Archived: Red Gables

We found people's care records were regularly updated, however the assessments did not always reflect people's needs and in some cases showed people's needs had not been properly assessed. Assessments for some people who required nursing care lacked nursing input. We found care was not always planned and delivered to meet people's needs.

We found the provider did not have enough suitably experienced nursing staff and there was a large use of agency staff which led to poor continuity of care.

The provider did not have adequate systems in place to monitor the quality of the service provision and there were not adequate mechanisms in place to seek the views of people who used the service, their representatives or staff. There was a lack of evidence that concerns raised by people's relatives and staff were adequately addressed.

We found that an accurate record was not maintained in respect of each service user as documentation was not always completed.

However we found evidence the provider had not identified risks to people's health, safety and welfare so appropriate care and treatment could be planned and delivered. We found the provider had failed to promptly identify and act on weight loss of people who used the service. We found people's needs had not been regularly re-assessed following changes to their needs.

We found the provider had systems in place to ensure people were provided with suitably nutritious food and appropriate assistance was provided at mealtimes.

We found the provider did not have enough staff to meet the needs of people who used the service and was heavily reliant on agency staff.

Robust arrangements were not in place to ensure that the quality of the service was continually assessed. The provider had not identified and acted quickly enough on emerging risks to the service.

We found appropriate documentation was not in place in relation to each person who used the service. Records were disorganised and sometimes missing.

People who used the service, their relatives and friends all told us they were happy with the standard of care at the home. One relative told us 'Mum is well looked after, I am confident when I am not here that she is ok.' Another relative told us 'I am very happy with the care here.'

We found the provider asked people for consent before they helped with care or support tasks. The provider had processes in place which ensured that where people did not have the capacity to make a decision, relatives and advocates were involved to ensure the decision made was in their best interests.

We found people experienced care, treatment and support that met their needs and protected their rights.

However we found people were not always protected against the risks of inadequate nutrition. The lunchtime meal was rushed and nutritional assessments and care plans had not been updated following weight loss.

We found the building was homely, well maintained with appropriate facilities to care for the needs of the people who used the service.

We found the home had appropriate systems in place to listen and act on people's comments and complaints.

We looked at the staff rotas for four weeks prior to the inspection and saw there were four staff during the day and three at night. The Registered Manager also told us they had completed recruitment of three new care staff to ensure the numbers could be maintained at the current levels. We observed care over the lunch period and saw staff available to support people who used the service. We did not see anyone waiting for support.