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 newly registered 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 75 (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.

The provider ensured peoples care and support needs were effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

We saw evidence of people’s needs being assessed prior to admission and regularly being re assessed and reviewed after their admission.

Families told us that could choose to be involved in the reviews if they wanted to and people generally felt that they were kept up to date with changes in their relative’s needs. However, one family told us “I would like them (staff) to be more proactive about telling us about things. You tend to get to know about things well after the event.”

Staff told us that there were limitations in completing areas within the electronic care plans. For example, staff had to state that a person used a hoist and provide the make and model number even if the person did not currently use one. Staff told us that this was in case the person needed one in the future. This provided a false record of a person’s needs. We discussed this feedback with the provider who agreed the care plans needed to reflect the current needs of people and would amend the care plan details.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

We found evidence of appropriate monitoring, recording and support around pressure care, nutritional needs and personal care needs.

Families told us that they felt the staff knew their relatives and that they were well supported in meeting their needs. A family member told us, "Staff know [relative] needs.”

We saw that referrals were made to health care professionals where there was a concern or change in people’s needs.

Kitchen staff were aware of people’s dietary needs, and we saw evidence of people being supported appropriately with eating and drinking.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff were able to update people’s daily needs and records in real time using handheld devices which were linked to the electronic care records.

Staff and services worked well together however, there were missed opportunities for people where this intervention could have been timelier. For example, one person was known to not always swallow their medication in pill form, and a referral to the GP for liquid medication may have addressed this sooner.

There was regular communication between the staff teams and team meeting minutes reflected these as opportunities to share information, share updates and learning.

Staff told us they felt they were generally well supported within their teams; however, they did feel there could be greater visibility from supervisors when on shift. Staff felt this would support a greater understanding of the day-to-day workings of each unit. A staff member told us, “Supervisors need to be on the units, I feel if they came out a bit more, they would see things.”

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.

Food choices were offered to people which included a healthy eating choice.

A family member told us their relative loved the food and stated, “[Relative] never had as good meals as they have here.” Another family told us, [Relative] loves the food and they often have two portions.”

People were supported to participate in a wide range of available activities, and there was access to a large garden area which offered opportunities for outdoor activities in summer months.

We saw evidence of people being supported to access health care professionals when needed.

People’s health and wellbeing was monitored daily and records within daily notes reflected this.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

People’s needs were regularly reviewed, and care plans were updated. Care plans reflected monitoring of weights, food and fluids and pressure relief. There was evidence of referrals to other services and professionals where risks were noted.

Where people’s needs had changed significantly, we saw evidence that other professionals and families were involved in future planning to ensure people’s needs could be met within the most appropriate environment.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

People’s agreement to consent to care and treatment was evident in their care plans.

We saw evidence of people being asked permission before tasks were undertaken with them.

Staff were trained in the Mental Capacity Act 2005 (MCA). Mental Capacity Act assessments and best interest decisions were recorded on individual care plans and there was evidence of families and Power of Attorney (POA) being involved in Best Interest decisions.