Grey Gables (New Milton) Limited

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.
Effective systems were now in place to review and mitigate accidents, incidents and allegations of abuse. Staff training had been improved and included a wider range of courses to address gaps in skills previously seen and additional staff had been deployed to meet people’s needs at night. Training completed by all staff included dignity in care and equality, diversity and inclusion, courses that had improved staff conduct and how people were interacted with. Staff now included people and their relatives in assessing risks and implementing risk mitigation measures that were person centred.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice.

Accidents and incidents were recorded, reviewed and learning from them shared with the staff team. Each day staff checked people’s rooms for safety concerns and shared with the manager and maintenance staff.

An electronic communication system was in use to ensure staff were briefed on any new learning and important changes before they started their shift to ensure they were working with the latest information. This information was available to them as an online resource which also informed the manager when information was received. There were also detailed handover records and handover meetings which ensured staff were aware of new learning about people.

Accident and incident reports and log were completed, and all records clearly stated any new learning to be shared. A separate falls log was shared with community nurses to ensure they were informed of all incidents.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

The provider had a robust process for new admissions including assessment and visits to the service. Initial pen pictures of people were supplied by the local authority; the manager met with people and their relatives to complete assessments and ensure their needs could be met by the service.
Regular referrals were made to health and social care providers, so people received timely care. Information essential to peoples care and wellbeing was shared with partners such as hospitals to ensure they received appropriate care.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

The provider had a safeguarding policy, and all staff had completed safeguarding training. A staff member told us, “If I were to suspect that someone was being abused, I would promptly report the matter to safeguarding and the Care Quality Commission (CQC). We have access to the necessary contact numbers within the facility to facilitate this process.” A second staff member said, “If I were concerned about abuse in the care home, I would not hesitate to firstly report to my care home manager and then CQC if I feel it has not been dealt with.”
Relatives believed their loved ones to be safe; one relative said, “I've always felt that my mother receives safe care from Grey Gables. She is fed well with nutritious foods and the staff have always treated her kindly with the dignity she deserves. They will always contact me if they have any concerns."

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Risk assessments were completed for a wide range of areas concerned with peoples care and support. These included falls, mouth health, and safety in bed, alongside for example, widely used assessments on skin integrity..
People and relatives were involved in managing risks when possible and contributed to assessments, particularly when people were admitted to the service. A relative told us, “I do feel my [loved one] is safe and well cared for. Security systems on doors are in place; [they] have a falls mat if needed and [their] call bell is responded to instantly.” A second relative told us, “On the whole I feel my [loved one] is in a safe environment. [They] appear to be well cared for and [their] needs are considered on a daily basis depending on how [they] are."

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Regular servicing and maintenance ensured the providers premises were safe, and equipment was in good working order.

A robust emergency action plan was in place in case of events that required the service to be evacuated. This included scenario based fire drills which provided staff with the experience and training to support people.

The premises were undergoing refurbishment, rooms were being decorated as they became vacant, and the communal areas had been refreshed. As a result of redecorating, we noted some wardrobes were no longer attached to the walls; this was remedied during our inspection.

The premises was accessible and also had accessible gardens people could use as they liked.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development. They worked together well to provide safe care that met people’s individual needs.

The provider completed a monthly dependency tool to calculate the staffing required to meet peoples care needs safely. Staffing levels reflected the most recent calculations, and we observed staff were supporting people in an unhurried way, taking time with people to chat and reassure them.

Staff had completed extensive training since the new manager commenced in post. New training courses had also been introduced to enable staff to more effectively support people’s needs, including Oliver McGowan training and additional learning disability training. If staff were particularly interested in an area following their training, the manager would look to extend their skills through additional training to enable them to support colleagues also.

Staff participated in regular supervision 1-to-1 meetings with the manager. All 13 staff who responded to our feedback requests told us supervisions had been positive, and they felt supported.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

The premises were clean, bright and airy and the recent redecoration gave a fresh appearance. Housekeeping staff completed cleaning according to schedules to ensure all areas were maintained and good infection control was achieved.
Staff used personal protective equipment (PPE) appropriate to the task they were completing. For example, gloves and aprons when supporting people with personal care.
When we inspected there had been no outbreaks of infection. There was also a clear policy stating outbreaks should be reported to the UK Health Security Agency. Staff had been trained to identify signs and symptoms of infection and also how to take and record health observations to inform healthcare professionals making a diagnosis.

The provider did not always make sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Staff did not always involve people in planning.

Medicines were not always safely managed. For example, during our inspection, 1 person did not receive their antipsychotic medicines as prescribed, because staff believed they had no stock. We saw a new bottle of the medicine in the trolley and showed staff who were not aware of it being there. The manager could not tell us when the medicines had been delivered, however they were in stock and available to administer at the time staff marked as omitted. The omission was reported to safeguarding and CQC when we prompted the manager to do so. The manager also sought healthcare advice and was assured the person would suffer no ill effects as a result of the omission.
The electronic medicines record system, (EMAR) did not provide an accurate record of medicines stock. We saw that despite medicines being administered, the number of tablets in stock did not reduce following each administration. The manager had identified the problems with the EMAR and had been actively seeking a new system that would hold both care and medicines records. This would be in use by September 2025.

In the interim period of continuing to use the flawed EMAR, there were no contingency plans to ensure medicines were counted and risks with the system had not been assessed or mitigated. A risk mitigation plan has been implemented since our inspection.