Bluebird Care (Cherwell)

This service is a domiciliary care agency. It provides personal care to people living in their own homes in Bicester and the surrounding areas. It provides a service to older adults some living with dementia, physical disabilities, sensory impairments and younger adults. Not everyone using Bluebird Care receives regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided. On the day of the inspection the service was supporting 74 people.

There was a registered manager in place. 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.

At the last inspection, the service was rated Good.

At this inspection, the service had made significant improvements and has been rated overall outstanding.

Why have we rated this service as Outstanding?

People were valued and respected as individuals allowing them to be partners in their care. There was an exceptionally strong ethos within the service of treating people with dignity and respect. People were at the forefront of the service delivery and the provider was committed to and passionate about providing a high-quality service.

We received exceptionally positive feedback from all people and relatives. The feedback reflected staff were very kind, caring and committed. People complimented the continuity of care provided by regular staff which contributed to building of meaningful relationships. Staff exceeded in recognising what was important to people and ensured individually tailored approach that met people's personal needs, wishes and preferences was delivered. There was evidence the staff often went 'the extra mile' to meet people's needs.

People and relatives, without exception said they had and would definitely recommend Bluebird Care to families and friends. Staff told us most of the referrals to the service were through word of mouth.

People's confidentiality was maintained at all times and the registered manager explored innovative approaches to ensure where the information was needed to be shared this was done in a secure and safe way. Staff always took time to support people to be independent and improve their well-being. The use of electronic records and care planning documentation allowed staff spending less time on the paperwork and meant staff were able to spend more quality time with people delivering a high-quality care.

Bluebird Care was very well-led which resulted in provision of outstanding care. The service had a clear management and staffing structure in place. Office staff and care staff worked well as a team. Staff aimed to provide a high quality of service and they had a sense of pride working at the service.

The leadership, governance and culture were used to drive and improve high-quality, person-centre care. The provider had effective systems in place to monitor the quality and safety of the service that included the use of technology. There was evidence available where an area for improvement had been identified, a prompt action was taken to address it. Actions from the audits were used to further develop the service. The registered manager monitored service delivery on ongoing basis and effectively used feedback from people, relatives and staff to improve the systems, practices and people's experiences.

The provider, management team and staff developed, promoted and implemented innovative ways of involving people in developing high-quality and outstanding practice that was sustained over time. The service growth was steered by people’s changing needs. The provider continually sought training opportunities for staff to ensure they could still provide excellent care. This meant continuity of care was guaranteed over time as staff could continue to meet people’s changing needs.

The service was an integral part of the local community. The team developed various community links that reflected the changing needs and preferences of the people who used the service. Staff were passionate about exploring community initiatives and new ideas. They had created positive links and a strong community presence within the local area most of it in their own time. People talked about how this involvement had impacted positively on their increased well-being.

Bluebird Care had an excellent workplace culture for staff. Staff were highly valued by the provider and management team. Staff contributions were highly appreciated and celebrated. Staff told us they were proud to work at the service and called it a family business. Staff told us they felt part of the family and spoke very highly about the support they received and how they were encouraged to be fully involved in the development of the service.

The service continued to provide safe care to people. People told us they felt safe receiving care from Bluebird Care. Staff had received training in safeguarding adults and understood their responsibilities to identify and report any concerns. The provider had safe recruitment and selection processes in place, these included completing checks to make sure new staff were safe to work with vulnerable adults.

Staff demonstrated they understood how to keep people safe and records showed that risks to people's safety and well-being were managed through a risk management process. There were sufficient staff deployed to meet people's needs. Medicines were managed safely and people received their medicines as prescribed.

People continued to receive effective care from staff who had the skills and knowledge to support them. People were supported to have choice and control of their lives and staff supported them in the least restrictive way possible; the procedures in the service supported this practice. People were supported to maintain good health and to meet their nutritional needs.

The service continued to be responsive. People received personalised care by staff who understood people's individual needs and preferences. People's changing needs were responded to appropriately. The service was flexible and supported people to attend social events and prevent social isolation. People knew how to complain and complaints were dealt with in line with the provider’s complaints policy. Staff knew how to support people during end of life care.

Bluebird Care worked well in partnership with other agencies, social and health professionals and external organisations.

There was a registered manager 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.

We received positive feedback about the staff, the culture of the service and its leadership. The provider and registered manager promoted strong organisational values which resulted in a caring culture that centred on people using the service.

People described staff as respectful, caring and kind. People and their relatives experienced kindness and consideration during care visits. People were given choices about how and when they wanted their care delivered. People were supported to make choices and decisions about their care.

Staff knew people well and told us about people's health and personal care needs. Staff spoke about people in a very caring and respectful way, referring to them by their preferred name. Staff understood people’s preferences and what was important to them.

People were supported to maintain their health and were referred for specialist advice as required. People were encouraged to remain as independent as possible. Staff understood the importance of promoting independence.

People had a range of risk assessments in place. Associated care plans were personalised and contained detailed information to enable staff to understand people’s needs and how those needs should be met. People were involved in their care and felt listened to.

People felt safe when being supported by staff. Staff told us there was an open culture at the service and were clear about the action they would take to keep people safe. People and their relatives knew how to raise concerns and felt their concerns would be addressed promptly and to their satisfaction.

Staff enjoyed working at the service and felt supported and valued. Staff were encouraged to attend training and the registered manager and other senior staff carried out checks to ensure staff were competent in their roles.

There were enough staff to meet people’s needs. People received their prescribed medicines when they needed them.

There were effective quality assurance processes in place to monitor the quality of the service. The registered manager looked for ways to continually improve the quality of the service.

People were asked for their consent before care was carried out. The manager and staff were clear on their responsibilities under the Mental Capacity Act 2005 if it was thought a person may lack the capacity to make certain decisions.

The service had grown since the last inspection in April 2013, and had recruited new staff. At the time of our inspection, Bluebird Care (Cherwell) supported 39 people living in their own homes, and told us they had eight new people who would be starting with the service.

We met with the nominated individual, [the person within the organisation with responsibility for supervising the management of the regulated activity], and the Registered Manager. We looked at records and five people's care plans. We spoke with five people who used the service, with two relatives of people who used the service and six members of staff.

People were involved in decisions about their care, and staff treating them with dignity and respect, one person told us the staff are 'always polite and nice'.

Senior staff told us the staff were 'dedicated'. One person who used the service told us that the staff 'really treat you like a human being, warm and friendly, that's really important'. Staff told us they felt supported, and people told us that they felt staff were appropriately trained to deliver care to them.

We noted that senior staff conducted quality checks. They checked that care staff delivered care in accordance with people's care plans. They also sought the views of people regarding their care. One person told us that when 'one [member of staff] wasn't quite what we wanted' the service 'changed the person', and that they had 'no quarrels' with the service.

We saw evidence that senior staff from the agency visited their homes, unannounced, and checked that the carers were doing what they were required to do. They also checked their uniforms and that they had their identification badge with them. People receiving care services, were asked about the quality and reliability of the agency from time to time and they knew who to contact if there were problems and how to make a complaint.

We saw care plans that demonstrated that the care people received was person centred and took into account their personal preferences, likes and dislikes.

People we spoke to said they were very happy with the service. One person said "The staff are very pleasant and polite, I am very happy".

Staff we spoke with said they enjoyed working for the service, felt confident they were appropriately trained to deliver care and that they felt supported by the management.