Bluebird Care (Mid and West Cornwall)

What life is like for people using this service:

• People using this service still benefitted from an outstanding caring and well led service. People consistently told us how they were treated with exceptional kindness, compassion and respect. We received overwhelmingly positive feedback on how staff were supportive and went the extra mile to get care just right for people.

• People were truly placed at the centre of the service and were consulted on every level. Respect for privacy and dignity was at the heart of the service's culture and values. It is embedded in everything that the service and its staff do. People and staff feel respected, listened to, and influential.

• People received exceptionally personalised care and support specific to their needs and preferences. People had a core team of staff to support them. Each person was respected as an individual, with their own social and cultural diversity, values and beliefs. People had their human rights upheld.

• People received effective care and treatment from competent, knowledgeable and skilled staff who had the relevant qualifications to meet their needs. The provider had a good system to ensure all staff had regular training to keep them up to date with best practice. Training methods included online, face to face training and competency assessments.

• The service encouraged people to be involved in the service to improve standards of care. For example, people attended bespoke training with staff so that they could all learn together. A person also produced a course on empathy training which was received positively by staff and all staff now attend. People’s views are sought in the recruitment of new staff.

• The whole service continued to have a good track record.

• Staff were, motivated by and proud of the service. There were high levels of satisfaction across all staff.

• The registered manager is passionate about promoting the care industry. The registered manager was involved in the initiative with South West Local Authority and Primary Care Trust on how they could promote the care industry. The registered manager is on the committee and organised the ‘Proud to care’ festival in Cornwall. This involved liaising with many health and social care providers to come together to celebrate and promote the benefits of working in the care industry, plus inviting guest speakers and voluntary groups

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

Rating at last inspection: Outstanding (report published September 2016)

Why we inspected: This was a planned inspection based on the rating at the last inspection. At our last inspection we rated the service Outstanding. At this inspection the service remained Outstanding.

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

Bluebird Care UK is a national franchise. A franchise is when a franchisee (the provider) has bought the right to sell a specific company's (the franchisor's) products in a particular area using the company's name. The franchise operates over two hundred locations across the United Kingdom. Bluebird Care (Mid and West Cornwall) is registered to provide personal care to; people who experience dementia, people with learning disabilities or who are on the autistic spectrum disorder, older people and people with a physical disability or sensory impairment.

The service provides three types of support to people in the community. The first is short visits to people in their own homes to provide personal care and domestic support. The second is to provide people with a supported living service. Supported living is where people live in their own home and receive care and support in order to promote their independence. As the housing and care arrangements are separate, people can choose to change their care provider without losing their home. The third type of support is a ‘Live In’ service. This support is also referred to as ‘companionship’ as the person’s care needs are low but they need reassurance and support to remain in their own home. Care staff live with the person in their own home for a particular time period.

The service is required to have a registered manager and at the time of our inspection there was a registered manager in post. A registered manager is a person who has registered with the 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.

People were extremely satisfied with the quality of the service they received. People told us “They [the staff] are really lovely. They genuinely care," “They are lovely, they do everything I want” and "They always come in with a smile and make me feel better too.” A relative told us; "They not only look after my husband but they also take care of me too. It means so much,” and “I couldn’t have done it without them, they support me as well as (person’s name).”

People told us they felt safe and were well cared for by Bluebird Care. Their comments included; ““I do feel safe,” and “They (care staff) are so caring and kind, they look after me very well.” People’s relatives echoed this and said; “I am reassured that my husband is receiving care from carers who really do care.”

People and relatives consistently praised staff for their caring attitudes. The registered manager and staff were able to tell us about how they went 'the extra mile' for people and the difference this had made for them. Staff were highly motivated and had gone out of their way to support people and used their own initiative to seek out ways to support people in a caring and kindly manner. Staff were observed to be kind and compassionate both to people and their relatives, who valued the interest staff showed in them as individuals.

People told us they had “never” experienced a missed care visit. One person told us; “It doesn’t matter if it’s snowing, hailing, thunderstorm, raining or sunny, they always come. They have never let me down.” The management team told us; “Missed visits are not an option. People in the community are vulnerable and we must and do visit when we say we will.” The service had robust and effective procedures in place to ensure that all planned care visits were provided. The service’s visit schedules were well organised and there were a sufficient number of staff available to provide people’s care visits in accordance with their preferences.

