thoughts on the support they received and enabled the management team to monitor the quality of service being provided.

People who used the service were provided with a copy of its Statement of Purpose and Service User Guide. These documents explained to the reader the aims and objectives of the service and what they could expect from the service themselves. This ensured that they were fully informed of the service and what it offered.

Care workers felt supported by the management team and told us that they felt able to talk to someone should they have a concern of any kind. One care worker explained: “If I had any concerns I would talk to my supervisor, she is very nice.”

People told us that the provider regularly discussed their care plans with them. They also told us how the provider asked them for their views and experiences in relation to their care.

People using the service told us that the provider always discussed changes to their care and respected their individual choices. The provider recorded peoples choices and ensured these were respected during the delivery of care.

We also found the provider regularly audited the service and took note of any themes or trends and adjusted the service delivery in order to continuously improve the standard of care.

People who used the service told us that the level of care provided was excellent. Carers were always on time and very professional.

People who used the service told us that the level of care provided was excellent. Carers were always on time and very professional.

Others told us they felt the carers sometimes had to sort things out themselves. One person told us "The carer was very good but had not received the initial care assessments when they started to provide care"

People’s care records were not always fully completed so staff did not always have a full picture about the person’s needs. There was little evidence that people had been involved in developing their care plans and that subsequent reviews were being completed at required intervals. Despite this, people felt they were getting the care they needed and staff said they were given information about the person’s care needs. One person who used the service told us that they were “very happy with the care”.

Staff were properly trained in safeguarding adults and people felt they were being cared for safely. People were being supported to take their medication by staff who were suitably trained in that area.

There were some gaps in the staff recruitment procedures which meant there was the possibility that people may be exposed to unsuitable workers, though people who used the service did not express any concerns in relation to the suitability of workers. There were enough staff provided to care for people and they were suitably trained. When asked whether they felt that the staff had the right skills to do their job, one person who used the service told us “I’m sure they do, one of them was a district nurse, they are very good”.

Gaps in record keeping means there is the potential for care needs to be overlooked. Ongoing contact with people to check their satisfaction with the service is not formalised so that there are no recognised systems in place for gaining people’s views and for quality monitoring.

This inspection took place on 28, 29 and 30 September 2015 and was announced. The provider was given 48 hours’ notice because the location provides domiciliary care service and we needed to be sure that someone would be at the office.

Bluewood Leicester is a domiciliary care service providing care and support to people living in their own homes. The office is based in the city of Leicester and the service currently provides care and support to people living in Leicester, Leicestershire, Loughborough and Northamptonshire. At the time of our inspection there were 110 people using the service.

A registered manager was 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.

People told us they felt safe with the staff that supported them. Staff were trained in safeguarding (protecting people who used care services from abuse) procedures and were confident that if they had any concerns about people’s safety, health or welfare they would know what to do.

People were supported by knowledgeable staff who understood people’s individual and diverse needs and how to support them to keep them safe. Risk to people’s health had been assessed and measures in place were detailed in the care plans for staff to refer to.

People told us that staff were well trained and knew how to support them effectively. Staff recruitment practices were robust and appropriate checks were carried out before people started work. Staff had a thorough induction and on-going training that equipped them to support people safely. Staff were supported regularly through supervisions and staff meetings and checks were carried out on their practices.

There were sufficient numbers of staff employed by the service to meet the needs of people. The service ensured the needs of people were met by staff with the knowledge, skills and matched with any known requirements such as individual preferences, cultural or diverse needs.

People were promoted to take their medicines by staff where people’s assessed needs and care plan required this. People told us that staff supported them to liaise with health care professionals if there were any concerns about their health.

People made decisions about their care needs and support needs. People told us that staff sought consent before they were helped and that staff always respected their choices and decisions.

Staff supported some people with their meals and drinks. Staff were trained to prepare meals, which met people’s nutritional and cultural dietary needs.

People told us that they were happy with the care and support received. People spoke positively about the staff, found them to be kind and caring and had developed positive relationships with them. People’s privacy and dignity was maintained, their choice of lifestyle was respected and their independence was promoted.

Staff provided care and support that was focussed on the person’s needs and took account of their preferences such as times, cultural and diverse needs. Staff employed by the service spoke a number of other languages reflective of the people living in the local community.

People told us they were aware of how to raise concern. They were confident that any concerns raised would be responded to by the registered manager and the provider.

People who used the service and relatives we spoke with told us that their views about the service was sought regularly. People told us that they were happy with how the service was managed.

The provider was activities involved and visited the service most days to check how the service was managed and assess the quality of care provided. There were systems in place to assess and monitor the service, which included checks on staff delivering care and support to people and review of people’s care. We found some improvements were needed to the communication between the staff providing the care and support and the management team. When this was raised with the registered manager they assured us that they would improve the current communication and recording system to help develop better monitoring systems that would help the service to develop.