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Archived: Gable Court Care Home Good

The provider of this service changed - see new profile

Reports


Inspection carried out on 09/09/2015

During an inspection to make sure that the improvements required had been made

This inspection took place on 09 September 2015 and was unannounced. At the last inspection on 15 January 2015 we saw care plans had not been reviewed monthly as outlined in the services record keeping policy and there was gap in the recording of care. After the comprehensive inspection, the provider wrote to us to say what they would do to meet legal requirements in relation to the breach.

We undertook this focused inspection to check that they had followed their plan and to confirm that they now met legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Gable Court Nursing Home on our website at www.cqc.org.uk.

Gable Court Nursing Home provides personal care, including nursing care for up to 51 people in a purpose built building located in a residential area. The service is arranged over three floors and there are garden and patio areas. Most people’s rooms have an attached private bathroom.

The service does not have 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. The previous registered manager was no longer working for the service.

At this inspection we found the provider had taken sufficient action to ensure people were protected from the risks of unsafe care and support as we found care records had been reviewed and updated regularly to reflect the needs of people.

Inspection carried out on 15 January 2015

During a routine inspection

This inspection took place on 15 January 2015 and was unannounced.

At our last inspection on 29 April 2014 we found the provider needed to make improvements to meet some of the standards we reviewed which included management of medicines, staffing levels, staff training and supervision and assessing and monitoring the quality of service provision. During this visit we saw that the service had made improvements in those areas.

Gable Court Nursing Home provides personal care, including nursing care for up to 51 people in a purpose built building located in a residential area. The service is arranged over three floors and there are garden and patio areas. Most people’s rooms have an attached private bathroom.

There was 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.

Safeguarding procedures were robust and staff understood how to safeguard the people they supported.

Records confirmed people’s preferences, interests, aspirations and diverse needs had been recorded and care and support had been provided in accordance with people’s wishes.

People who used this service were able to make choices with regard to their daily lives such as what they would like to wear or when to eat or whether they would like to join in any activities.

People’s needs were assessed and care and support was planned and delivered in line with their individual care plan.

The service had suitable arrangements in place to protect people against the risks associated with the unsafe management of medicines, which included the obtaining, recording, administering, safe keeping and disposal of medication.

There were systems in place to monitor how the service was run to ensure people received a quality service. People using the service, their relatives and other professionals involved with the service completed an annual satisfaction survey. Where shortfalls or concerns were raised these were addressed.

Inspection carried out on 9 April 2014

During Reference: not found

Inspection carried out on 29 April 2014

During a routine inspection

Gable Court Nursing Home provides personal care, including nursing care to up to 51 people in a purpose built building located in a residential area. At the time of the inspection, 38 people were using the service, most of them had needs relating to their physical health, and some of them had dementia. The service is arranged over three floors and there are garden and patio areas. Most people’s rooms have an attached private bathroom.

The previous registered manager of the home left the service in February 2014. At the time of the inspection, the manager of the home, who had taken up her role in March 2014, had not yet applied to be registered with the Care Quality Commission. A registered manager is a person who has registered with the Care Quality Commission to manage the service and shares the legal responsibility for meeting the requirements of the law with the provider. The situation will be kept under review by us to ensure Gable Court has a registered manager.

Most people who used the service and their relatives told us the service was effective in planning and meeting people’s needs in relation to their health. A person’s relative told us, “one of the staff is brilliant and they knew exactly what to do when [my relative] was going downhill. They made sure they got the treatment they needed.” Records showed staff had worked with health professionals to ensure people’s complex needs were met effectively.

Staff understood their responsibilities in relation to people who may lack the mental capacity to make decisions about their care and support. People’s relatives were involved in making decisions in their best interests. We did not observe any restrictions on people and staff understood their legal responsibilities in relation to the Deprivation of Liberty Safeguards. The service complied with the requirements of the Mental Capacity Act 2005.

People said that staff were kind but very busy. A person’s relative told us that, “staff give people the basic care but have not really had time to get to know them or find out anything about their past life or interests.” People said there were delays in them receiving their meals in their rooms which meant food was not as hot or appetising as it could have been. They also said that their tea and coffee was sometimes not hot. A person told us, “when you are in your room all day, these little things matter.” A person’s relative told us that they had noticed that people did not always receive their care promptly whilst in their rooms upstairs. They said this was especially evident when staff were away from the upper floors taking people to and from activities on the ground floor.

Some people attended a range of activities which took place on the ground floor of the home during the week. They told us they enjoyed them. Most people stayed in bed in their rooms on the first and second floor of the home. Some of these people said they preferred to do this, but other people told us that they felt isolated and bored in their rooms. A person’s relative told us, “it is very quiet upstairs.”

The manager told us that the provider calculated the staffing budget for the home from information she supplied to them on the number of people using the service and their level of need. During the inspection we found that there were insufficient staff to meet people’s needs.

The manager told us she anticipated that new people would be moving into the home and staffing levels would be adjusted accordingly. She said she was looking at the arrangements for activities and how people received their meals and drinks in order to improve people’s experience of the service.

We checked how people’s medicines were managed. We could not be certain that people had consistently received their medicines safely as prescribed. This was because staff had not kept accurate records.

We also spoke with staff and checked the arrangements that were in place to provide them with training and support. Although some staff had received appropriate supervision and training, we found that other staff had not been given all the support they required to deliver people’s care to the required standard.

The provider carried out checks on the quality of the service which had identified areas for improvement. However, there were no clear timescales for the implementation of these changes. There were breaches of health and social care regulations. The action we have asked the provider to take can be found at the back of this report.

Inspection carried out on 13 June 2013

During a routine inspection

People told us that the service was able to meet their health care needs. One person said "my glasses were not good, I asked for a new pair and I got them the next day." Another person replied "yes they do" when asked if staff new how to meet their needs. We found that care plans and risk assessments were in place which set out how to meet people's individual needs.

People told us they felt safe at the service. We found that staff had undertaken training on safeguarding vulnerable adults and that they knew how to respond to allegations of abuse. We found medications were stored securely and that they were properly administered.

We found that staffing levels had increased since the previous inspection, and that there were now enough staff to meet people's needs. The service had various systems in place for monitoring the quality of service provided.

Inspection carried out on 2 August 2012

During a routine inspection

People told us they were treated with respect, and that they are involved in choosing how they are cared for and supported. One person told us, “I normally tell them I like things done a certain way, and they do it.” People said that they liked the staff, but that there were not enough of them. One person said, “They are always short staffed. There are a lot of people here for two carers. Sometimes we don’t get our tea at 11am or 3pm and I have to ring my bell.”

Inspection carried out on 12 September 2011

During an inspection to make sure that the improvements required had been made

On this visit we did not speak to anyone who uses the service about the way that the home manages their medicines.

We observed that the care home was very busy and people had to wait for their mid-morning drink. We also noted that one of the care plan's read during our visit lacked essential information.

These observations were discussed with a visiting registered manager from a local BUPA service, and with the nurse-in-charge at the time of the inspection. We were informed that one member of staff was off sick and a replacement person could not be found at short notice.

We will be following up these findings by carrying out another unannounced inspection.

Inspection carried out on 7 June 2011

During an inspection in response to concerns

People living at Gable Court told us that they received help with their medication; they were supported with eating and drinking and they felt that the staffing arrangements met their needs.

Reports under our old system of regulation (including those from before CQC was created)