We carried out a review of the data available to us about The Gables Care Home on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about The Gables Care Home, you can give feedback on this service.
We found the following examples of good practice.
• The registered manager told us a nominated relative and/or friend for each person was spoken with on a weekly basis to give them updates. E-mails /letters which set out any changes to COVID-19 guidance and guidelines such as restricted visiting (appointment only) were also sent. People were supported to have socially distanced visits from friends and family.
• There was a named infection prevention and control lead at the service. Staff had specific infection prevention and control training including COVID-19 training. They also had additional training around handwashing and how to put on and take off their PPE safely. Housekeeping staff had training from an external company about equipment and cleaning products to use during COVID-19.
• The provider had invested in an air sanitizer with a UV light that killed viruses and bacteria. This was used in the communal areas of the service. The provider had also organised a monthly ‘anti-viral fogging machine’ from an external company, to be used throughout the building. This is a special machine which lets out an anti-bacterial mist, designed to destroy viruses in the air or on surfaces.
• Infection prevention and control audits were completed. The registered manager undertook handwashing and PPE spot checks on staff.
Further information is in the detailed findings below.
The Gables Care Home is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The care home accommodates up to 49 people in a two-storey property. The original listed building has been extended to include additional accommodation. There were 29 people living at the home at the time of our inspection visit.
At the last inspection in January 2016, the service was rated 'Good'. At this inspection, we found the service remained 'Good' as the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated any risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
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.
The service is rated as good as the provider and registered manager had maintained the standard and quality of care that people received.
The service was safe as people were supported by staff who were knowledgeable about safeguarding and its reporting processes. Risk assessments were in place and these promoted people to make decisions about their safety. Systems were in place including policies and staff training about infection prevention and control. A sufficient number of staff had been recruited safely and they were deployed in a way which met people's needs in a timely manner. Actions were taken to learn any lessons when things did not always go as planned. Medicines were administered as prescribed and they were managed safely.
The service was effective as people received a service that met their assessed needs by staff who had been trained to have the skills they needed. People were supported with their eating and drinking to achieve a healthy lifestyle. Staff enabled and supported people to access healthcare services when this was required. The registered manager and staff team worked with other organisations to help ensure that people's care was coordinated and person centred. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported this practice.
The service was caring as people’s needs were met in a kind, considerate and compassionate way. People were made to feel they mattered by staff who put people first and foremost. People were involved in their care and staff promoted their independence in a way which helped ensure each person had equal opportunities. Staff knew the people they cared for well and respected people’s privacy and dignity.
People received a responsive service. Staff used their skills to support each person with a huge variety of meaningful stimulation. This gave people many opportunities for them to be able to reminisce about their pasts. Staff encouraged people to retain their independence and uphold people's dignity. People were completely involved in their care by staff who responded wholly appropriately to each person’s preferences. Staff ensured that people's well-being and active community engagement was enabled in a way which made a huge difference to people’s lives.
The service and its staff team supported people to feel good about themselves and to have positive emotions by encouraging people to stay active and socialise with others. There were regular planned pastimes for people as well as other spontaneous activities, which completely considered people's individual interests and hobbies and this helped prevent social isolation. Concerns were responded to before they became a complaint. Staff worked well with other stakeholders to ensure that peoples end of life care was well managed and this helped ensure people could have a dignified death.
The service was well-led as the registered manager led by example and fostered an open and honest culture within their staff team. Quality assurance, audit and governance systems were effective in driving improvements. Staff were given the means to achieve their potential including regular support and training which was based on each staff member’s role. Staff were reminded of their responsibilities and this made a positive difference to the quality of people’s lives. People, staff and external stakeholders had a real say in how the service was run and their views influenced changes. Continuous improvement was seen by all staff groups as a day to day activity where people came first and foremost. The registered manager and their staff team worked in harmony with other organisations.
Further information is in the detailed findings below.
The Gables Care Home is registered to provide accommodation for up to 49 people who require nursing and personal care. At the time of our inspection there were 20 people living at the service. The service is located in the town of Chatteris close to local shops, amenities and facilities. On-site parking is provided as well as the home being easily accessible to people, staff and visitors. Access to the accommodation is provided by stairs, stair and passenger lifts to the first floor. There are two floors which people are able to access freely. Bathing and shower facilities are available for people with this preference.
This unannounced inspection took place on 20 January 2016.
The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.
All appropriate recruitment checks had been completed to ensure that staff were safe to work with people who used the service. These checks helped the provider determine staff’s suitability for the role they had applied for. People’s needs and preferences were met by an appropriate number of staff in a timely manner. An effective induction process was in place to support new staff.
Safe medicines administration was undertaken by trained staff whose competence to do this had been assessed. Staff were knowledgeable about identifying any potential harm to people and also the correct reporting procedures.
The CQC is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS) and to report on what we find. The registered manager and staff were knowledgeable about when an assessment of people’s mental capacity was required. No person using the service currently met the criteria to be lawfully deprived of their liberty. However, not all staff had an embedded understanding of the MCA and how a DoLS would be determined. This meant that there was a risk that people could be provided with care that was not always in their best interests.
