• Care Home
  • Care home

Archived: St Gabriel's House - Apartments

Overall: Good read more about inspection ratings

St Gabriel's House, 44 Elm Grove, Westgate-on-Sea, Kent, CT8 8LB (01843) 834673

Provided and run by:
The Royal National Institute for Deaf People

Important: The provider of this service changed. See new profile
Important: The provider of this service changed. See old profile

All Inspections

24 November 2020

During an inspection looking at part of the service

St Gabriel’s House is a service providing personal care to six people with a learning disability and hearing loss. The service can support up to eight people.

We found the following examples of good practice.

¿ The registered manager ensured staff worked in one location to minimise the risk of infection. Staff used PPE appropriately and the registered manager had sourced PPE which was the most appropriate for supporting people with a hearing loss and learning disability.

¿ When the registered manager emailed staff to update them on any changes to guidance or explanations of expectations, the emails were also sent to people’s family members. The registered manager told us this ensured transparency and enabled families to know what they should expect from staff.

¿ People and their loved ones were supported to access regular testing to enable them to maintain visits to their families when appropriate. Risk assessments were completed and agreed with family members.

Further information is in the detailed findings below.

13 December 2019

During a routine inspection

About the service

St Gabriel’s House is a residential care home registered to provide accommodation and personal care for up to eight people. The service is based across two apartments, which are in the same building as a day service run by the provider. There were seven people living at the service at the time of this inspection. People had a range of learning disabilities. Some people were living with autism and some people required support with behaviours that challenged. Some of the people were living with hearing loss and used British Sign Language (BSL) to communicate.

The service is in a quiet road, close to local shops and the sea. Each apartment has large living and dining areas, a kitchen, four bedrooms and several bathrooms.

The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The building design fitted into the residential area. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

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

People were happy and fulfilled living at St Gabriel’s House. Staff focused on people’s health and emotional wellbeing and ensured their needs were met. There was a person-centred and enabling culture at the service, which people and staff were positive about. People’s privacy and dignity was promoted.

Communication needs were clearly understood and ensured people were involved in all aspects of their care. Risks had been assessed and measures needed to positively manage these were embedded into daily practice. People were supported to develop daily living skills, independence and to achieve their goals. People were part of their local communities.

People were supported to understand their choices and had control of their life. They were supported to maintain and develop friendships through visits and technology such as video calls. There were enough staff to support people. People felt safe and were protected from abuse and avoidable harm.

Needs were fully assessed and people received the care they needed to achieve the best quality of life. Staff were experienced and competent and felt well supported by the registered manager. Where they wanted to be, people were involved with menu planning, shopping and meal preparations. People were supported to maintain their health and well-being.

Medicines were stored and managed safely. There were policies and procedures in place for safe administration of medicines. People received their medicines when they needed them from staff who had been trained and had their competency checked.

There was an extremely positive, open culture within the service, the registered manager provided strong leadership and led by example. They had a clear vision and strong values about how people were supported, which was echoed by all the staff we spoke with. Staff were proud to work for the service and felt they were an active part of an organisation where they mattered, people mattered and all voices were equal. People, relatives and staff were all engaged with the service and asked for their views.

Governance systems were well-embedded and there were effective assurance systems that ensured self-compliance. The registered manager proactively monitored the quality of the service. They reviewed risk management plans, training for staff and measured the quality of service delivered.

The registered manager positively influenced good practice in the care and support people with a learning disability and autism received by engaging with other providers to share good practice.

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.

The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

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

Rating at last inspection

The last rating for this service was Good (published 15 March 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

1 February 2017

During a routine inspection

This inspection was carried out on 1 February 2017 and was announced.

St Gabriel’s House is registered to provide accommodation and personal care for up to eight people. There were six people living at the service when we visited. People had a range of learning disabilities. Some people were living with autism and some people required support with behaviours that challenged. Some of the people were living with hearing loss and all used British Sign Language (BSL) to communicate.

