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Inspection Summary


Overall summary & rating

Good

Updated 23 June 2016

The Gables is registered to provide accommodation for up to 16 people who require nursing and person care including those living with dementia, Autistim or with a learning disability. There were twelve people using the service when we inspected.

This unannounced inspection took place on 25 May 2016.

The service had a registered manager. 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.

Staff had been trained in, and were knowledgeable about, protecting people from harm.

A process and checks were in place to help ensure that staff’s suitability to work with people living at the service was to an appropriate standard. There was a sufficient number of suitably qualified and experienced staff to support people and meet their needs.

Staff were trained in medicines administration and they had their competence to do this regularly assessed. Only those staff deemed competent were then duly authorised to safely administer people’s prescribed medicines. People’s medicines were managed safely.

Risk assessments were in place to help manage each person’s assessed health risks. Staff used positive behaviour techniques to support people with behaviours which could challenge others.

The CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. The service’s registered manager and staff were knowledgeable about when an assessment of people’s mental capacity was required. Staff were aware of the circumstances and conditions when an application to lawfully deprive any person of their liberty was required. Appropriate applications had been made and these had been acknowledged to lawfully deprive some people of their liberty.

Staff were regularly supported with both formal and day to day supervision. This was to develop their skills, increase their knowledge and help determine the most appropriate qualifications for their role.

People’s care was provided with compassion and in consideration of each person’s assessed needs. People were supported to improve their independent living skills by staff who knew the people they cared for well.

People were supported by staff with the person’s preferred means of communication. Relatives, nursing and care staff, health care professionals and social workers contributed to people’s to the assessment of people’s care needs. People’s care plans were in a format that promoted people to be as involved, as much as possible, in planning and determining their care needs and levels of independence.

People were supported and encouraged to access a wide range of health care professionals including dieticians, speech and language therapists and GP services. Staff’s adherence to the advice and guidance provided by health care professionals had a positive impact on people’s lives.

People were supported to eat and drink in a safe way and they were encouraged to eat and drink sufficient quantities to achieve a healthy and balanced diet. A choice of meal options were available and staff knew people’s preferred times and places to eat.

There were missed opportunities for people’s social stimulation including hobbies and interests. The registered manager adopted a proactive approach in dealing with and managing concerns that had been raised. Staff knew when people were happy with their care.

The provider and registered manager had effective audits and quality assurance procedures in place. Information gathered from audits was used to identify what worked well and what did not work quite so well. Improvements made were consistent and sustained.

Inspection areas

Safe

Good

Updated 23 June 2016

The service was safe.

Staff had a good and confident level of understanding about how to protect people from harm. Safe medicines administration and management practice was adhered to.

People were supported by a sufficient number of suitably trained and qualified staff to safely meet people’s needs.

Risks to people using the service were identified and managed in a way that gave people control over the risks they could take.

Effective

Good

Updated 23 June 2016

The service was effective.

People were only deprived of their liberty where this was lawful. People’s decisions were respected.

Staff were mentored in the role they performed and were supported to gain additional health care related qualifications.

People‘s health and nutritional support needs were met.

Caring

Good

Updated 23 June 2016

The service was caring.

People were provided with care that gave compassionate consideration to the finer points of people’s lives.

People had the privacy they needed and they were cared for with dignity.

People could be as independent as they wanted to be and had control over the support they needed.

Responsive

Good

Updated 23 June 2016

The service was responsive.

People were to undertake those hobbies, interests and aspects of their lives that were important do them.

Concerns and complaints were acted upon.

Well-led

Good

Updated 23 June 2016

The service was well-led.

Robust quality assurance procedures and monitoring of staff’s performance helped drive continual improvement.

The registered manager kept themselves aware of current care and best practice in many areas of care.

All staff embraced a positive and open culture of working as a team and putting people first and foremost.