Archived: Three Gables

Three Gables is a care home that provides accommodation for up to 19 older people who require a range of care and support related to living with a mental health condition. This includes a dementia type illness and behaviours that may challenge others. On the day of the inspection 16 people lived there. There is a registered manager at the home who is also one of the partners of the business. 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.

This was an unannounced inspection and took place on 17 and 18 November 2014.

Staff knew people well; they had a good knowledge and understanding of the people they cared for. They were able to tell us about people’s care needs, choices, personal histories and interests. However, when people’s needs changed not all the information had been recorded in their care plans. This meant there was no guidance for staff to ensure consistency or demonstrate evidence that people’s care needs were met.

The home was clean throughout. Visitors to the home told us, “It’s always really clean.” However, staff did not have always have access to appropriate hand washing facilities throughout the home. They did not always use appropriate protective equipment such as aprons when they were in the kitchen to help prevent cross infection.

There was information about individual risks to people and guidance for staff to follow. However, equipment had been stored throughout the home but there were no risk assessments to show that people’s safety had been considered in relation to these areas.

Care was provided to people by a sufficient number of staff who were trained and supported to keep people safe. Staff had received training in how to recognise and report abuse. They told us what procedures to follow should they have any concerns. Staff told us and records showed they received regular training and supervision. They said they felt supported by the registered manager. Recruitment records showed that appropriate checks were in place to ensure staff were suitable to work at the home.

Medicines were stored, administered and disposed of safely by staff who had been trained to do so.

Staff had a good understanding of people’s nutritional needs. However, people who required support did not always receive appropriate assistance in a timely way.

The registered manager and staff understood their responsibilities under the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS). Where people lacked the mental capacity to make decisions staff were guided by the principles of the Mental Capacity Act 2005 to ensure any decisions were made in the person’s best interests.

People had access to health care professionals including GP’s, district nurses and mental health workers to meet their specific needs. Staff told us and healthcare professionals confirmed people were referred to the appropriate health care professionals.

People appeared happy and relaxed in the company of staff and other people. It was apparent that staff knew people well and had developed caring relationships with them. People told us that staff “Were kind.” However, we observed some instances where staff could have treated people in a more respectful way.

Although there were some checks and audits in place there were no care plan or maintenance audits to help the registered manager identify, assess, manage and monitor the quality of service provision.

The registered manager told us how they were involved in the day to day running of the home. People and staff told us the registered manager was always available. We saw there was an open, relaxed atmosphere in the home where staff felt supported.

There were a number of breaches of the regulations. You can see what action we told the provider to take at the back of the full version of the report.