The Gables

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last inspection we rated this key question good. At this inspection the rating has remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 63 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People’s care and treatment was not always effectively planned or recorded. For example, the management team described 1 person’s needs. They identified this person can be resistant to certain types of intervention from staff members. However, this was not recorded in their care or support plans. Another person had confusing instructions on how to support them with their mobility. This inconsistency put people at the risk of receiving a contradictory approach from staff members. However, we saw other instances where people’s care and support was well documented giving instructions to staff on how best to assist. One healthcare partner told us they believed information following professional visits was usually recorded in the person’s electronic record. Important information was handed over to the manager or senior carer, who they believed shared the information with carers and ensured it was in the persons care plan.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. All those we spoke with could not recall being involved in the completion of their care or support plans. No one could recall being involved in any reviews. Some aspects of people’s care were well documented including diet and nutrition. However, some areas required clearer instructions, including mobility. We spoke with the management team who stated they recognised this was not effectively recorded. However, the care plans were reviewed by a key worker but conversations with people had taken place during the previous month rather than in a single conversation. The management team committed to review how they involved and captured people’s views regarding their care needs.

The service worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. People told us the staff worked well with other healthcare providers to ensure they received a positive outcome. One person told us how they were reassured by the management team at The Gables sharing appropriate information with a healthcare partner effectively. A healthcare partner told us they communicate as needed and felt they had good communication with the manager. The GP carried out a weekly ward round.

The service supported people to manage their health and wellbeing to maximise their independence, choice and control. People were supported to live healthier lives through regular access to health care professionals such as their GP's. People we spoke with told us they were referred for additional support without any delays if they needed it. The management team monitored changes in people’s wellbeing. For example, unexplained weight loss. Any concerns were acted on. For example, referring to GP services for advice and guidance. One healthcare partner told us there was a good working relationship with the carers and management team and they had effective communication channels with named points of contact at both sides.

People could not always be assured they were being supported by a management team or staff who fully understood what ‘good outcomes’ were or how to achieve these. We saw nonspecific risk assessments and care plans regarding people’s mobility and eating and 1 person choking.

People told us they had to wait for assistance at times when they were in discomfort and 1 person was living in unacceptable conditions. The provider was not supporting one person to achieve positive outcomes in relation to the cleanliness of their living environment. People told us they had to wait for assistance at times when they were in discomfort.

These were examples where people had experienced poor outcomes. However, in other instances, the service monitored people’s individual health changes to identify if any additional support was required. One person told us they had regular appointments to regarding their health. They went on to tell us staff referred them for any additional help if they needed it including arranging hospital appointments and supporting them to attend consultations. They found this reassuring.

The service told people about their rights around consent and respected these when delivering person-centred care and treatment. Everyone we spoke with told us they agreed for the care and support they received. Where necessary the provider had procedures in place to engage people with legal authority or responsibility to make decisions within the requirements of the Mental Capacity Act 2005. This included the duty to consult others such as carers, families and/or advocates, where appropriate. Where it was needed the provider completed appropriate applications in line with The Deprivation of Liberty Safeguards (DoLS). This is a legal framework under the Mental Capacity Act 2005 to safely support people where there is a requirement to restrict their liberty.