This inspection took place on the 17 and 23 May 2018.Our last inspection of the service was carried out in January 2016. At that inspection we rated overall Good and Outstanding in the domain Caring part of the report. At this inspection the service was rated overall Outstanding.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.
The office of Bluebird Care (Cornwall North) is located in the centre of Camelford, and it is readily accessible for people using the service and staff. This service is a domiciliary care agency. It provides support for people living with dementia, older people, physical disabilities care, learning disabilities and autism spectrum disorder and sensory impairment. At the time of our inspection 93 people were receiving support from the service.
The service provides three types of support to people in the community. The first one is for short visits to provide personal care or domestic support. The second service is to provide a 24 hour package of care with a core staff team supporting a person in their own home. The third service is to provide short term live in cover for people whose main carer might request a respite service.
There was a registered manager in place at the time of our inspection. 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.
The culture of Bluebird Care (Cornwall North) was exceptionally inclusive. The providers values were person-centred and made sure people were at the heart of the service. Staff shared this view and had a common vision to provide a service where people were enabled to live their lives as they chose and maintain their independence. Staff demonstrated they cared through their attitude and engagement with people. Staff clearly understood the need to respect people’s individual wishes and choices. One person told us, “They [staff and managers] are exceptional. I have the utmost respect for them all. They all go over and above in what they do.” This was reflected many times by managers, staff and people using the service throughout the inspection.
The service was proactive in ensuring equality and diversity standards were integral to people's care plans. For example making sure people’s needs were clear to help staff in delivering care and support. Staff told us the information helped them to identify any diverse needs and to respect people for who they were. People told us staff were respectful. One person said, “I have a disability but [staff names] understand and respect me for who I am. Not the disability.”
The provider and registered manager were innovative and demonstrated governance systems were embedded into the core framework, to ensure continual development and monitoring of the quality of care and support they delivered. They worked in partnership with other organisations to make sure they followed current best practice and provided a high quality service.
Senior staff were dedicated to providing quality care to people. They valued staff and promoted their development. There was an open culture at the service where staff felt exceptionally supported, able to raise any concerns and put forward suggestions for improvements. The provider encouraged people to provide feedback on how things were managed and to share their experiences of the service in creative ways which suited their needs.
The service used technology to support staff in their work. All staff had links to the system used, with password access to information about the people they were supporting to ensure the information was protected. They told us the system was excellent and was updated constantly so any changes were recorded as they occurred.
The registered manager and staff were confident about the action to take if they had any safeguarding concerns. The registered manager had raised issues with the local authority when alerted to concerns. 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. If there were any sudden changes people told us they were always informed, with the time and name of the staff member.
Medicine procedures were safe. The service supported people with their medicines by prompting them and administering them. Where medicine was administered records were completed by staff.
Recruitment and selection was carried out safely with appropriate checks made before new staff could start working for the service. Staff had the skills, knowledge and experience needed to care for people. They received training to carry out their role and were knowledgeable about how to support and care for people. They had the skills, knowledge and experience to provide safe and effective support. People had been supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.
There was a strong focus on continually striving to improve. This included the introduction of an innovative electronic care recording system to support an effective delivery of a high quality service to people. The system supported the registered managers and supervisors to monitor the delivery of people's care as it happened. The provider, registered manager and staff told us it was working extremely well and that it had helped in improving communication and responding to changes. People's care was being delivered more safely, effectively and responsively due to the provider's utilisation of technology to support the planning, delivery and monitoring of care.
The management team strove continually to improve the quality of service they provided. There were robust processes in place to seek people's views on the service and monitor the quality of the service.
Information from customer surveys and the actions the provider took were shared openly and honestly with people. Feedback from people through surveys and complaints was used to continuously drive improvement.
The provider engaged with other Bluebird Care franchisees in the south west region and nationally to discuss operational issues and good practice examples. Bluebird North Cornwall had received an organisational award for best service in the South West. The registered manager and staff told us this recognition meant a lot as it had made them feel valued as a team.