Gabriel Court Limited

Updated 29 March 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection, we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 2 inspectors and an expert by experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Gabriel Court Limited is a ‘care home.’ People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Gabriel Court Limited is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was no registered manager in place.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service.

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 17 people using the service and had discussions with 4 relatives to gain their view of the service. We spoke with 11 staff including the operations and interim managers, deputy manager and 8 care and support staff. We also spoke with a visiting health professional.

We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included 6 people's care records and 14 medication records. We looked at 2 staff files in relation to recruitment. A variety of records relating to the management of the service, including quality assurance audits, training records, key policies and meeting minutes were reviewed.

Updated 29 March 2023

About the service

Gabriel Court Limited is a residential care home without nursing, providing personal care for up to 44 older people, including those living with dementia and mental health needs. At the time of the inspection 36 people were being supported.

Gabriel Court has accommodation across two floors, in one adapted building (Bluebell unit) and one purpose-built building (Foxglove unit).

People’s experience of using this service and what we found

We observed there were insufficient staff to meet people’s needs safely, particularly in the Bluebell Lounge which was the high dependency unit.

The registered manager had left, and the provider had recruited an interim manager swiftly to ensure the smooth running of the service. They were being supported by the operations manager to continue to drive improvement at the service. Recruitment for a new permanent manager was taking place at the time of our inspection.

Improvements had been made to the systems for safe medication administration. However, further information was required to ensure the PRN protocols guided staff to administer ‘as required’ medicines safely and consistently.

The provider's quality assurance systems and processes had been overhauled and improved to ensure they were more effective. This meant the managers and the provider had better oversight of the service. Many of these systems were newly implemented and needed time to become embedded into staff practice so they could be assessed for their effectiveness. Not all systems in place had been effective and had failed to identify staff deployment issues.

Improvements had been made to the fabric of the building to ensure it was conducive to effective cleaning. We saw flooring had been replaced and areas repainted, so they were more easily cleanable. The environment had been improved to ensure it was safe for people.

Staff understood safeguarding procedures and were confident in reporting any concerns. Risks to people's safety were assessed and well managed, and people’s care plans detailed current risks and individual needs.

Staff were appropriately recruited to ensure people were suitable to work at the service.

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

People's care needs were assessed before they went to live at the service, to ensure their needs could be fully met. Staff received an induction when they first commenced work at the service, and we found improvements had been made to staff training to ensure they had the skills and knowledge to provide effective care.

People were supported to eat and drink enough and staff supported people to live healthier lives and access healthcare services.

Staff felt well supported and said the management team were open and approachable. The service worked in partnership with outside agencies.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was Requires Improvement (published 15 November 2022) and there were 3 breaches of registration in relation to Safe care and treatment; Adapting service, design, decoration to meet people’s needs and Good Governance. Continued conditions were applied to the provider's registration. This service has been rated requires improvement for the last 4 consecutive inspections.

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of 2 regulations but remained in breach of regulation 17 Good Governance. We also found a breach of Regulation 18 Staffing, at this inspection.

Why we inspected

We undertook this focused inspection to check that the provider had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions of Safe, Effective and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions, not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has remained Requires Improvement.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Enforcement and Recommendations

We have identified 1 continued breach of regulation in relation to Good Governance and a new breach of regulation in relation to staffing at this inspection.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.