Staff understood and were attentive to people’s needs and supported people in a compassionate manner. Staff knew what was meaningful and important to people. People’s privacy and dignity was respected by staff.
People and their relatives or representatives were involved in planning the care they/ their family member received. Staff ensured that people’s care plans and records were regularly reviewed and updated. The registered manager provided people with information on accessing independent advocacy if any person required this support.
Arrangements were in place to, respond to and, support people with their health care needs. This was by the most appropriate, or a combination of, health care professionals such as speech and language therapist or occupational therapist. Health care professional advice was adhered to by staff. Up-to-date risk assessments to help safely support people with risk to their health were in place and these were kept under review according to each person’s needs.
People were supported to achieve and maintain a healthy weight. Sufficient quantities of food, drinks and snacks for people were made available to people when they wanted. This included a choice of appropriate diets for those people at an increased risk of malnutrition, dehydration or weight loss.
People were given various opportunities to help identify and make key changes or suggestions about any aspects of their care. People were supported with a wide range of hobbies, social interests and stimulation. Staff recognised and responded promptly to any situations where people were unhappy about any aspects which affected their day-to-day living.
A range of effective audit and quality assurance procedures were in place. These were used as a means of identifying areas for improvement and also where good practice had been established. Information regarding the running of the service and people’s care was shared through a range of forums including residents’, managers’ and staff meetings.
The registered manager kept themselves aware of the day to day culture in the service. They supported staff as well as engaging with people on a day to day basis.
Below is a summary of what we found.
Is the service safe?
People who we spoke with told us that they felt safe and they liked the staff. One person said, “I am settled here. The staff are kind.” Assessments of any potential risks to people had been carried out and measures put in place to reduce the risks. This meant that people were protected from the risk of harm. People were protected from the risk of infection because appropriate guidance had been followed.
People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.
The provider had a system in place to demonstrate that they had given consideration to whether each person using the service had the capacity to make decisions about their day to day care under the Mental Capacity Act (2005). The Mental Capacity Act is a law which requires an assessment to be made to determine whether a person can make a specific decision at the time it needs to be made. It also requires that any decision made on someone’s behalf is recorded, including the reasons why it has been made, how the person’s wishes have affected the decision and how they were involved in the decision making process.
Is the service effective?
People we spoke with told us, and our observations confirmed, that people were happy with the service which they received. Staff we spoke with told us they enjoyed their job. Some staff expressed concerns that since more people had come to live at The Gables, they did not always have time to meet the needs of each person. It was clear from our observations, and from our conversations with staff and the manager, that staff knew people’s needs well. One person who used the service, one person's relative and one health professional expressed the view that on occasions staff seemed very rushed.
Staff worked closely with professional health staff to ensure that people’s needs were met by staff with the most appropriate, knowledge, skills and experience.
There were effective recruitment and selection processes in place. Appropriate checks were undertaken before staff began work.
Is the service caring?
One of the staff we spoke with said, “I enjoy working here.” We observed that people were listened to and staff spoke to people and responded to them in a respectful and kind way. Staff told us how they supported people and they spoke in a caring and sensitive way about each person’s needs.
We spoke with five people who used the service. Each person said that the staff were kind and caring. One person who used the service said, “The staff look after us well here.” One person’s relative said, "I am very satisfied with the care my family member receives."
Is the service responsive?
People’s needs and care plans were regularly reviewed by the staff and management at the home. Referrals were made to health professionals to ensure that people received appropriate support by people with the most appropriate knowledge and skills.
Support plans included information on people’s likes and dislikes and their preferences, to ensure care and support was delivered taking into account their personal preferences. The staff we spoke with told us they were trained to do their job and knew how to meet the needs of people using the service.
People participated in a range of activities of their choice and were encouraged to participate in activities within the local community.
Is the service well led?
Staff told us they received regular supervision and appraisals. They told us they received guidance from the management team. Some staff told us they did not always feel well supported by the management team, who sometimes seemed very busy.
The majority of relatives we spoke with told us they felt the service was well-managed. Relatives we spoke with said they were confident to raise any concerns or complaints they had with the manager. One relative said, "The manager is very approachable.”
The provider had effective quality assurance and audit systems in place to monitor all aspects of the service and ensure improvements were made where necessary.
All of the people who we spoke with had positive comments about the standard and quality of their support and care and had no cause to complain. However, they said that, although there were opportunities for them to engage in activities, they told us that they would like to do more different things.
People who used the service said that they felt safe living at The Gables Care Home. There were financial and staff systems in place to protect people who used the service from the risk of abuse.
Members of staff said that they enjoyed their work, which they found rewarding. They also said that they had the support and training relevant to safely do their job. People, who used the service, and a visiting health care professional, said that they had confidence in the ability of staff to provide people with safe and appropriate care.
Arrangements were in place for people who used the service, their family members and members of staff, to make suggestions and comments about the standard and quality of the service provided at The Gables Care Home. There were also checking systems in place to make sure that people who used the service were protected from unsafe support and care.