The Gables Retirement Home

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.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 71 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Whilst care plans had been reviewed and updated since our last inspection, we received feedback these had not always been done with people and those important to them. Some relatives felt improved communication was needed regarding people’s day to day care. Leaders planned to conduct annual reviews with people and their families. We discussed the importance of involving people as much as possible in the care planning process.

People’s health, care, wellbeing and communication needs had been assessed and reviewed. Consideration had been made to how individual diagnoses could impact on other aspects of people’s care and support needs, such as the impact of diabetes on skin integrity.

Leaders audited care plans. These checks were detailed and focused on ensuring people’s holistic needs were clearly assessed and documented. We found improvements had been made in the accuracy and consistency across people’s care plans and risk assessments.

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.

Nationally recognised tools informed people’s care and daily care records showed people received support in line with their assessed needs. For example, where people needed regular repositioning to maintain their skin integrity, this was carried out. Food and fluid targets were monitored to ensure people were eating and drinking sufficient amounts.

Weights were regularly monitored and concerns about weight loss were appropriately managed. For example, referrals to dietician, increased weight monitoring and fortified diets.

People were given choices in what they wanted to eat. During our inspection, kitchen staff explained to people the menu options for the day but clearly explained they could be flexible and make anything of their choice. People told us they preferred home cooking. Relatives told us, “The choice of meals is OK. [Person] eats pretty well, they are offered snacks and biscuits and a cup of tea. Their weight is stable.” Another said, “They try to make [person] things they like, such as cheese on toast. They are trying to get [person] to eat. They tried all the flavours of Fortisips. Some of the residents love the food there.”

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.

Systems were in place to share information internally, and externally. This included changes in people’s needs and concerns about health and/or safety. The manager worked well with the providers off-site support systems to monitor people’s care and support.

Overall staff reported improvements in collaborative working. One staff member told us, “It feels a lot better, all the staff are working as a team now.” And “Staff are more cooperative and supportive than they were before.” Some staff felt further improvements were needed to ensure the use of agency staff led to consistent ways of working.

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. Records showed people were supported by relevant healthcare professionals as required, including recommendations given. Additionally, there was a weekly ward round with a visiting advanced nurse practitioner, and systems in place to flag changes in need or health deterioration.

Relative feedback confirmed people were supported to access relevant healthcare professionals. For example, “[Person] sees a chiropodist, and gets seen by dentist and district nurse if needed.” And, “They rang me letting me know [person] had an audiology appointment.”

A ‘hydration station’ initiative had been put in place to encourage people to drink more and promote independence.

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.

Clinical risks were clearly outlined in people’s care records, including signs and symptoms of health deterioration for staff to monitor and how to escalate if required. Systems were in place to monitor daily care tasks. Changes in people’s needs and any actions required were raised with the manager on a daily basis. For example, where people had not met their fluid targets. This meant prompt actions could be taken to ensure people achieved good outcomes.

Overall, relatives were satisfied with the communication about their loved one’s health outcomes. One relative told us, “Staff let me know referral options, I asked about their teeth. I have no complaints.” Another said, “Staff phone me and tell me anything I need to know. Hospital appointments they keep me up to date.” Leaders discussed the importance of prompt communication with families at their staff meeting.

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

Since our last inspection, mental capacity assessments had improved to ensure they followed the principles of the Mental Capacity Act (2005) when supporting people who lacked capacity to make decisions about their care and treatment. Ongoing reviews of all mental capacity assessments were still in progress.

Staff supported people to make everyday choices where possible. We observed staff talk through the support they were providing, such as when moving and handling.