People told us that their visits were on time but there were ‘rare occasions’ when care staff could be late for their planned visits. However people, and relatives, did not have a concern regarding this as they understood that any lateness was due to care staff needing to provide extra support to a person in an emergency or due to travel issues, especially in holiday seasons. People told us that the Bluebird Care office staff would phone them if a care worker was going to be late which gave them reassurance that their visit would still continue.

We found staff consistently provided care visits of the correct visit length. People and relatives told us their staff never rushed them and stayed for the correct duration of their visit. Bluebird Care operated an on call system outside of office hours. Care staff told us managers would “Always respond promptly” to any queries they might have. People and a relative told us they had not needed to call for assistance during the evening/night but knew how to contact staff if needed.

The registered manager was confident about the action to take if they had any safeguarding concerns and had liaised with the safeguarding teams as appropriate. Risk assessments clearly identified any risk and gave staff guidance on how to minimise the risk. They were designed to keep people and staff safe while allowing people to develop and maintain their independence.

There were processes in place to protect people and the security of their home when they received personal care, including staff wearing uniforms and carrying identification. People received information about who they should expect to be delivering their care so they were aware of who was due to call upon them.

People told us staff had sought their consent for their care. The Mental Capacity Act 2005 (MCA) provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. Staff had received relevant training and understood the principles of the Act. People’s consent to their care and support was in line with legislation and guidance.

People were supported by stable and consistent staff teams who knew people well and had received training specific to their needs. Training records showed staff had been provided with all the necessary training which had been refreshed regularly. Staff told us they had “lots of training” and found the training to be beneficial to their role. Staff said they were encouraged to attend training to develop their skills, and their career.

Staff underwent a rigorous induction programme prior to providing people's care. The Induction of new members of staff was effective and fully complied with the requirements of the Care Certificate. People told us they were introduced to new staff before they supported them in their home. People and relatives confirmed they had consistent care staff to support them and had built up positive relationships with care staff.

Everyone told us staff ensured their dignity and privacy was promoted. People were treated with respect by staff, both when they were having their care delivered and in the way people were formally referred to.

Staff had high expectations for people and were positive in their attitude. Staff were respectful of the fact they were working in people’s homes. One staff member said “We have to remember this is their home. We need to respect their privacy and choices. So they choose what TV programme to watch, not me.” The service offered flexible support to people and were able to adapt in order to meet people’s needs and support them as they wanted.

People’s care plans were detailed, personalised and provided staff with sufficient information to enable them to meet people’s care needs. The care plans included objectives for the planned care that had been agreed between the service and the individual. All of the care plans we reviewed were up to date and accurately reflected each person’s individual needs and wishes. The service’s risk assessment procedures were designed to enable people to take risks while providing appropriate protection.

People unanimously told us that staff consulted them about how they wanted their care to be provided and gave them choices about their care. People's preferences were recorded in their care plans for staff to consult. Staff understood people's communication needs and used non-verbal communication methods where required to interact with people. Staff also used verbal reassurance and touch, when people had limited understanding of the care staff were providing for them, in order to enable the person to feel safe and cared for.

The provider had a compliments, concerns and complaints policy which outlined to people how and to whom they could address any concerns they had with the service. People told us they knew how to complain if they needed to and that if they had raised an issue it had been promptly addressed.

The provider valued their staff and saw them as an asset when delivering high quality care to people. They appreciated that people wanted consistency in their care and that staff retention was an important factor in this. To achieve this they had identified a range of ways to retain their staff. Care staff feedback was that the providers and registered manager were “all approachable”, “very caring” and were “Always ready to listen, support me and do as we do to our customers, - care.” People told us the service was “well managed”.

The directors and registered manager provided clear leadership to the staff team and were valued by people, staff and relatives. There was a positive culture and the provider's value system placed people at the heart of the service. There was a whole team culture, the focus of which was how they could do things better for people. Staff felt able to raise any concerns with management.

Staff told us they enjoyed their work and were well supported thr