Mutual Benefit Care Limited t/a Bluebird Care is based in Gloucester and provides personal care to over 83 people living in their own homes in North Gloucestershire. It is a franchisee of a national franchise Bluebird Care Limited which monitors service delivery and offers support and advice.

At the last inspection on 2 December 2014, the service was rated Good. At this inspection we found the service remained Good.

People received individualised care which reflected their personal preferences, wishes and routines. They were mostly supported by staff who knew them well. They liked to have the consistency of staff who were known to them but accepted at times new staff needed to attend to their needs. Wherever possible new staff shadowed existing staff so they could establish a relationship with people. People were treated with dignity, respect and kindness. They said staff were “excellent”, “competent and caring”, “they are really nice ladies, lovely” and “on the whole they are very good”. People’s care records were kept up to date with their changing needs and by closely working with health care professionals the risks to people’s health and well-being were reduced. People were supported to eat and drink. They were encouraged to make choices about their care and support and to be as independent as possible.

People were supported by staff who had access to training and support to acquire and maintain the skills and knowledge they needed to meet their needs. They were supported to develop in their roles through individual meetings and annual appraisals. The skills of staff were recognised through a monthly carer of the month award and by nurturing their skills to develop further. Changes had been introduced to improve the effectiveness of their work, working in teams and improving the office systems for allocation of staff to people using the service. Further improvements were planned to reduce gaps in rosters and to pay staff for travel time.

People’s views were sought as part of the quality assurance process to drive through improvements to the service. Feedback about poor communication between people and the office had resulted in changes to the way in which office staff worked. A range of quality assurance systems monitored the standards of care provided. The Bluebird franchisor also monitored the quality of the service delivered to ensure they maintained the quality of home care and support they expected of their franchisees. The registered manager and senior staff kept up to date with national and local changes in legislation and guidance.

Further information is in the detailed findings below.

This was an announced inspection which included a visit to the offices of Mutual Benefit Care Limited on the 2 December 2014. This was followed up with visits to people in their own homes on 3, 4 and 5 December 2014.

There was a registered manager in post who was in transition to another role within the company. 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 and associated Regulations about how the service is run. A new manager had been appointed and had submitted applications to CQC to become registered with us. The manager was supported by a management team who were actively involved in service delivery.

Mutual Benefit Care Limited t/a Bluebird Care is based in Gloucester and provides personal care to over 120 people living in their own homes in North Gloucestershire. It is a franchisee of a national franchise Bluebird Care Limited which monitors service delivery and offers support and advice.

People said, “I feel safe having them (staff) in my home”. People were supported by sufficient staff with the skills and understanding to provide their care and support. Staff knew how to reduce risks and to recognise signs of abuse keeping people safe from harm. People were given advice on how to stay safe. Staff were well supported and kept their knowledge up to date through training and courses. People wanted a consistent staff team to help them each day and for most people this was provided. Bluebird Care was recruiting staff to help achieve this. People were matched with staff and changes made to their staff team where necessary to improve their experience of the care provided. People’s health, nutrition and diet were monitored to keep them well. If necessary staff liaised with community professionals who said they found the service responsive and kept them actively involved.

People were treated with dignity and respect. Staff understood their preferences and background. Care and support reflected these providing individualised care. Staff had a good understanding of the needs of people living with dementia and had innovative and creative ways of working with them. People were supported to maintain their independence and to remain at home. People, their relatives and health care professionals were involved in the planning and review of their care. Visits to people reflected their wishes and preferences. Visits were arranged to respond to people’s needs and there was flexibility about rearranging or rescheduling visits if needed. Staff quickly responded to changes in people’s needs involving social or health care professionals if needed.

A person told us, “I can’t fault Bluebird Care, they are all professional, I would recommend them, they are first class.” Staff shared the vision and values of the managers to provide a family run business delivering high standards of care. People, their relatives, staff and community professionals were asked for their views which were used to make improvements and develop the service. Where complaints were received these were investigated and action had been taken to address any mistakes which had been made. Quality assurance systems monitored the standards of care provided and were used to maintain and improve people’s experience. Managers and staff were involved with national and local organisations to make sure Bluebird Care delivered a service which reflected current best practice.

As part of our inspection, we visited five people in their homes and spoke with seven people on the phone. We also spoke with staff and reviewed people’s care plans. Some of the comments we received about care included “I am comfortable with staff”, “Staff are really caring and friendly” and “most staff who come understand what having dementia means”. Some comments from the 2013 survey included “I am more than happy with the care received” and “Care could not have been better”.

People were positive about the care they received. They said they had confidence in staff. Some people reflected that staff were often a little late. People told us that they were able to complain if needed and felt listened to. The provider undertook satisfaction surveys and used complaints and incidents as a learning opportunity.

We found that medication was administered safely and staff received appropriate training. Although care records were generally good, we found there were some inconsistencies in the records that we reviewed. The provider was in the process of changing the paperwork and also planned to introduce more structured quality reviews of record keeping.

We carried out a themed inspection looking at domiciliary care services. We asked people to tell us what it was like to receive services from this home care agency as part of a targeted inspection programme of domiciliary care agencies, with particular regard to how people's dignity was upheld and how they could make choices about their care.

The inspection team was led by a CQC inspector joined by an Expert by Experience, who has experience of using or caring for someone who uses this type of service.

We used telephone interviews and home visits to people who use the service and to their main carers (a relative or friend) to gain views about the service. We visited four people in their own home as part of this review and spoke with them about their experiences of the support they received. We spoke with the provider, the manager and two co-ordinators at the time of our visit to the office, and three care workers during or after the home visits. We spoke with eight people who received a service from this agency over the telephone.

Each person we visited at home told us that overall they were happy with the service provided by the agency. People we spoke with told us if they had any concerns they knew how to contact the agency and felt confident that their concerns would be listened to. People also told us that they received a consistent service and the agency kept them informed of any changes to times.

The people we spoke with over the telephone told us that they were overall very happy with the service. People told us "I would recommend Bluebird Care to anyone" and "I think they do very well, they do a good job and you have no problem about anything".

A relative of a person using the agency said, " We were given sufficient information about the service." People told us they were treated with dignity and respect.

People told us "I am very very happy with the service I receive", "Staff do as I ask, they read the care plans and follow them" and "we are happy with the service we receive."

People said they knew how to make a complaint. One person said, "I have no concerns about the service provided" and another person told us "I would talk to the managers if I had any concerns, and I know I would be listened to and my concerns addressed." Other people we spoke with confirmed this was also their experience.

People said "the service I receive is very good", "they are the best carers I have ever had" and "the standard of care is very good."

Generally some people felt that staff were busy and did not have enough time between visits. People told us that although they were provided with a rota of staff due to support them each week they were aware this was subject to change. For most people it was important to have a consistent staff team supporting them. There was mixed feedback from people about whether this was possible.