Lifeways SIL Limited (North West)

Bluebell Court provides specialist support and recovery services for people with enduring mental health needs, supporting them to transition from Hospital, Secure and other institutional living environments to their own tenancy within the community. Bluebell Court is the registered office for regulated activity provided by SIL in the North of England. Each service is staffed 24/7 by a team of recovery support workers with an on-site manager and additional support is provided by an allocated mental health professional from within the quality and practice team. Bluebell Court is registered for the regulated activity of personal care, which could be provided at any of their services located in the north of the country. This care could also be provided elsewhere in the community if the service wanted to.

Bluebell Court provides care and support to people living in specialist ‘extra care’ housing. Extra care housing is purpose-built or adapted single household accommodation in a shared site or building. The accommodation is rented, and is the occupant’s own service. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for extra care housing; this inspection looked at people’s personal care and support service. Not everyone using Bluebell Court receives a regulated activity; CQC only inspects the service being received by people provided with ‘personal care’; help with tasks related to personal hygiene and eating. Where they do we also take into account any wider social care provided.

At our last inspection we rated the service 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 place. 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

Three people received personal care from Bluebell Court when we inspected. During the inspection we spoke with two of them. They told us they felt safe and well supported by staff.

There were procedures in place to minimise the risk of unsafe care or abuse. Staff had received training and knew how to keep people safe. Risk assessments had been developed with each person. These enabled people to remain as independent as possible while reducing the risk of harm. Care plans were personalised, reflected people’s wishes and involved them and where appropriate, their relatives. These had been regularly reviewed.

Medicines were managed safely. They had been ordered appropriately, checked on receipt into the service, given as prescribed and stored and disposed of correctly. People received their medicines when needed and were supported to administer their own medicines if safe to do so. Appropriate records had been completed for entering, administering and disposing of medicines.

We saw from records and talking with staff that they had been recruited safely, appropriately trained and supported. People told us there were sufficient staffing levels in place to provide the support people required to progress their independence and skills.

Staff had documented information about people's dietary needs. People were supported to shop for and prepare food where needed and encouraged to eat a balanced diet. People had access to and support to see healthcare professionals and their healthcare needs had been met.

There were safe infection control procedures and practices and staff had received infection control training. Staff wore protective clothing such as gloves and aprons when needed. This reduced the risk of the spreading infection.

We looked at how accidents and incidents were managed by the service. Where they occurred any accident or incident was reviewed to see if lessons could be learnt and to reduce the risk of further incidents.

We saw the service had carried out assessments of the environment and equipment when supporting people. Where potential risks had been identified action taken by the service had been recorded.

Staff provided care in a way that respected peoples’ dignity, privacy and independence. People told us staff treated them as individuals and delivered personalised care.

People had been supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.

People were told they ways they could complain and were given information about how to complain. People we spoke with told us they felt able to complain and express any concerns. Where people raised a complaint appropriate action was taken. People also had information about support from an external advocate should this be required.

The registered manager assessed and monitored the quality of the service. These included regular audits and ways to seek people’s views about the service provided. People who were supported told us the management team staff were approachable and willing to listen.

Further information is in the detailed findings below.

Bluebell Court is a supported living agency providing support for up to twelve people with enduring mental health conditions. Service users live on site in spacious, self-contained flats. There are communal areas for the use of residents and there is lift access between the ground and first floor. Parking is available and the service is situated in a quiet residential area of Blackpool. At the time of the visit 10 people were living at Bluebell Court.

There was a registered manager in place. 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.

At the last inspection in April 2014 the service was meeting the requirements of the regulations that were inspected at that time.

Systems were in place to protect people from abuse and unsafe care. People we spoke with people told us they felt safe and were happy living independently with staff support.

We looked at the care records for one person. There was information in place about support needs for the person and how these were being met. A programme to promote independence had been developed, with evidence people who lived in their own flats were involved in their daily routine plan.

People were kept safe and free from harm. There were appropriate numbers of staff deployed within the building to support people. We found staff had been safely recruited to ensure people would be supported by suitable personnel.

People who received support from the service managed their own medicines with guidance and support from staff. Staff had received appropriate medication training to ensure they had the competency and skills required.

People were supported by staff who had a good understanding of protecting people’s dignity and respecting their privacy. One person who was supported by the service said, “They have always respected my privacy. They are not in your face all the time.”

Care plans were person centred and clearly showed input from the person. The level of detail was good and showed there was an appreciation of the person as an individual to maintain their independence within a support framework from staff and other professionals.

People were provided with support and guidance to meet their aims and goals. For example staff provided guidance and support for people who wished to achieve education or gain employment.

We found a number of audits were in place to monitor quality assurance. The registered manager had systems in place to obtain the views of people who lived independently at Bluebell Court.

People's medication was dispensed in a safe and supportive way. We observed staff interacting with people in a supportive and respectful manner. This matched their related care plans. Care records were person-centred and reviewed regularly. One person told us, 'I would like to live at Bluebell Court forever, if I could'.

However, staffing levels did not always ensure people were fully supported. Additionally, Bluebell Court did not always protect people against unsafe care by ensuring the quality monitoring of service provision.

"Very happy with the service. The staff are all very friendly and approachable. They completely respect my privacy".

"Everything completed to a high standard. The staff are excellent".

"The staff are always available when needed. They have helped me so much since I moved here. I am fully involved in decision making about my care and have grown in confidence so much. I will be attending my care plan review tomorrow".

"The staff are really good. They help me to budget my finances".