We carried out a review of the data available to us about The Gables on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about The Gables, you can give feedback on this service.
We found the following examples of good practice.
Staff followed government guidance in relation to personal protective equipment (PPE) and infection prevention and control (IPC) practices. The service had an ample supply of PPE and stock levels were monitored by the registered manager and the IPC lead.
COVID-19 testing was taking place for all staff and three people using the service. Where people lacked capacity to consent to testing, a mental capacity assessment and best interests meeting had been carried out. Staff monitored people for signs and symptoms of COVID-19, and appropriate processes were in place and followed should anyone display any symptoms of COVID-19.
Staff supported people’s social and emotional wellbeing. The provider and staff kept family members up to date about the latest guidance and their relative’s health via regular telephone calls and emails.
Audits were in place and used to ensure the service was providing safe care and staff were following government guidance.
All staff had undertaken training in IPC. This included putting on and taking off PPE, hand hygiene and other COVID-19 training.
The Gables is registered to provide residential, personal and social care for up to eight people with learning disabilities and an associated sensory impairment. The Gables is a large detached building on a main road between Knaresborough and Harrogate. The immediate local area is Starbeck; which has a number of services and amenities. The registered provider is Homes Together Limited. At the time of this inspection there were seven people using the service.
The Gables is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection.
The care service has been developed and designed in line with the values that underpin the 'Registering the Right Support' and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
At our last inspection we rated the service 'good'. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
Staff had received safeguarding training and were aware of how to recognise and respond to risk. Individualised risk assessments were in place and people were supported with positive risk-taking to maintain their independence, choice and control.
We found that the management of medication was safely carried out.
Staff had been employed following robust recruitment and selection processes. There were sufficient numbers of staff who were deployed appropriately in the service to meet people's needs and support people to live safely and as they had chosen to.
Communication was effective, People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
People enjoyed good food. Their health needs were identified and staff worked with other professionals, to ensure these needs were met.
People’s independence was promoted. The service provided people with care that met their wishes and choices, whilst protecting their privacy and dignity.
Staff were knowledgeable about people’s individual care needs and care plans were person-centred and detailed. People participated in a wide range of activities within the service and in the community, they also enjoyed the company of others in the service.
People were able to see their families as they wanted. There were no restrictions on when people could visit the service. People were supplied with the information they needed at the right time, were involved in all aspects of their care and were always asked for their consent before staff undertook support tasks.
The service was well-led; systems were in place to assess and improve the quality of the service and complaints were responded to thoroughly. There was an open culture and learning was encouraged to drive improvement.
Further information is in the detailed findings below
This inspection took place on 6 February 2016 and was unannounced. There were no breaches of regulation at the last inspection on 10 September 2014.
The Gables is registered to provide residential, personal and social care for up to eight people with learning disabilities and an associated sensory impairment. The Gables is a large detached house on a main road between Knaresborough and Harrogate. The immediate local area is Starbeck, which has a number of services and amenities. The registered provider is Homes Together Ltd.
The home has a registered manager in place. 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 were able to tell us what they would do to ensure people were safe. The home has sufficient suitable staff to care for people safely. Staff received regular supervision and they were safely recruited.
People were protected because staff handled medicines safely. The home was regularly cleaned and staff were trained in infection control. Overall the premises were suitable. However, we made a recommendation about the unrestricted access to a first floor balcony, via double doors. We also noted that one bedroom carpet posed a potential risk due to wear and damage caused by a repair and suggested this be replaced as part of the overall refurbishment of the home.
Staff had received training to ensure that people received care appropriate for their needs. Staff were able to tell us about effective care practices and people had access to the health care professional support they needed.
Staff had received up to date training in the Mental Capacity Act (MCA) 2005 and Deprivation of Liberty Safeguards (DoLS). Staff ensured that people were supported to make decisions about their care. People were cared for in line with current legislation and they were consulted about choices as much as possible. People’s needs in relation to food and drink were met. People enjoyed the meals and their suggestions had been incorporated into menus. We observed that the dining experience was pleasant and that people had choice and variety in their diet.
