Bluebells Care Home

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• 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

The rating for the Effective key question remains Requires Improvement. We assessed the quality statement involving Consent to care and treatment, the service had made improvements to the recording of people's capacity, best interests decisions, risk management and people's choices and preferences. People told us they had been involved in decisions about their care and going out. We assessed a total of 8 quality statements from the safe, effective, caring, responsive and well-led key questions and found areas of good practice. The scores for these areas have been combined with scores based on the key question ratings from the last inspection. Though the assessment of these 8 quality statements indicated areas of good practice since the last inspection, our overall rating remains requires improvement.

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Assessing needs during this assessment. The score for this quality statement is based on the previous rating for Effective.

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

We did not look at How staff, teams and services work together during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

Staff explained who was able to make complex decisions and who was able to make day to day decisions. They had identified one person was unable to make complex decisions and had applied for a Deprivation of Liberty Safeguards (DoLS) authorisation. Staff knew people well and how to support them to make decisions including different ways of communication. The management team understood their responsibility to protect people who were unable to make decisions. The manager had obtained copies of Lasting Power of Attorney to understand who was able to make decisions on people’s behalf, and described how they involved these people in decisions.

There were systems and processes in place to access people's capacity to make decisions including complex and day to day decisions. These assessments had been recorded in people's care plans and discussed with staff to make sure staff understood how to support people. When a DoLs had been authorised, these had been recorded and any conditions the staff had to put in place. The management team checked monthly for any authorisations due to expire and applied for people to be reassessed as required.

People told us, staff respected their decisions and supported them to make decisions. Staff knew how to support people to make decisions. For example, they held up one person’s cloths to support them to make a choice, knowing the person did not like to put their hearing aid in before they got dressed. We observed staff supporting people to make choices. One person discussed with staff where they should sit for lunch, the staff member replied, “you can sit where ever you want”. People told us they had a choice of meals, how and where they wanted to spend their time. Relatives told us the amount of choice people were given now had improved and people had been supported to change rooms and go out regularly