The Care Quality Commission
  • Care Home
  • Care home

Archived: High Gable House

Overall: Good read more about inspection ratings

295 Lincoln Road, Enfield, Middlesex, EN1 1SY (020) 8804 1115

Provided and run by:
Vijaykoomar Kowlessur

All Inspections

18 July 2014

During a routine inspection

We carried out this inspection under section 60 of the Health and Social Care Act 2012 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2012 and to pilot a new inspection process being introduced by the Care Quality Commission (CQC) which looked at the overall quality of the service.

We undertook an unannounced inspection to High Gable House on 18 July 2014. High Gable House is a care home registered for a maximum of nine adults who have learning disabilities. The home consists of two separate houses.

At our last inspection on 25 February 2013 the service met the regulations inspected.

The service had a registered manager who had been in post since December 2013. A registered manager is a person who has registered with the CQC to manage the service and has the legal responsibility for meeting the requirements of the law; as does the provider.

Safeguarding adults from abuse procedures were robust and staff understood how to safeguard the people they supported. Managers and staff had received training on safeguarding adults, the Deprivation of Liberty Safeguards and the Mental Capacity Act 2005. Staff said they had considered people's needs in regard to this legislation, and were liaising with the local authority to establish if people needed to be assessed.

People received individualised support that met their needs. The service had systems in place to ensure that people were protected from risks associated with their support, and care was planned and delivered in ways that enhanced people’s safety and welfare according to their needs and preferences.

People were involved in decisions about their care and how their needs would be met. People were supported to eat and drink according to their individual preferences. Staff supported people to attend healthcare appointments and liaised with their GP and other healthcare professionals as required to meet people’s needs.

People told us they were happy with the care provided. Staff were appropriately trained and skilled to care for people. They understood their roles and responsibilities as well as the values and philosophy of the home. Staff received supervision and an annual performance review. They confirmed they were supported by the manager and received advice where required.

The management team was accessible and approachable. People who used the service and staff felt able to speak with the manager and provided feedback on the service. Monthly audits were carried out across various aspects of the service, these included the administration of medication, care planning and training and development. Where these audits identified that improvements were needed action had been taken to improve the service for people.

6 March 2014

During an inspection in response to concerns

We carried out this unannounced inspection in response to a complaint regarding staff support at the home. We spoke with a person who used the service, the registered manager, registered provider and two care staff. We examined the staff records and details of meetings to make a judgement as to whether the provider was meeting Outcome 14: Staffing, and was compliant with Regulation 23 (Health and Social Care Act 2008 Regulated Activities) Regulations 2010.

People in the home had learning disabilities. Two people did not provide us with an opinion regarding the care provided. The third person who used the service stated that they were well cared for and staff had treated them with respect. We observed that all three people who were in the home during the inspection appeared well cared for.

Care staff we spoke with were satisfied with the support they received. They stated that they worked well as a team and had been provided with supervision and essential training.

At this inspection we were satisfied that the service had suitable arrangements to ensure that care staff were provided with the support and supervision they needed. This ensured that they were able to provide care for people who used the service.

26 November 2013

During a routine inspection

People were provided with care and support that was tailored to their needs and reflected their individual routines, preferences and cultural backgrounds. Care plans contained a detailed assessment of needs along with actions and measures to reduce or avoid identified risks. There were regular reviews and updates to ensure that care was appropriate to current needs. There were procedures in place to ensure the safety of people using the service and manage emergencies.

We observed that staff took time to communicate with people living at the home and used appropriate measures to involve them and obtain their consent to the care delivered. For example they used pictorial representations of food and activities to help them make choices.

We spoke to two relatives of people using the service who were both very satisfied with the care provided. One told us, 'He's very happy there, the house is marvellous.'

Another person said, "Everything is always up to scratch - they have plenty of food and they are always all clean, washed and dressed."

Staff were provided with regular training updates and supervision which formed part of an overall programme of personal development.

The provider cooperated effectively with a range of other services to support people using the service and provide an integrated package of care. There were systems in place to monitor and maintain the quality of the service and a formal procedure for making complaints.

25 February 2013

During a routine inspection

We observed that people were involved and consulted about decisions affecting their care. People were involved in the care planning process and had taken part reviews.One person told us, "I like the food here." We observed that people were offered a choice of meals for lunch. People were involved in planning the weekly menu. People were able to access all parts of the home safely. We saw that they had personal items in their bedrooms. These reflected their personal interests and cultural backgrounds.

Staff told us that they had been through a thorough recruitment process. This involved completing an application form and being interviewed. Staff told us they had provided references, and that a criminal records check had been carried out. We observed that staff kept records securely relating to people who used the service. We saw that staff knew how to communicate with people. They maintained confidentiality by not sharing information when other people were present.

3 May 2012

During an inspection looking at part of the service

We observed that people were involved and consulted about decisions affecting their care. Professionals had told us that the decision to change a person's bedroom had been discussed at a recent review of their needs. We found that this was recorded in the information about their care.

The registered manager had notified us of a number of incidents and the action he had taken to maintain people's safety. He was able to show us records of information he had sent to the local authority relating changes to the care and treatment of people. The service shared information appropriately so that people's safety was promoted.

We looked at financial records for three people who use the service. These gave detailed information about how people were spending their money. There were we receipts, and all expenditure was itemised. Appropriate financial records ensure that people were protected from the risk of financial abuse.

10 January 2012

During an inspection looking at part of the service

Staff knew how to communicate with people. However, a person who uses the service had been moved to a new bedroom without the registered manager having carried out a best interests assessment with the local authority. We looked at a number of care plans, and found that these gave a detailed description of people's needs. The registered manager had developed a training plan to make sure staff continued to develop the skill and understood the needs of people. The annual quality survey showed how people would be involved in making suggestions to improve the service.

A recent safeguarding investigation had highlighted that a suspected financial abuse of a person who uses the service had not been notified to us. People were at risk as important events that affect their health and well-being were not reported, and prompt action was not taken to ensure their safety. Staff understood why it was important to maintain confidentiality of information about people. Staff explained that financial records were not available in one house that made up the service. The lack of available and appropriate financial records in part of the service may put people at risk of financial abuse.

28 June 2011

During an inspection in response to concerns

We observed that people were involved and consulted about decisions affecting their care. People liked the food. There was no evidence to show that people had been involved in planning their care. People may not receive the care and support they need in line with their personal preferences. The home is not regularly assessing and monitoring what it is doing, so people may not consistently receive the care and support they need. People had been consulted about how they wished their bedrooms to be decorated. These reflected their personal interests and cultural backgrounds.