The service is in a quiet road, close to local shops and the sea. The service is based across two flats, which are in the same building as a day service run by the provider. Each flat has large living/dining areas, a kitchen, four bedrooms and several bathrooms.

The service is run by a registered manager who was present on the day of the inspection. 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. The registered manager shared their time between St Gabriel’s House and another residential service for five people nearby that they also managed. They were supported to do this by two deputy managers and senior support workers.

The care plans gave staff guidance on what support people needed and how they liked staff to support them. Care plans were not always available in a format which was accessible to people. A member of staff was piloting a new person centred plan using pictures but this had not yet been completed. The registered manager agreed this was an area for improvement.

Some staff told us that they could contact the registered manager for support but other staff told us that the management team was distant and they did not feel supported. Some staff felt that their opinion was valued but others stated that they were not listened to and their ideas were dismissed. There had been a number of changes at the service and this had resulted in a period of uncertainty, long standing staff leaving and staff vacancies which appears to have led to low staff morale. The registered manager told us, after the inspection, that they were meeting with staff to try to address their concerns.

There were enough staff to support people and the number of staff available was based around people’s activities and needs. Staff had been recruited safely and had received a variety of training for their role. Staff had not always received the training required to meet people’s individual needs, especially related to supporting people whose behaviours could challenge. The registered manager had requested further training for the staff before our inspection but did not have a date for when this would happen. All staff were completing the care certificate to refresh their knowledge. The care certificate is an identified set of standards that social care workers work through based on their competency.

Staff knew people well and talked about people’s personalities and favourite things to do. People were supported to maintain relationships with family and friends, through visits and the use of technology including email. Each person had a keyworker who co-ordinated their care and support. People had keyworker meetings weekly which were recorded, this gave people a chance to discuss any worries or concerns and what had gone well in the past week.

People and staff seemed very comfortable in each other’s company. Staff adapted their way of working for each person, and treated people with dignity and respect. Family members and visitors said they always felt welcomed at the service

Risks relating to people had been assessed and plans put in place to minimise the impact of the risks. People were supported to develop new skills and to look after their home. People had weekly residents meetings to discuss any issues and plan the menu each week. People were supported to have a varied and balanced diet. People could access the kitchen whenever they liked and could prepare their own snacks or meals.

People had health action plans in place detailing their health needs and the support they needed. There was information in place for people to take with them if they were admitted to hospital. This laid out important information which healthcare staff should know, such as how to communicate with the person and what medicines they were taking. People kept their medicines in a locked cupboard in their bedrooms and staff supported them to take their medicines safely.

Staff knew how to recognise and respond to abuse. The registered manager was aware of their responsibilities regarding safeguarding and staff were confident the registered manager would act if any concerns were reported to them.

People had complaint forms in their rooms which included pictures to make them meaningful. There had been no complaints but there was a procedure in place to respond to them should they arise.

Staff told us how they supported people to make their own decisions and choices. Staff had received training on the Mental Capacity Act (MCA) 2005. The MCA provides the legal framework to assess people's capacity to make certain decisions, at a certain time. CQC monitors the operation of the Deprivation of Liberty Safeguards (DoLS) which applies to care services. The requirements of DoLS were met.

Accidents and incidents were recorded and shared with the provider using an online tool. A risk management team employed by the provider worked with the registered manager to identify any themes or opportunities for learning from any incidents.

The registered manager audited the service monthly. The provider had a compliance team who audited the service annually and gave the registered manager an action plan to complete. The area manager followed this up in her quarterly audits. Regular health and safety checks were undertaken to ensure the environment was safe and equipment worked as required. Regular fire drills were completed.

People were asked for their views of the service in their weekly meetings. Each person had an annual review and all participants, people, relatives and health and social care professionals were asked for feedback. There was not a system in place to request feedback outside of these meetings. This was an area for improvement.

The registered manager was experienced in working with people with learning disabilities and providing person centred care. The CQC had been informed of any important events that occurred at the service, in line with guidance. Staff understood the need for confidentiality and records were stored securely.