Gable Court Care Home

Gable Court Care Home is a residential care home providing the regulated activities accommodation for persons who require nursing or personal care and treatment of disease, disorder or injury to up to 50 people. The service provides support to older people, some of whom have nursing care needs and/or are living with dementia. At the time of our inspection there were 49 people using the service. This is a purpose build care home, spread over three floors. The upper 2 floors provide nursing and personal care while the ground floor provides support with personal care.

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

Systems were in place to protect people from the risk of abuse. Risk assessments had been carried out to identify the risks people faced. These included information about how to mitigate those risks. Steps had been taken to help ensure the physical environment was safe. There were enough staff working at the service to meet people's needs and the provider had robust staff recruitment practices in place. Medicines were managed in a safe way. Infection control and prevention systems were in place. Accidents and incidents were reviewed to see if any lessons could be learnt from them.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

Quality assurance and monitoring systems were in place to help drive improvements at the service. People and staff told us there was an open and positive culture at the service. People were supported to express their views. The provider was aware of their legal obligations, and worked with other agencies to develop best practice and share knowledge.

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

Rating at last inspection and update

The last rating for this service was good (published 23 November 2021).

Why we inspected

We received concerns in relation to infection control practices, staffing levels, moving and handling and wound care. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe and well-led sections of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Gable Court Care Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Gable Court Care Home is a residential care home providing personal and nursing care to 44 people aged 65 and over at the time of the inspection. The service can support up to 50 people. The service is on three floors. Each floor has separate adapted facilities. There are dining and common areas on each unit and adapted bathrooms.

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

People received their medicines on time and as prescribed by their doctors. Staff had training on safe administration and management of medicines. The service had systems in place to protect people from abuse. Risk assessments were completed and reviewed to ensure risks to people were mitigated and people were safe. There were enough staff to meet people’s needs, and the service carried out pre employment checks to ensure staff employed were suitable and safe to work with people in a care home. There were effective infection control and prevention measures in place. Staff reviewed accidents and incidents to reduce the risk of similar incidents happening again.

The service had quality assurance and monitoring systems in place to help drive improvements. These included regular auditing of different aspects of the service and seeking feedback from people who used the service and others. The service worked with other agencies to help develop best practice. There was a clear management structure in place and staff were positive about how the service was managed.

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

Rating at last inspection and update

The last ratings for this service was requires improvement (published 18 February 2021) and there were two breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations

Why we inspected

We undertook this focused inspection to check they had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection . The overall rating for the service has changed from requires improvement to good. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Gable Court Care Home on our website at www.cqc.org.uk.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

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

Medicines were not always managed in a safe way. The provider did not have effective quality assurance and monitoring systems in place to review and improve the care and support provided. Some relatives told us they thought more staff would be helpful.

Relatives were generally positive about the service and the support people received. Systems were in place to help safeguard people from the risk of abuse. Risk assessments for people included information about how to mitigate the risks they faced. Steps had been taken to ensure the premises were safe. Robust staff recruitment practices were used so that suitable staff were employed. Effective infection control and prevention measures were in place. Accidents and incidents were reviewed to reduce the likelihood of similar incidents re-occurring.

There was a positive working culture at the service and staff felt supported by management. People and relatives were regularly asked for their views about the service. The provider worked with other agencies to share knowledge and develop best practice.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 26 February 2020). The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection enough improvement had not been made and the provider was still in breach of regulations.

The service remains rated requires improvement. This service has been rated requires improvement for the last two consecutive inspections.

Why we inspected

We carried out an unannounced comprehensive inspection of this service on the 5,6 and 10 December 2019. Breaches of legal requirements were found.

We undertook this focused inspection to check the provider had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the key questions of safe and well-led which contain those requirements.

The ratings from the previous comprehensive inspection for those key questions not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has remained requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Gable Court Care Home on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to the safe management of medicines and ineffective quality assurance systems at this inspection.

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

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the 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.

Gable Court is a residential care home providing personal and nursing care to 49 people aged 65 and over at the time of the inspection.

Gable Court is purpose built to accommodate 50 people. The service is on three floors. Each floor has separate adapted facilities. There are dining and common areas on each unit and adapted bathrooms.

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

Risk assessments did not always reflect possible risks to people living with chronic health conditions and did not always include guidance for staff to minimise and mitigate risks.

The service had systems and processes in place to safely administer and record medicines use. However, some medicines were not stored according to legislation.

Quality assurance systems were not always effective to monitor the quality and safety of the service provided. Systems in place were not always effective to protect people’s right to confidentiality.

People and their relatives felt more staff could be available. We have made a recommendation about deployment of staff.

Repairs were not always completed in a timely manner. We have made a recommendation about monitoring repairs.

Staff were trained to support people to take their medicines and measures were in place to protect people from the spread of infection.

People told us they felt safe. Systems were in place to protect people from abuse and the service had notified local safeguarding teams of safeguarding concerns in a timely manner. Pre-employment checks were carried out to ensure staff were suitable to support people. There were procedures for responding to and learning from incidents and accidents.

The service carried out assessments of people’s needs prior to admission to the service to ensure they could meet their needs. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

People were supported to eat and drink enough to meet their needs. Staff had completed required training to perform their roles effectively and felt supported in their role. The service worked with other agencies to promote people’s health, safety and well-being.

People and their relatives told us they were happy with the care and support provided. People and their relatives were included in decisions about their care. People received care and support from staff who were caring and compassionate. Staff treated people in a respectful manner maintaining their dignity and encouraging independence. The service was inclusive and people were respected for their differences.

Care plans were not always detailed to contain information about people’s needs or to guide staff on how to meet their needs. The providers care planning system was under review to ensure personalisation.

People had access to meaningful activities of their choice. People and their relatives told us they felt their views were considered by the service. Complaints procedures were in place and people told us they knew how to make a complaint.

People and staff told us they found the manager approachable and supportive. Staff were positive about the culture of the service.

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

Rating at last inspection

This service was registered with us on 03/12/2018 and this is the first inspection.

Why we inspected

This was a planned inspection.

Enforcement

We have identified breaches in relation to assessing risk and leadership at this inspection. 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.