About the service:

Bluebell Gardens is an extra care housing scheme for older people, comprising of 61 flats with some communal areas. People who lived at the service had a separate care and tenancy agreement. At the time of our inspection the service supported 30 people with personal care. Some people who lived at the service received care and support from another provider. Other people required social and domestic visits or welfare calls only.

People’s experience of using this service:

•People were confident to raise any concerns they had with the registered manager.

•People had individual risk assessments so that staff had the information they needed to support them safely and minimise the identified risks.

•People's medicines were being managed safely and administered by trained staff. Staffing levels were sufficient to meet people’s needs and protected them from harm. The service carried out pre-employment checks on staff before they worked with people to assess their suitability.

•People and relatives provided consistently positive feedback about the care, staff and management. They said the service was caring, timely, effective and well-led.

•People's care was person-centred. The care was designed to ensure people's independence was

encouraged and maintained.

•People were supported by staff who were trained and received regular supervision.

•People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

•People told us staff were kind and caring and treated them with dignity and respect at all times.

•The registered manager completed audits to ensure the service was running in line with their policies and procedures.

•People and their relatives were asked for feedback about the service and were kept updated about any changes.

More information in Detailed Findings below.

Rating at last inspection: Good (report published 20 July 2016).

Why we inspected: This was a planned inspection based on the rating at the last inspection. The service remained rated Good overall.

Follow up: We will continue to monitor intelligence we receive about the service until the next inspection. If any concerning information is received we may inspect sooner.

The inspection took place on 22 June 2016. We gave the registered manager 48 hours’ notice of our intention to undertake an inspection. This was because the organisation provides a domiciliary care service to people in their own homes and we needed to be sure that someone would be available at the office.

Housing & Care 21 Bluebell Garden Extra Care provides personal care and support to older people who occupy or own their own flats located within the premises at Bluebell Garden. There are 68 flats in total and at the time of our visit 38 people were receiving support with personal care.

At the last inspection of the service on 21 May 2014 we found the service was meeting the regulations.

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 told us their visits were provided on time and there were sufficient staff available to provide all planned care visits.

People looked comfortable and relaxed at Bluebell Gardens. We saw people enjoyed the company of their staff who they approached for support and conversation without hesitation.

People enjoyed spending time in the service’s communal lounge chatting to staff and other people.

People we spoke with told us they felt safe and well looked after at Bluebell Gardens

People's comments included, "I feel safe with staff". They look after me very well",

People had pendants (a wireless life line system) available throughout the service to enable them to summon help from staff when required. Everyone told us staff responded promptly to their request for support and one person said “They come right away as soon as I press my pendant”.

Training records showed staff had received all the necessary training which had been updated regularly. In addition staff told us they were well supported, and records showed regular supervision and spot checks on staff performance had been completed.

The service's systems for the induction of new members of staff were effective and fully complied with the requirements of the Care Certificate. Recently recruited staff told us they had felt well supported during their induction training and commented that they had gained confidence before supporting people independently. The registered manager asked for feedback on my initial performance from people.

People received care and support from staff who they knew well and who understood their care and support needs. Staff respected people's privacy and supported their independence. Everyone was able to lock their own front doors and staff always knocked and waited for a response before entering people's rooms. Each person's care plan included an access agreement which set out the circumstances in which people were happy for staff to enter their rooms, if they failed to respond when staff knocked on their door.

People's care plans were detailed, personalised and provided staff with sufficient information to enable them to meet people's care needs. All of the care plans we reviewed were up to date and accurately reflected people's individual needs and wishes.

People's feedback was valued by the registered manager. Surveys were used to monitor the service's performance and residents meetings were held regularly. The minutes of these meetings showed people's suggestions and concerns had been acted upon and resolved. The complaints received had been resolved to the complainant's satisfaction. People told us, "I've got nothing to complain whatsoever" and. “I am very happy”.

People told us they were regularly asked by the manager for feedback on the performance of new members of staff.

The purpose of this inspection was to answer five key questions. Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. The summary is based on our observations during the inspection, seeking experience and views from people who used the service and the staff supporting them and from looking at records.

Is the service caring?

People that we spoke with were happy with the support they received from the service. We received a number of positive comments such as “they are respectful – they are thoughtful” and “they are wonderful”.

People had support plans in place which were person centred and gave staff information that would allow them to meet people’s individual needs and preferences.

People told us that they were treated with dignity and respect and that they were encouraged to be independent where possible.

Is the service responsive?

People that we spoke with told us that they had no concerns or complaints but that they felt able to raise any issues and were confident that they would be acted upon.

Incidents and accidents were recorded and this gave the provider opportunity to respond to any trends in the number and type of incidents occurring.

Is the service safe?

People that we spoke with told us that they felt safe and trusted staff who came to support them. Staff told us they felt able to identify and report any safeguarding issues and had received training to support them in their safeguarding duties. Staff understood the term ‘whistleblowing’ and knew where they could go to report concerns outside of the organisation.

There were robust recruitment procedures in place to ensure that people who worked in the service were safe and suitable to do so. This included undertaking checks and gathering two references as well as accounting for any gaps in a person’s employment history.

Risk assessments were in place to help ensure that people were supported in a safe and appropriate way in accordance with their needs. People had access to alarms to call for urgent help if they needed it.

Is the service effective?

People that we spoke with confirmed that they were involved in planning their own support and asked for their opinions. This would help ensure that the support was tailored to their particular needs and preferences. Support plans were reviewed on a regular basis to help ensure that they were current and up to date.

Is the service well led?

There were systems in place to monitor the quality and safety of the service provided. People who used the service were able to give their opinions through monthly meetings and as part of the support plan reviews.

Audits were carried out to check on aspects of the service including MAR (Medication Administration Record) sheets and daily notes.

If you want to see the evidence supporting our summary please read the full report.

People that we spoke with told us that they felt respected by staff and were able to make choices about the care and support they received. Overall, they were very happy with the care and support they received. One person said," I am settled here I have made great friends here I am really pleased."

We looked at six care records and found that the support plans were clear, reviewed regularly and gave details of the persons' specific needs so that staff knew how to care for them. Risk assessments were reviewed and up to date risk to enable staff to care and support people who used the service safely.

We found there were enough staff with relevant knowledge and experience to meet people's needs. One person said, "There is always staff here when you want them."

There was an effective complaints process in place and people who used the service knew how to raise any concerns or complaints. We looked at the complaints file and found that any complaints that had been raised were managed appropriately.

There were induction programmes in place and mandatory training was provided to ensure that staff were competent to deliver care. Staff were regularly supervised to monitor their work performance and development needs.

We found that people’s records were safe and accurately maintained.

Quality assurance procedures were in place to monitor the running of the agency. People who used the agency were able to provide feedback on the care and support they received.

We spoke with ten people receiving a service, seven members of staff, including senior management team and five relatives during our visit.

People told us they liked the care and support the received from Bluebell Gardens Extra Care. They told us that the staff were supportive and helpful.

People told us that they could choose when to get up and when to go to bed at night. They said us they had tenancy agreements and this had been discussed with them and where relevant their families. People told us that they had the choice to eat at the restaurant or be supported by staff to prepare their own meals.

Some people told us their care files were kept in their bedroom and they were involved in decisions about their care.

People said they had good relationships with each other and staff and said their views on the service were listened to and acted upon.

People told us they felt safe and enabled by the staff to be independent.

One person described the service as “a very good place”.