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Bluebirds Neurological Care Centre Good


Inspection carried out on 13 April 2018

During a routine inspection

Bluebirds Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Bluebirds Nursing Home is registered to accommodate up to 25 people; at the time of our inspection, there were 24 people living in the home. The service provides care and support to people who have a range of neurological conditions, including dementia.

At the last inspection in January 2016, the service was rated good. At this inspection, we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and on-going monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.

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.

People were supported to develop and maintain life and social skills and maintain as much independence as possible, using individually created support programmes. These programmes were developed and overseen by a skilled, multi-disciplinary staff group, who shared a strong person centred ethos.

People told us their relationships with staff were positive and caring. We saw that staff treated people with respect, kindness and courtesy. People had detailed personalised care plans in place to enable staff to provide consistent care and support in line with people’s personal preferences.

Staff had been appropriately recruited in to the service and security checks had taken place. There were enough staff to provide care and support to people to meet their needs.

People were consistently protected from the risk of harm and received their prescribed medicines safely. Staff followed infection control procedures to reduce the risks of spreading infection or illness.

The care that people received continued to be effective. Staff had access to the support, supervision, training and on-going professional development that they required to work effectively in their roles. People were supported to maintain good health and nutrition.

Staff understood the principles of the Mental Capacity Act, 2005 (MCA) and ensured they gained people's consent before providing personal care. People were encouraged to be involved in decisions about their care and support and information was provided for people in line with the requirements of the Accessible Information Standard (AIS).

People knew how to raise a concern or make a complaint and were confident that if they did, the management would respond to them appropriately. The provider had implemented effective systems to manage any complaints that they may receive.

The service had a positive ethos and an open and honest culture. The registered manager and unit manager were present and visible within the home. The provider had systems in place to monitor the quality of the service and continually drive improvement.

Some improvements were required to ensure that records provided a clear account of the care provided to people. We discussed these concerns with the management team and were assured that appropriate action had been taken to improve staff practice.

Inspection carried out on 29 January 2016

During a routine inspection

This inspection took place on 29 January 2016 and was unannounced.

Bluebirds Nursing Home provides nursing and personal care for up to 22 people who have a variety of neurological conditions, including dementia. When we inspected there were 22 people living at the service.

The service had a registered manager. 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.

Staff protected people from incidents of harm or abuse. They had training in this area and were aware of their responsibilities in terms of reporting and recording incidents. Risk assessments were put in place to ensure people were safe, whilst still able to do the things they wanted to. Staffing levels were sufficient to meet people’s needs. Staff members and volunteers had a series of checks carried out, to ensure they were of good character and suitable to work at the service. Trained members of staff helped people to take their medication safely and appropriately. There were systems in place to record and check medication administration.

There were training and development systems in place to ensure staff had the skills they needed to perform their roles. Staff also received regular supervision and appraisal sessions, to help them develop in their roles. People’s consent was sought within the care plans and on a day-to-day basis. Where people were unable to give consent, the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards were used appropriately to ensure decisions were made in their best interests. People were happy with the food and drink they received, and staff provided appropriate support to help people maintain a healthy diet. Staff also provided people with support to ensure their health needs were managed, and to ensure they saw health professionals when required.

People had positive and meaningful relationships with members of staff. Staff spent time talking and interacting with people and their roles were not purely task-based. Where possible, people were involved in planning their own care, and family members were also consulted. There was information, such as complaints procedures, available to people and family members in care plans and around the service. People were treated with dignity and respect by members of staff.

People’s care was person-centred and based on their specific needs and wishes. Their care plans were reviewed regularly, with the input of themselves and their family members, to ensure that it was accurate and up-to-date. People were also supported to take part in activities which they enjoyed, both in and out of the service. There was an effective system in place to gain people’s feedback and encourage complaints.

Staff were highly motivated to perform their roles and provide people with quality care. The provider had established a number of initiatives to help motivate and empower staff, and listened to the feedback they received from staff to develop the service. They also invested both in staff and the service, to help ensure people received high quality care. There was clear and visible leadership at the service, and the registered manager was well support by staff at the service, and more senior management. There were a number of quality assurance systems in place which were designed to drive improvements in people’s care. These processes were also reviewed, to ensure they were effective.

Inspection carried out on 28 May 2014

During a routine inspection

We considered all the evidence we had gathered under the outcomes we inspected during our inspection at Bluebirds Nursing Home. We used the information to answer the five questions we always ask.

� Is the service safe?

� Is the service effective?

