Gables Care Home

Updated 30 January 2024

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

The inspection team consisted of 3 inspectors, 2 medicines inspectors and 2 Experts by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Gables Care Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Gables Care Home is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 12 people and 16 relatives about their experience of the care provided. We spoke with 18 members of staff including the registered manager, senior home manager, quality assurance manager, digital lead manager, operations director, divisional director, digital lead manager, quality manager, a chef and care staff. We also received written feedback from 4 other staff members.

During the inspection we reviewed 7 peoples medicine records including MAR charts, support plans and care plans.

We reviewed documentation, inspected the safety of the premises and carried out observations in communal areas. We reviewed a range of records including 3 people’s care records and quality audits. We looked at 2 staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were also reviewed.

Updated 30 January 2024

About the service

Gables Care Home provides accommodation, personal and nursing care for up to 64 people, across 4 separate wings. Two of the wings provide nursing care and one of these specialises in providing nursing care to people living with dementia. At the time of the inspection there were 32 people living in the home.

People’s experience of using this service and what we found

People were not always supported to receive their medicines in a safe way. Staff did not feel supported and did not receive regular supervisions in line with the provider’s policy. Risks to people were assessed but risk assessments were not always updated to reflect people’s changing needs. The quality and safety of the service was not fully monitored. Quality systems in place at the service hadn’t indicated shortfalls found during the inspection.

There were malodours evident throughout the home and some areas were not thoroughly cleaned.

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice.

Staff did not always meet people’s social needs. There were limited activities available that were not always reflective of people’s individual hobbies and interests. We have made a recommendation about this.

Staff morale was low in the home. People and relatives were happy with the service. However, there was limited evidence that people and relatives were consulted about the development of the home. We have made a recommendation about this. Staff felt that they were not kept informed of changes in the home and communication with management was poor.

People and relatives felt the service was safe. Staff safeguarded people from abuse. There were enough staff to meet people’s needs. Accidents and incidents weren’t thoroughly recorded although there was limited evidence that the provider learned from accidents and incidents to mitigate future risks.

People’s needs were assessed before they moved into the home and on an ongoing basis. Staff were suitably trained. People were supported with their nutritional needs and to access a range of health care professionals.

Staff treated people with respect and supported them in a dignified manner and in line with their wishes. Relatives told us, “The staff are a credit to the home; I can’t fault them. They are very supportive, and they listen” and, “The quality of the staff is what makes the home a good one.” Staff were passionate about their roles and caring for people. One staff member said, “All I want is for the residents to be happy and comfortable.”

Care plans detailed how people wished to be supported. Staff knew how to effectively communicate with people, although alternative communication methods were not always detailed in care records. People and relatives knew how to raise concerns and any complaints received were investigated and actioned in line with the provider’s policy.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk.

Rating at last inspection

The last rating for this service was good (published 28 February 2020).

Why we inspected

The inspection was prompted in part due to concerns received about staffing, culture, medicines management, governance, management and the safety of the service. A decision was made for us to inspect and examine those risks.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

We have found evidence the provider needs to make improvement. Please see the safe, effective, caring, responsive and well-led sections of this full report.

Enforcement and Recommendations

We have identified breaches in relation to safe care and treatment, consent to care, good governance and staffing. We have also made recommendations around activities and engaging with key stakeholders to improve services.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.