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Archived: The Gable Requires improvement

The provider of this service changed - see old profile

The provider of this service changed - see new profile

Inspection Summary


Overall summary & rating

Requires improvement

Updated 29 November 2018

We carried out an inspection of The Gable on 1 and 2 October 2018. The first day was unannounced. The Gable is a 'care home'. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission (CQC) regulates both the premises and the care provided, and both were looked at during this inspection. The Gable provides accommodation and care and support for up to six people with a learning disability. The service does not provide nursing care. There were six people living in the home at the time of the inspection.

At the time of our inspection, we were informed the ownership of the home had change. Appropriate applications had been forwarded to CQC for consideration.This meant new systems and records were being introduced at the time of our inspection.

The Gable is a large end terrace in a residential area close to Burnley town centre. The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

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.

At the last inspection on 16 and17 November, the overall rating of the service was 'requires improvement' and our findings demonstrated there were three breaches of the regulations in respect of unsafe management of medication, failing to ensure risks to people's wellbeing and safety were assessed and managed and a lack of compliance with the Mental Capacity Act 2005. The service was rated "Requires Improvement." Following the last inspection, we asked the provider to complete an action plan to show what they would do and by when to improve the service.

At this inspection we found the provider was in breach of five regulations of the Health and Social Care Act (Regulated Activities) Regulations 2014. They related to the provider having insufficient risk assessments, unsafe processes for the management of medication, a lack of appropriate training for new staff, lack of oversight of the service and a lack of compliance with the Mental Capacity Act 2005. You can see what action we told the provider to take at the back of the full version of the report.

At the last inspection, the service was rated as overall 'requires improvement,' at this inspection the rating had remained as 'requires improvement.'

We were aware the proposed new provider was committed to an extensive programme of development which would improve people's lives. This included changes to the environment, policies and procedures and to the records and systems. During this inspection, we found changes were in progress.

We found there were management and leadership arrangements in place to support the day to day running of the home. However, the provider needed to ensure better oversight of the service to ensure they were meeting the regulations and that the service was effectively managed.

There had been improvements to the management of medication since our last inspection and an updated medication policy, including "covert medication" guidance was due to be issued by the new provider.

We found that people's concerns and complaints were not always acted upon and risks around individuals were not fully assessed and managed safely. A safeguarding alert was raised during the inspection, due to concerns raised by a person living at the home.

People were supported to have choice and control of their lives and staff supported them in the least res

Inspection areas

Safe

Requires improvement

Updated 29 November 2018

The service was not safe.

People's concerns were not being acted upon appropriately and safeguarding procedures were not always being followed.

Risks to peoples individual safety were not being assessed and managed properly.

Care records were not stored securely.

Guidance around medication was not effective.

Effective

Requires improvement

Updated 29 November 2018

The service was not always effective.

People were encouraged and supported to make their own choices and decisions. However people's care and support was not always provided in line with the principles and requirements of the Mental Capacity Act 2005.

Staff had not always received adequate training to carry out their roles and responsibilities.

Caring

Requires improvement

Updated 29 November 2018

The service was not always caring.

People told us they were happy with the care and support they received.

People told us the staff were caring and we observed positive interactions between staff and people using the service. However, one person raised concerns about the conduct of one staff member and this is currently being investigated.

People were supported in a way which promoted their dignity, privacy and independence.

Responsive

Requires improvement

Updated 29 November 2018

The service was not always responsive.

People's care plans did not always contain the most up to date information about individuals.

There were processes in place to manage and respond to complaints. However, these were not always addressed appropriately.

People were consulted about their care. Some people had individualised person-centred plans.

People had access to community resources and most people were happy with the choice of activities offered to them.

Well-led

Inadequate

Updated 29 November 2018

The service was not well led.

Auditing and monitoring systems were not robust enough to identify the issues noted during the inspection.

Certain actions identified from the previous inspection had not been actioned.

The registered manager was not always clear about her legal responsibilities as a registered manager and had been reluctant to follow safeguarding procedures.

People at the service and staff members felt that the registered manager was approachable and had an "open door" policy.