Relatives and other representatives from the local authorities, who visited, told us that the management team communicated with them well and were quick to ask and act on advice or suggestions. People had access to health care services when they needed them. We noted throughout our visit and were told by relatives that people were treated with kindness and compassion. We saw staff had a good rapport with people, whilst treating them with dignity and respect. Staff had a good understanding of people’s needs and worked together as a team. Care plans provided detailed information about people’s individual needs and preferences. People were supported to live their lives the way they chose to. We saw people smiling and engaging with staff. Staff knew how best to communicate with people, this included gestures, touch and key phrases, which the person understood. Staff responded quickly to people’s changing needs and knew people well enough to know when a subtle facial expression or a sound indicated they needed assistance or support. Needs were regularly monitored through staff updates and staff meetings. There had been no complaints or concerns raised in the last twelve months. The registered manager worked with the team, monitoring and supporting the staff to ensure people received the care and support they needed. People told us they got on with the registered manager and that they were approachable and listened to them.
The registered manager and staff told us that quality assurance systems were used to make improvements to the service. We sampled a range of safety audits and looked at the results of a recent quality survey sent out to relatives, healthcare professionals, including social workers.
Below is a summary of what we found. The summary describes what people using the service, their relatives and staff told us, what we observed and the records we looked at.
If you want to see the evidence that supports our summary please read the full report.
This is a summary of what we found:
Is the service safe?
We found safeguarding procedures to be robust and staff understood how to safeguard the people they supported.
Systems were in place to make sure that managers and staff learned from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. This reduced the risks to people and helped the service to continuously improve.
The home had proper policies and procedures in relation to the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards. We also found relevant staff had been trained to understand when an application should be made, and how to submit one. This meant people were safeguarded as required.
The service had been well maintained and we found that it was comfortable and clean. This meant that people were not put at unnecessary risk.
Is the service effective?
People's health and care needs were assessed with them, and they were involved in
developing their plans of care.
New staff had received relevant induction training which was targeted and focussed on improving outcomes for people who used the service. This helped ensure the staff team had a good balance of skills, knowledge and experience to meet the needs of people who used the service.
All the people had a keyworker who supported them with their care and welfare needs. Staff told us how they supported people with any appointments with their doctor, dentist or consultant. They told us that they needed to be flexible and responsive as people's care and support needs can change on a daily basis.
Each staff member we spoke with told us they felt supported in their work. They told us they received a full training programme and had regular supervision and appraisals. One person told us, 'We work as a staff team. We have regular staff briefings. They all told us that they felt supported by the manager and could approach them at any time for support or to raise any issues or concerns.
Is the service caring?
We saw staff communicated well with people and were able to explain things in a way which could be easily understood. People were not rushed when care was delivered and we saw staff interactions with people were caring.
People's preferences, interests, aspirations and diverse needs were recorded and care and support was provided in accordance with people's wishes.
Is the service responsive?
People's care needs had been reviewed at least every month. We saw when people's requirements had changed the provider had responded appropriately and reviewed the care and support they delivered in line with these changes. Care records had been updated to reflect the person's current needs.
People's preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people's wishes.
The service carried out an annual satisfaction survey. Results were collated and analysed and action plans in response were agreed and actioned.
The service provided specialist equipment to meet people's needs;
In this report the name of a registered manager appears who was not in post and not managing the regulatory activities at this location at the time of the inspection. Their name appears because they were still a registered manager on our register at the time.
We found that people were supported to make choices and preferences about their care and support, and people experienced care and support that met their needs.
People had care plans and risk assessments in place which helped staff to understand and meet people's needs. We observed that staff and people who used the service had positive relationships, and staff had the knowledge and experience to meet people's needs. One person told us they liked living at the home.
The agency had systems in place for supporting people with medication and staff were trained in the safe handling of medicines.
There were sufficient staff available to meet people's needs; staffing was arranged flexibly in order that people could be supported in activities of their choice.
The provider had systems in place to audit and monitor the quality of service people received.
We spoke with two relatives of people who use services. They told us 'We went to a lot of places all round the country before we decided on The Gables, and we've never regretted the choice' and 'my relative is really happy there, it's their home.'
Staff told us they felt settled and happy in their jobs, and were well supported by the manager and area manager. We spoke with two social care reviewing officers from Local Authorities who had placed people in the service. They told us they were generally happy with the service, although one had previously raised some concerns over the turnover of staff and managers.
The recently appointed manager and area manager were present for the inspection.
We spoke to a relative by phone who said "The Gables is a brilliant home we have no problems what so ever. My relative likes living there and is very happy" They also told us that if they had any complaints that they would be dealt with appropriately by the home and "any issues would be rectified"
We spoke with the Local Authority Contracts Officer who informed us that they did not have any concerns about this service.