Bluebells Care Home

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

We assessed if people received effective care. We found improvements had been made, people were now receiving evidenced based care. People were referred to health professionals when their needs changed. Staff followed guidance from health professionals to maintain people’s health. People were involved as much as possible in decisions about their care and support. Staff supported people to attend appointments such as opticians.

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.

Relatives told us they were involved in assessing people’s needs. One relative told us, “I have access to my loved ones care plan, so every time a review is done I can see it. Recently it was recommended my loved one needed more help with personal care. I can provide input if I disagrees with anything. They have completed an assessment and this shows my loved one’s skin is deteriorating, they are under the care of the GP for this”. Another relative said, “I was involved with assessing my relative’s needs when they first moved in, several years ago. Last year I went into the home to go through my relative’s care plan. There was a long discussion around some medication as staff didn’t understand why they were on it, and wanted to take them off it. My relative was taken off the medication, after consulting with the GP, and has not needed to take it since”.

The registered manager described to us how they met with people and their relatives to assess people’s needs before they moved into the service. They also gathered information from other health care professionals to make sure they had all the information they needed to complete robust assessments. These are reviewed every few days for the first two weeks as people and staff got to know each other. The registered manager told us they shared information with health professionals, this was made easier as they used the same assessment tools.

There were processes in place to use nationally recognised assessment tools to understand the risk of people losing weight or developing pressure ulcers. These were reviewed monthly to identify any changes in people’s needs. Assessments of people’s needs were reviewed monthly to ensure staff had up to date information about people’s needs and understood any changes. Assessments were reviewed more often when people’s needs changes, such as on return from a hospital stay.

People and relatives were unable to provide us with feedback around this.

The registered manager explained how they followed best practice guidance while people were waiting to be assessed by specialist health care teams. For example, if people were at risk of choking they were referred to the Speech and Language Therapist. While they were waiting to be seen, people were offered softer foods which were easier to chew and swallow to reduce the risk. Staff followed the local health trust ‘Food first’ guidance when people were at risk of losing weight. This meant increasing the calories in people’s foods by offering them extra snacks and fortifying their food with additional high fat foods such as butter and cheese.

The registered manager kept up to date with changes in best practice including guidance from the National Institute of Clinical Excellence. There were effective processes in place to make sure staff followed the guidance. The use of recognised guidance supported staff to recognise when people's needs changed.

Relatives felt staff worked well with health care professionals. Their comments included, “I have access to the care records. I can see when they’ve sought medical attention. They’re making the right approaches, to the right people and taking on their advice and guidance” and “My relative needed new glasses and they arranged for an optician. They were concerned about my relative’s breathing too and arranged for tests”.

Staff told us everyone at the service worked together as a team to care for people. They described to us how they met at the beginning and end of each shift to hand over any important information to the new staff coming on shift. This was backed up by handovers on the electronic computer system which alerted staff of new information as soon as they logged in.

Healthcare professionals confirmed staff knew people well and were supported them when they visited.

There were processes in place to record and share people's information effectively between health professionals and the service. The electronic care plan system enabled staff to print or send a person's care plan to other professionals.

Relatives told us people were supported to live healthier lives. They confirmed people had been supported to see the optician, dentist and podiatrist when they needed to.

The management team described to us how they had developed a positive working relationship with visiting health care professionals including the GP and district nursing team. They reported, “We have changed the culture and now have a positive working relationship. We work together to get the best care and treatment for people”. The registered manager told us the GP was supportive and undertook medication reviews when requested to ensure people got the maximum benefit from their medicines. They also told us, “The GP sits and chats to staff as equals about people’s treatment and prognosis”. This enabled staff to support people and relatives understand their health needs and planned treatment. They also described how the GP had supported them to have a person admitted to hospital when they were unwell. Staff had been raising this with other healthcare professionals but had not been supported. They discussed it with the GP who arranged for the person to be admitted and receive the treatment they needed.

There were systems in place to support people to lead as healthy lives as possible. People were offered a healthy diet to meet their needs. For example, fresh fruit was always available, people were able to select what they wanted from fruit bowls. Staff supported people to be as active as possible including walking and go out into the garden.

Relatives felt their loved ones', physical and mental wellbeing was monitored and action was taken to support them when needed. One relatives told us, “I can see in the records when staff have noticed something and it’s reported to a senior member of staff. My relative had a lot of swallowing problems and choking. They took professional advice and offer them softened foods”. Three of the relatives we spoke with told us they had noticed significant changes in their loved ones care since the registered manager and deputy manager had been appointed. Their comments included, “I have noticed a difference since new management took over”, “I hadn’t realised how bad the home was previously run, and had irritations with the way management were starting to interact with me. There’s a much more relaxed feel to the home now, and it feels more open. It now feels a lot more pleasant and homely” and “I cannot speak too highly of them all, especially since the management change. Staff are efficient helpful, and kind”.

Staff described to us how they reviewed people’s care plans and risk assessments monthly or more often if needed to ensure their needs were being met as they wished. One staff member described how people’s safety was reviewed if they fell and strategies were put in place to keep them as safe as possible. These strategies and any equipment were based on people’s needs. For example, some people used alert mats to kept staff know they were moving around in their bedroom. Other people would step over the mat, increasing their risk of falls so other equipment was used to alert staff they were walking around.

There were processes in place to evaluate actions taken to reduce risks or when people's needs have changed. When actions had not been effective or stopped being effective changes were made in consultations with staff and people.

We did not look at Consent to care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.