The Gables Care Home

The Gables Care Home is a residential care home providing personal and nursing care to up to 55 people. The service provides support to older people who may require nursing care and those living with dementia. At the time of our inspection there were 26 people using the service.

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

The Gables Care Home was an organised and well run service that had an open and

transparent culture. The registered manager was clear about how the service should be provided and they led by example.

Staff knew how to keep people safe from harm. The provider had systems in place to protect people from the risk of abuse and people told us they felt safe. Risk assessments were completed to help identify and minimise risks people faced.

Staff were caring and treated people with kindness and respect. There was enough staff on duty to meet people's needs. Incidents and accidents were managed safely, the managers took necessary actions to keep people safe and minimise the risk of incidents reoccurring.

People were supported to access healthcare services, staff recognised changes in people's health, and sought professional advice appropriately. Medicines were ordered, stored and administered safely.

People were supported by staff who completed an induction, received appropriate training and support to enable them to carry out their role safely. There was time for people to have social interaction and there was a varied activity programme which changed to ensure people’s choices were considered.

Infection control measures were safe. Steps were taken to learn lessons if things went wrong.

The registered manager provided good leadership and clear direction. Staff felt supported and were confident people received good care. Systems and processes for monitoring quality and safety were effective.

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.

For more information, please read the detailed findings section of this report. If you are reading this as a separate summary, the full report can be found on the Care Quality Commission (CQC) website at www.cqc.org.uk

Rating at last inspection:

The last rating for this service was requires improvement (published 11 October 2021). At this inspection we found improvements had been made.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

The Gables Care Home was providing personal and nursing care to 42 people, aged 65 and over, at the time of the inspection. The service can support up to 55 people in one adapted building, all on the same level.

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

The service was relying heavily on agency staff and we found that staff were not always deployed effectively to meet people’s needs in a timely way. People had not always been supported, prompted and encouraged to eat at mealtimes. This could put them at risk of malnutrition. We recommended that the manager reviewed the dining experience to ensure that it meets the needs and preferences of people living at the service.

There was a lack of meaningful activities and engagement with people. We found that not all staff knocked on people’s door before entering, showing a lack of privacy and respect.

The provider had quality auditing system, but this has failed to identify some of the areas we identified that needed improvement.

Staff received an induction when starting at the service. Regular training, specific to their role, was delivered and refreshed when needed. Staff felt supported by the management team.

Risk to people was assessed and care plans, which supported staff to deliver personalised care, were put in place. People were supported to maintain their health and access healthcare support.

Staff worked in partnership with other agencies to ensure people received the right support.

Staff had received safeguarding training and were aware of their responsibility to report safeguarding concerns.

We were assured by the infection prevention and control measures that were in place. Medicines were well managed.

There was an open culture within the service, where people and staff could approach the manager who acted on concerns raised to make improvements to people's care.

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.

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 28 February 2018).

Why we inspected

We undertook this inspection as part of a random selection of services rated Good and Outstanding to test the reliability of our new monitoring approach.

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.

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.

We found the following examples of good practice.

An area in the service had been created to provide isolation for people returning from hospital or any new admissions. This area had its own dedicated staff.

Staff followed the requirements in the use of PPE. Staff had received training in infection control, taking off and putting on of their personal protective equipment and handwashing.

The registered manager ensured all staff had completed a risk assessment and additional risk assessments had been put in for those staff who were in higher risk categories.

Staff ensured all visitors to the service, including professional visitors and contractors, had their temperature taken on arrival and completed a health questionnaire. Visitors wore full PPE (personal protective equipment) throughout the duration of their visit to reduce the risk of spreading any infection to all people living at the service.

We signposted the provider to consider additional resources to support staff in maintaining the cleanliness of the environment at all times.

The Gables Care Home accommodates 55 people in one adapted building all on one level.

This unannounced comprehensive inspection took place on the 23 January 2018. This is the first inspection since the provider was registered with the Care Quality Commission in January 2017

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 were kept safe and staff were knowledgeable about reporting any incidents of harm.

People were looked after by enough staff to support them with their individual needs. Pre-employment checks were completed on staff before they were assessed to be suitable to look after people who used the service. People were looked after by staff who were trained and supported to do their job.

People were safe at the service because the provider had systems in place which minimised risks.

People were helped to take their medicines by staff who were trained and had been assessed to be competent to administer medicines.

Staff were able to demonstrate their understanding of the principles of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS); these provide legal safeguards for people who may be unable to make their own decisions.

People were treated by kind, respectful staff who enabled them to make choices about how they wanted to live.

People were supported to eat and drink sufficient amounts of food and drink. They were also supported to access health care services and their individual health and nutritional needs were met.

Comprehensive care plans were in place detailing how people wished to be supported and had been produced jointly by staff with people living in the service. People and or their relatives had agreed and were fully involved in making decisions about their care and support.

People participated in a range of activities within the service or in the community and received the support they needed to help them to do this.

People were involved in the running of the service. Regular meetings were held for the people and their relatives so that they could discuss any issues or make recommendations for improvements to how the service was run.

There was a process in place so that people’s concerns and complaints were listened to and were acted upon.

There were clear management arrangements in place. Staff, people and their relatives were able to make suggestions and actions were taken as a result. Quality monitoring procedures were in place and action was taken where improvements were identified.