Bluebell Manor

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

This is the first inspection for this newly registered service. This key question has been rated good. This meant people's outcomes were consistently good, and people's feedback confirmed this. Staff said that teamwork was not always effective however, external partners felt the service worked well with them. People’s needs were assessed and met in a person-centred way. Care records were detailed and clinical assessments were undertaken and updated regularly. Best practice guidance was followed when treatments and care were given. Decisions about care were made in line with the mental capacity act.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People told us their care needs had been assessed and they were involved in care planning. One relative said, “I’m very much involved with the [person’s] care plan.”

Staff told us there were effective systems in place to assess and monitor people’s needs. This included handover meetings and documents. One staff member explained that as they only worked 2 days a week, they were able to use the handover documents to understand new resident’s needs and people’s changing needs.

Robust systems were in place to ensure people's care and support needs could be met by the service before admission. Changes to people’s needs were usually acted on quickly. We found one instance where a person’s needs had changed following a hospital visit and action had not been taken to address this quickly enough.

People told us they were asked about their care and support requirements and usually received care in line with their requests.

People’s care was based around what is important to them and according to their preferences. Permanent staff knew people’s care and support needs. One staff member was observed engaging with a person who was becoming distressed, they successfully de-escalated the situation, demonstrating they knew the person well. Staff said it was sometimes difficult to make contemporaneous notes about care due to the ratio of people requiring support to staff. This meant there was a risk that care records were not always be accurate.

Care records reflected people's care and support needs. The service made timely and appropriate referrals for specialist support from other professionals such as the GP and the speech and language team (SALT).

People and relatives had no concerns about the ways staff worked with each other.

Some staff felt that teamwork wasn’t always as good as it could be. They felt that the high use of agency staff affected the effectiveness of the team. There was a disconnect between some of the units within the home. One staff member commented, “I feel, along with other staff that no one else matters except the Bluebell unit, they have 4 care staff and a nurse every single day for at max 17 patients. Yet, Millview is struggling with 2 (staff) and even then, it is usually 1 permanent and 1 agency. This causes frustration between permanent staff.” Managers explained that contract restrictions for the Bluebell Unit meant it was not always possible to distribute agency staff use more widely across the whole service, and that this did place a disproportionate burden on other units in managing staffing. Managers tried to ensure permanent staff worked across the service to provide some equity of provision. Since the inspection the provider has increased staffing to support the Wansbeck and Millview units.

Healthcare partners felt that staff worked well with them. NHS managers supporting the Bluebell unit said the home manager worked in collaboration with them.

Processes were in place to share information across the service. Regular staff meetings were held. Information shared by visit professionals was disseminated to staff.

People told us they were supported to access health care when they needed it. One person said, “[Staff] would get the doctor quickly.”

Staff supported people appropriately. Staff monitored people closely, such as after a fall, and took action when the support of other medical professionals was needed.

People’s health care needs were being met. People had access to health professionals whenever they were needed.

People told us the care they received was good. People and relatives said staff monitored them appropriately. One person said, “[Staff] comfort me, I had a migraine, I had nothing to eat, they kept coming in to check on me.”

Staff were aware of people’s needs, and who required close monitoring. For example, staff ensured people who needed movement monitors had them in place when they were sat in communal spaces.

Systems were in place to monitor and improve outcomes. The clinical compliance manager held regular meetings with a view to improving outcomes for people. We found occasions when monitoring was not documented correctly. The manager took action to improve this during the inspection.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People told us they were asked for their choices and staff respected their decisions. One person said, “[Staff] come round with the menu and ask for my choice. I’m a vegetarian they manage that.” Another person said, “I’m never out of this room, it’s my choice. [Staff] would take me out if I wanted to.”

Staff knew how to support people in a way which respected their decisions and supported them to make choices. The manager and staff were aware of the principles of the Mental Capacity Act (MCA) and the need to ask for consent.

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. The Act requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). Staff supported people in least restrictive ways. Records around people’s capacity contained all relevant information and were completed in line with national guidance.