Bluebird Care Stamford, Rutland, Peterborough & Oundle

We inspected the service on 19, 20 and 21 February and 6 March 2018. The inspection was announced. At the time of our inspection 85 people were receiving a personal care service.

The service had a registered manager. A registered manager is a person who has registered with CQC to manage the service. Like registered providers (the 'provider') 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 our last inspection in January 2015 we rated the service as Good. At this inspection we were pleased to find that the quality of the service had improved and the service is now rated as Outstanding.

The directors of the company that owned the service were actively involved in day-to-day operations and provided strong and principled leadership to their team. The directors and the registered manager had a very open and accessible approach and had created an extremely positive and caring organisational culture. As a result, people were supported with exceptional kindness and compassion in ways which often went far beyond formal contractual requirements. People were treated with dignity and respect and were encouraged to retain their independence and exercise choice and control over their lives. End of life care was provided sensitively.

The directors and the registered manager also took a great interest in the welfare and happiness of their team and went to very considerable lengths to promote this. As a result, staff enjoyed coming to work and could think of no ways in which the running of the service could be improved.

The provider maintained a systematic and comprehensive approach to staff training, personal development and supervision. As a result, staff had the skills and knowledge required to provide safe, effective, person- centred care and had been commended by other healthcare professionals for their expertise. Staff understood each person's individual needs and preferences and used this knowledge to provide them with flexible, responsive support which enhanced the quality of their lives. Since our last inspection, the provider had invested in an innovative new electronic care planning and call monitoring system which had increased the safety of medicine administration and enhanced communication, enabling staff to respond more quickly and effectively to people's individual needs and wishes. People were closely involved in the development of their individual care plan and met with the provider on a regular basis to discuss and agree any changes.

The provider had a careful, conscientious approach to call scheduling which meant care calls were almost

always on time. The provider had responded to feedback from people who used the service and taken action to ensure people were supported by the same care staff on every call, wherever this was possible.

Led by the directors, there was a strong culture of innovation within the service. Since our last inspection, a number of successful initiatives had been introduced to enhance the person-centred nature of the service and further actions were in hand for the future. Systems were in place to identify organisational learning from significant incidents.

The provider assessed any potential risks to people and staff and put preventive measures in place to address them. Staff knew how to recognise and report any concerns to keep people safe from harm and were aware of people's rights under the Mental Capacity Act 2005. People who needed staff assistance to take their medicines were supported safely and staff worked closely with local healthcare services to ensure people had access to specialist support whenever this was required. Staff supported people to prepare food and drink of their choice.

Without exception, people told us how highly they thought of the service. People said they had no reason to complain but were confident that any complaint would be handled properly if they did. The provider maintained a range of auditing systems to monitor service delivery and ensure it remained in line with people's needs and preferences. The provider sought people's opinions through regular customer surveys and took action to address any suggestions for improvement that were received.

The five questions we ask about services and what we found