The Gables

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the service met people’s needs.

At our last inspection we rated this key question good. At this inspection the rating has remained good. This meant people’s needs were met through good organisation and delivery.

This service scored 68 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People were not always at the centre of their care and support choices. The provider did not always ensure staff worked in partnership with people, to decide how to respond to any relevant changes in people’s needs. Some staff interactions were task focused rather than person focused. For example, when 1 person required assistance staff dismissed the concern and focused on supporting them when they did the ‘toilet round.’ This toilet round created a predefined time for supporting people without accounting for changing needs outside of these times. Some people’s care and support plans required greater and more consistent detail for staff to effectively respond to their needs. For example, 1 person’s mobility assessment was confusing, and another’s did not account for some aspects of their needs including their non-concordance with personal care. Whilst some aspects of people’s care records reflected people’s care needs, our observations indicated that these preferences were not always met in practice. These issues meant people were not at the centre of all care interactions.

The service understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity. People’s diverse needs and wishes were identified by the provider and recorded. People told us they received support which promoted their individual backgrounds and cultures. One person described how they were provided with food which was reminiscent of their background. People’s individual circumstances were known by the staff supporting them. When it was appropriate these were shared with other healthcare services to promote inclusive care and continuity. One healthcare partner told us, “Communication between the service and healthcare partners was good, with regular contact as needed. The GP carried out a weekly ward round, supporting continuity of care for residents.

The service supplied appropriate, accurate and up-to-date information in formats that were tailored to individual preferences. People had their individual communication needs recorded which were known by staff. For example, relatives were involved with their family member whose verbal communication had changed. They supported staff with learning new words specific to this person’s first language to help them engage better with them.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. One person told us about their food preferences. They said, “I don’t ask as I try to keep a low profile, they tell me I moan and that I’m a fussy eater.” Another person said they didn’t like to ask for things as they didn’t want to be seen as a troublemaker. However, others told us if they told staff they didn’t like something they were responded to positively. One person told us they were happy to talk with any staff member if they had a concern and felt they would be supported appropriately. The provider had systems in place to seek feedback from people and relatives and to respond to compliments, complaints or comments. This included a process for investigation and feedback to the relevant person’s if needed. Despite the provider’s systems some people still did not feel involved in their home or felt their comments were invited.

The service made sure that people could access the care, support and treatment they needed when they needed it. All those we spoke with told us they were promptly referred to healthcare services and outside support if it was needed free from discrimination.

Staff and leaders actively listened to information about people who were most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this. When it was appropriate and needed the management team and staff advocated on behalf of people to ensure they had access to services that matched their individual care needs.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life. People, and when needed those close to them, were supported to identify their wishes for future care. These were recorded in their personal care and support plans which would move between healthcare providers, if necessary, to ensure their wishes went with them.