� Is the service caring?

� Is the service responsive to people's needs?

� Is the service well-led?

This is a summary of what we found:

Is the service safe?

The three people we spoke with told us they felt safe living at Bluebirds Nursing Home. We observed that plans of care included risk assessments to promote people�s safety, such as assessments for malnutrition, the risk of falls and movement and handling. We also observed staff used safe moving and handling techniques.

Staff told us that they involved other health and social care professionals to support people with their needs and we saw documentation to confirm this. Where people displayed behaviour which may challenge others appropriate support, including one to one, was in place to keep people safe.

We found that there was enough skilled and experienced staff on duty to support people safely and to meet their needs appropriately.

The Care Quality Commission is required by law to monitor the operation of the Deprivation of Liberty Safeguards (DOLs). At the time of our visit one person was the subject of a DoLs and other people had applications being considered. Therefore people�s human rights were properly recognised, respected and promoted.

Is the service effective?

We saw that people, or a relative on their behalf, were involved in their care planning and that individual preferences had been documented. This meant people were involved in making decisions about their care and support. Staff we spoke with had a good understanding of people�s needs and knew how they preferred to be supported.

Is the service caring?

People told us that staff treated them well. We observed that staff had a good understanding and knowledge of people�s needs and preferences and supported them appropriately. Staff were respectful and promoted the dignity of the people who used the service. For example, a person received one to one support unobtrusively.

Staff spent time interacting with the people who used the service and supported them to maintain family contacts outside of the care home.

Two cats lived in the care home and a dog was a daily visitor. This stimulated the people who used the service and gave them something to care for if they wanted to.

Is the service responsive?

Staffing levels were good and allowed for people to be supported appropriately. At the time of our visit there were nine care staff and a qualified nurse rostered to care for 21 people. The staff team underwent regular updates of their training to ensure they had the collective resources to meet people's needs. This ensured that people were cared for, at all times, by staff that had the appropriate training.

Throughout our visit we saw that people received care and support in a timely fashion and were not kept waiting which meant people�s needs were responded to appropriately.

Is the service well-led?

The service had an effective management structure. The registered manager was responsible for the operation of the home but on a day to day basis staff referred to the unit manager.

There was effective quality monitoring systems in place to ensure Bluebirds Nursing Home provided a safe and satisfactory service and people were kept safe.

Inspection carried out on 10 June 2013

During a routine inspection

Some people were unable to speak with us because, for example, their neurological conditions had impaired their ability to express their views. We used a number of different methods to help us understand the experiences of people using the service.

We used observation, for example, to inform our inspection, and we looked at people�s records to see what care and support they needed and had received. We also spoke with four staff individually and we spoke, in private, with three people who were visiting the home. We also saw examples of recent surveys completed by relatives and friends of people being cared for at �Bluebirds Nursing Home� so we could see what they had said about the standard of care provided.

One relative we spoke with commented, �The care here is excellent. I am always made so welcome and the staff are all kind and very conscientious.�

We found that people's privacy and dignity were respected and that people were enabled to participate in meaningful activities that suited them individually.

We found that people's needs had been comprehensively assessed and were regularly reviewed so that people consistently received the care and support they needed. We saw that staff were attentive to people�s needs.

We saw that the home was clean, appropriately maintained, and free from odour.

Inspection carried out on 22 October 2012

During a routine inspection

We used a number of different methods to help us understand the experiences of people using the service, because the people using the service had complex needs which meant they were not able to tell us their experiences. We spoke to the relatives of one person, who told us that the staff at the home looked after their relative well, and they were happy with the service. We found that people were treated as individuals and had their needs met.

Inspection carried out on 27, 28 April 2011

During a routine inspection

People told us that staff respected their privacy and dignity. They were provided with personal care in the privacy of their bedroom and they were able to choose what clothes they wished to wear.

People said that they were able to make decisions about their care with support from family members. Where their care included some degree of risks, this was explained to them. They said they were registered with the home�s general practitioner (GP) and the GP would visit them if they were unwell. They told us that the home�s staff organised regular social activities such as, parties, summer fetes and outings.

People said that they enjoyed their meals and they had a choice of two hot meals at lunch time. They told us that they felt safe living at Bluebirds Nursing Home. They said that they received their medicines at the right time and staff would inform them and their relatives if there were changes to their medicines.

They told us that there were always sufficient staff on duty. They said that they knew how to raise a concern and they were confident any concerns raised would be acted on appropriately.

Reports under our old system of regulation (including those from before CQC was created)