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Archived: The Gables Residential Home Inadequate

Inspection Summary


Overall summary & rating

Inadequate

Updated 9 January 2018

We inspected The Gables Residential Home on 11 July 2017. This was an unannounced focused inspection following concerns we received about the care being provided to people living in the home and in receipt of the home care service. We undertook this focused inspection to check that they had followed and met the legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for The Gables Residential Home on our website at www.cqc.org.uk.

At our last inspection on 28 February and 2 March 2017 we found two breaches of legal requirements. We took enforcement action and placed a condition on their registration. The Registered Provider must not admit any service users to the location The Gables Residential Home, without the prior written agreement of the Care Quality Commission. The term "admit" includes re-admit and this restriction should be understood to include any person who has been resident at the home at any time. The service was also placed into special measures. Following the inspection the provider was required to submit an action plan to say what they would do to meet legal requirements in relation to the breach in Good Governance and Safe care and treatment. We also requested additional information from the provider about their service. The provider failed to provide us with the information we requested.

At this inspection we found that the provider had made some of the required improvements. However, we continued to find the service was not meeting the regulations and further improvements were required. There continued to be breaches of the regulations we inspected against and safe and well led domain remained inadequate. Therefore the service remains in special measures.

The Gables Residential Home provides accommodation for people who require personal care for up to 10 people and personal care for people living in their own homes. At the time of the inspection seven people were living in the residential home and eight people were receiving care in their own home. However, one person was in hospital on the day of the inspection meaning there were only six people who were currently using the service. The home is located on two floors with a stair lift to access both floors. The home had a communal lounge and dining room. Most people who received care in their own homes lived in flats that were on the same grounds as the residential home. The same staff group worked between both the residential home and flats.

The service had a registered manager who was registered to manager both accommodation for people and personal care. 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 not protected from risks relating to their health and safety. Some assessments had been carried out but had not been reviewed when people’s needs had changed. Assessments to determine what support people needed had not been carried out since our last inspection placing people at risk of harm.

Staff could identify the potential signs of abuse and knew how to report any concerns. Where incidents had occurred that may cause concern these had not always been investigated to determine the cause. Measures had not been put in place to protect people from the likelihood of reoccurrence.

There were not enough staff deployed to keep people safe. Staffing levels had been assessed based on incorrect information. People did not have their needs assessed and it was not known how many staff were needed to meet their needs safely.

People living in the flats did not receive their medicines in a safe way or as prescribed by their

Inspection areas

Safe

Inadequate

Updated 9 January 2018

The service was not safe.

People were not protected from risks relating to their health and safety. Where people’s needs had changed risks had not been assessed.

Incidents had occurred and the cause of these had not been identified to try and reduce the likelihood of them happening again.

Staff had not had pre-employment checks completed before they started work. Staffing levels had not been assessed effectively to ensure there were enough staff to meet people’s needs safely.

People did not always receive their medicines safely. Medicine records were not completed correctly.

Effective

Requires improvement

Updated 16 May 2017

The service was not consistently effective.

People were supported to access healthcare services. Where people received support in their own homes, referrals to health professionals for assessments were not always made as soon as they were needed. Where people’s food intake needed to be monitored to reduce the risk of malnutrition the amount of food people had been given was not recorded.

Staff asked people for consent before supporting them with their care. People were asked to make choices.

Staff received support through an induction to the service and supervision. We found that staff had not been trained fully to meet the needs of people who used the service. Staff training had not been updated to make sure that they were working in line with current best practice.

People were supported to access healthcare services. The provider did not always ensure that advice given by health professionals was followed.

Caring

Requires improvement

Updated 16 May 2017

The service was not consistently caring.

People told us that the staff were kind. Staff respected people’s privacy while they were receiving care. However, the provider had not always respected people's dignity in respect to their personal clothing.

People had not always been asked for their opinion on things that were happening in their home.

Staff members knew people well and were able to tell us about their likes and dislikes. People’s friends and relatives were able to visit then they wanted to.

Responsive

Requires improvement

Updated 16 May 2017

The service was not consistently responsive.

People had not had their needs assessed when they had changed. People were not involved in reviews of their needs to make sure that information about them was up to date.

The provider did not always offer to make changes to the service to meet people’s needs when they needed more support.

People were able to participate in activities.

People felt they could raise concerns. A complaints procedure was available to tell people how to do this.

Well-led

Inadequate

Updated 9 January 2018

The service was not well-led.

Actions that had been identified at previous inspections had not been completed. Feedback that had been given had not been used to improve the service that was delivered.

The provider had implemented systems and processes to monitor and improve the quality of the service that had been provided. These did not identify or address concerns we found during this visit.

Staff usually felt supported in their role and they could approach the registered manager.

The provider failed to submit information we requested following their inspection.