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Howard Goble House Requires improvement

Inspection Summary

Overall summary & rating

Requires improvement

Updated 31 July 2019

About the service

Howard Goble House provides care and support for older adults with profound and multiple

learning disabilities and some who live with dementia. It can accommodate up to 12 people over two floors. At the time of the inspection the home was providing care and support to 11 people.

The service has not been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This meant that people who use the service did not live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. However, people using the service did not receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

People's experience of using this service Medicines were not always safely managed. Medicine Administration Records (MAR) were not always completed in full and medicines handover sheets were not always signed. People were protected against the risk of infection. Assessments were carried out to ensure people's needs could be met. Risks were identified, and management plans were in place to manage these safely. Accidents and incidents were appropriately managed, however, learning from this was disseminated to staff.

Appropriate numbers of suitably skilled staff were not available to meet people's needs in a timely manner. Staff were supported through induction, training and supervisions. 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.

Staff were not always kind and caring and people’s privacy and dignity was not always respected, and their independence was not always promoted. People were encouraged to eat a healthy and well-balanced diet. People had access to different healthcare professionals when required to maintain good health.

Information was available to people in a range of formats to meet their communication needs if required. There was a system in place to respond to complaints in timely manner.

There were systems in place to assess and monitor the quality of the service provided, however these were not effective. The service was not currently supporting people with end of life care needs, if they did this would be recorded in their care plans. The provider worked in partnership with key organisations to ensure people's needs were planned and met.

The outcomes for people using the service did not reflect the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support was not focused on them having as many opportunities as possible for them to gain new skills and become more independent.

For more details, please see the full report which is on the CQC website at

Rating at last inspection: The last rating of the service was good (published on 12 January 2017)

Why we inspected: This was a planned inspection based on the previous rating.

Enforcement: Enforcement: We found five breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to person-centred care, dignity and respect, safe care and treatment, good governance and staffing.

Please see the action we have told the provider to take at the end of this report.

Follow up: We will ask the provider to complete an action plan to show what they will do and by when to improve to at least good. We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any

Inspection areas


Requires improvement

Updated 31 July 2019

The service was not always safe.

Details are in our safe findings below.



Updated 31 July 2019

The service was effective.

Details are in our effective findings below.


Requires improvement

Updated 31 July 2019

The service was not always caring.

Details are in our caring findings below.


Requires improvement

Updated 31 July 2019

The service was responsive.

Details are in our responsive findings below.


Requires improvement

Updated 31 July 2019

The service was not always Well-led.

Details are in our well-led findings below.