Gabriel House

Updated 30 June 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was conducted by 1 inspector, a medicines inspector and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Gabriel House is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced. Inspection activity started on 09 May 2023 and ended on 24 May 2023. We visited the location’s service on 09 May 2023 and 14 May 2023.

What we did before the inspection

We reviewed information we had received about the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We also used information obtained from the local authority. We used all of this information to plan our inspection.

During the inspection

We spoke with one person who used the service about their experience of the care provided. We spoke with 5 members of staff including the registered manager, assistant manager and care staff. We reviewed a range of records at the service. These included 3 peoples care records and their medications records. We reviewed 4 staff files in relation to recruitment and staff supervision. We reviewed a number of other records including training and documents relating to the management of the service including policies and procedures.

Updated 30 June 2023

About the service

Gabriel House is a small residential care home that provides accommodation and personal care for up to 5 adults with learning disabilities and/or autism. At the time of our inspection there were 3 people being supported at Gabriel House.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support: Recruitment at the service was not always safe. There was sufficient staff at the service to allow individuals to access the community safely. The environment needed some maintenance and upkeep and we have made a recommendation about this to the service who are already making steps to achieve this. Individuals had positive behaviour support plans which helped staff support individuals and use de-escalation. Staff provided person centred support. Medicines management at the service was safe.

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.

Right Care: There were sufficient staff deployed to meet people's needs and wishes. A small number of agency staff were used to cover staff vacancies however following recruitment this had reduced. We have made a recommendation about agency staff induction. People received person-centred care. Staff recognised and responded to changes to individual's physical and emotional needs.

Right Culture: The quality assurance systems did not provide full oversight of the service. Audits had not highlighted some of the areas we found on inspection. Improvements were needed in oversight and embedding the new systems in place. The service had a new registered manager who was making improvements in this area.

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 08 July 2021).

Why we inspected

The inspection was prompted in part due to concerns received about oversight and staffing. A decision was made for us to inspect and examine those risks.

You can see what action we have asked the provider to take at the end of this full report. We have assurances that the issues identified are being acted upon by the management team.

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.

Enforcement and Recommendations

We have identified breaches in relation to staffing and oversight at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.