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Archived: The Gables Nursing Home Requires improvement

Inspection Summary


Overall summary & rating

Requires improvement

Updated 6 May 2017

This inspection took place on 7 and 8 February 2017 and was unannounced.

The provider is registered to provide accommodation for up to 26 older people living with or without dementia in the home over two floors. There were 11 people using the service at the time of our inspection. The home provides nursing care for older people.

At our last inspection on 20 and 21 September 2016, we served warning notices on the provider in the areas of medicines and good governance. We also asked the provider to take action to make improvements in the areas of person-centred care, safe care and treatment, safeguarding service users from abuse and improper treatment, premises and equipment, and staffing. We received an action plan setting out when the provider would be compliant with the regulations. At this inspection we found that the concerns in the areas of safeguarding service users from abuse and improper treatment and premises and equipment had been fully addressed. However, while improvements had been made, more work was required in all other areas.

The registered manager was no longer working at the home. They had left in September 2016 and a new manager was in place. The new manager had started the process to be registered with the CQC at the time of our inspection. They were available during the inspection. 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.

Staff did not always safely manage identified risks to people. Sufficient numbers of staff were not always on duty to meet people’s needs. The management of medicines required improvement.

Staff knew how to keep people safe and understood their responsibilities to protect people from the risk of abuse. Staff were recruited through safe recruitment processes. Safe infection control practices were followed.

People were not effectively supported by staff to have sufficient to eat and drink. Staff received appropriate induction and training but supervision and appraisal required improvement.

People’s rights were protected under the Mental Capacity Act 2005. External professionals were involved in people’s care as appropriate. People’s needs were met by the adaptation, design and decoration of the service.

Most staff were kind and permanent staff knew people well. People and their relatives were involved in decisions about their care. Advocacy information was made available to people. People received care that respected their privacy and dignity and promoted their independence.

People did not always receive personalised care that was responsive to their needs. Activities required improvement. Care plans required improvement to ensure that they contained sufficient information to guide staff to provide personalised care for people. A complaints process was in place and staff knew how to respond to complaints.

The provider was not fully meeting their regulatory requirements. Some systems were in place to monitor and improve the quality of the service provided, however, they were not fully effective. People and their relatives were involved or had opportunities to be involved in the development of the service.

We found one breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of this report.

Inspection areas

Safe

Requires improvement

Updated 6 May 2017

The service was not consistently safe.

Staff did not always safely manage identified risks to people. Sufficient numbers of staff were not always on duty to meet people�s needs. The management of medicines required improvement.

Staff knew how to keep people safe and understood their responsibilities to protect people from the risk of abuse. Staff were recruited through safe recruitment processes. Safe infection control practices were followed.

Effective

Requires improvement

Updated 6 May 2017

The service was not consistently effective.

People were not effectively supported by staff to have sufficient to eat and drink. Staff received appropriate induction and training but supervision and appraisal required improvement.

People�s rights were protected under the Mental Capacity Act 2005. External professionals were involved in people�s care as appropriate. People�s needs were met by the adaptation, design and decoration of the service.

Caring

Good

Updated 6 May 2017

The service was caring.

Most staff were kind and permanent staff knew people well.

People and their relatives were involved in decisions about their care. Advocacy information was made available to people.

People received care that respected their privacy and dignity and promoted their independence.

Responsive

Requires improvement

Updated 6 May 2017

The service was not consistently responsive.

People did not always receive personalised care that was responsive to their needs. Activities required improvement.

Care plans required improvement to ensure that they contained sufficient information to guide staff to provide personalised care for people.

A complaints process was in place and staff knew how to respond to complaints.

Well-led

Requires improvement

Updated 6 May 2017

The service was not consistently well-led.

The provider was not fully meeting their regulatory requirements.

Some systems were in place to monitor and improve the quality of the service provided, however, they were not fully effective.

People and their relatives were involved or had opportunities to be involved in the development of the service.