We inspected Bluebird (Cheshire East) on 21, 22 and 23 September 2016. As this was a domiciliary care agency service, we contacted the registered manager 48 hours before the inspection. This was so that we could ensure that staff were available at the office. At the last inspection in January 2014 we found the service met all the regulations we looked at. Bluebird Care (Cheshire East) is registered to provide personal care to children and adults who live in their own homes. The offices for the service are located in Crewe. At the time of the inspection 38 people were in receipt of personal care.
The service has 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 were very positive and complimentary about the support they received from Bluebird Care (Cheshire East). They found the service to be very reliable and responsive to their needs. Comments included “I can’t speak too highly of them, they are excellent,” “They care greatly” and “I am indeed happy with the way they treat me.”
People told us that they felt safe and we found that people were protected from harm and abuse. Staff were trained in safeguarding procedures and understood their responsibilities to report any concerns of this nature. Two staff members were uncertain where they could report safeguarding concerns to outside of their organisation. The registered manager addressed this immediately and ensured that all staff had a copy of the service’s safeguarding process flow chart with contact details.
We found that there were sufficient staff to meet the needs of the people supported by the service. The service was focused on the recruitment of new staff and the manager told us that additional care packages would not be accepted unless they had the staff to cover these. People told us that their care calls were never missed, and that staff always arrived to support them as expected.
All new employees were appropriately checked through robust recruitment processes.
People who required support with taking their prescribed medicine were provided with this. We saw that medicine administration records (MAR) had been written and printed by staff. However we found in a few cases, the information written on the MARs did not always reflect the current medication requirements, although people were receiving their medication as required. The registered manager took immediate action to address these issues.
Staff were skilled and knowledgeable. We found that staff completed an induction prior to starting work in the service and received regular and on-going training. Staff told us that they felt supported, they received regular supervision and appraisals.
Staff had an understanding of the Mental Capacity Act (MCA). Staff ensured that they obtained consent from people prior to carrying out any support tasks. The registered manager told us that all of the people they supported at the current time had the capacity to make decisions about their care.
We found that people were well cared for and treated with compassion. Staff supported people in a caring manner. They knew the people they were supporting well and understood their requirements for care. People told us that were treated with dignity and respect.
People received personalised care and the service was responsive to people’s changing needs. Assessments and care plans were in place. They provided sufficient information and were regularly reviewed. The care plans and risk assessments provided some person centred information but this was an area that the service had already identified for further improvement.
The service had a complaints policy and procedure that was included in people's care records. People and staff spoken with said they felt confident they could raise concerns with the registered manager and staff. Records showed the service responded to concerns and complaints and learnt from the issues raised.
The management team were friendly and approachable. We found that information was organised and readily available. There were systems in place to monitor the care provided and people's views and opinions were sought regularly about the quality of the service. Staff told us that they felt well supported by the management team. Communication within the staff team was effective and the registered manager ensured that staff were kept up to date with best practice guidance. There were plans in place to develop and improve further the quality of the service.