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. This is the first assessment for this service. This key question has been rated good: This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 67 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them. We received mixed feedback from people in relation to being involved in their care planning, however, people told us staff knew them well and they had chosen not to be involved. One person told us, “I was involved in how my care needs are met, but I am more than able to tell them if anything changes or I change my mind”. Another person said,” I have no idea what is in my care plan, I don’t care as I do what I want and the staff are great, they know what I like”. There was evidence of 6 monthly care plan review meetings involving people and relatives, where care plans had been reviewed, changes had been made. For example, a person had chosen to change the layout of their bedroom to enjoy the views. Daily staff and clinical meetings were completed to share changes with staff in care delivery or any concerns relating to people’s health and wellbeing. Additionally, there was daily handovers and a resident of the day process which reviewed people’s care plans, risk assessments, health records, food preferences and social activities.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. Risk assessments were in place to help identify risk factors specific to each person, such as manual handling, falls and specific clinical needs. This helped provide staff with information on how to manage and minimise these risks and provide people's care safely. However, although there was no impact to people, we highlighted to leaders some areas where there were inconsistencies in information . For example, some peoples care plans had conflicting information regarding the manual handling equipment they required and what their assessed levels of risk were. We shared this with leaders who updated the relevant care plans during our visits. Where required, people’s weight and fluid intake was monitored and reviewed regularly to ensure oversight at management level. People told us the quality food was good, one person told us, “The food is really good and plenty of it”. We observed there were snacks and drinks available for people and several food choices were on offer. We saw where people changed their mind, alternative meals were provided.

The provider worked well across teams and services to support people. People were supported by staff who worked together with other healthcare professionals and external visitors. Staff shared information appropriately and made timely referrals. We spoke with 2 visiting healthcare professional’s during our visits. Both shared there had been recent improvements with communication and responses taken by the service. One healthcare professionals told us, “We have seen some improvements since there has been a change in management. If I make a suggestion, it would be implemented, the staff are very willing to work as a team and work alongside us. Previously it has been a battle, there were so many different staff which caused communication issues. I visit frequently, I now see the same staff, especially seniors, they have very good knowledge of people living here, if I have any queries I speak with (staff member), they are amazing and know everything about people”. Staff told us they work well with other teams, one staff member said, “We have good relationships with district nurses and Advanced Nurse Practitioner (ANP), this is working really well, we discuss referrals and staff do skin checks. If we were concerned, we would share this with healthcare professionals and make a referral”.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support. Care plans evidenced people had access to external professionals, these included GP’s, district nurses, dietitians, chiropodists and Speech and Language therapists. A person commented, “I have Specsavers coming on Friday, I am also at the dentist next month, I arrange the appointments and I tell the staff and they organise transport for me”. The service had an exercise programme which was varied, it included, tai chi, yoga, body balancing with a new dance-based instructor.

The provider routinely monitored people’s care and treatment to continuously improve it. Care plans contained information about people’s health and wellbeing and had been regularly reviewed, however not all of the latest information had been consistently updated throughout people’s care plans. We identified where people’s daily care interventions were recorded, this was not always consistently completed. For example, with oral care support, repositioning charts and nightly welfare checks. Although there was no impact to people, we could not always be assured people received their nightly welfare checks, oral care support or were repositioned as per the guidance in their care plans. We shared this with leaders who told us they had already identified this as an issue as part of their internal auditing processes and had started to take action. Leaders had planned some targeted training courses to ensure staff understood their responsibilities with accurate record keeping. Where people had specific healthcare needs and conditions, these were reviewed regularly by the relevant external healthcare professionals, however we also identified some further detail was required with people’s diabetes plans.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. The provider was working within the principles of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty (DOLS). Leaders ensured Deprivation of Liberty [DoLS] authorisations were sought when needed and any conditions imposed by them were followed. People told us staff ask their consent before carrying out any care tasks. One person told us, "The staff are good, they always ask before they help me, they know how I like things done”. People were supported in line with the Mental Capacity principles, and there were effective systems in place to support people’s rights and choices. Staff had a good understanding of the Mental Capacity Act and how to ensure people’s consent was gained.