The Gables Retirement Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm.

At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good. This meant people were safe and protected from avoidable harm.

This service scored 69 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

Since our last inspection, a consistent system to oversee and learn from accidents, incidents and falls had been implemented. Further work was underway to ensure learning was fully embedded to mitigate further risks following accidents and incidents. The manager regularly reviewed all accidents, incidents and falls as well as carrying out a root cause analysis of each individual incident, and identifying lessons learned. Themes and trends were explored to reduce risks and improve safety. A lessons learned approach had been introduced into staff meetings, meaning staff were informed on how risks were being managed.

Most relatives felt safety incidents were appropriately managed and communicated. Overall staff were aware of their responsibilities to report and record accidents and incidents, however some had raised with management an uncertainty about the correct procedure when filling out accident and incident forms. This was actioned by leaders and additional training was agreed.

Since our last inspection, care plans and risk assessments had been reviewed and updated. However, not all relatives felt care and support was organised with them. One relative told us, “[Leaders] had updated care plans but not involved relatives, they have rushed to do care plans.” And “We were not asked about [relatives] new care plan. We were told in the relatives meeting that the care plans had been reviewed.” Others felt they were consulted with.

The provider worked with healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. For example, nursing resources from the provider’s other locations were utilised to review and assess people’s skin integrity needs. Care records were informed by advice and recommendation from appropriate professionals and daily records showed care was carried out in line with these assessed needs.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. An organised and systemic overview of safeguarding had been implemented, and leaders were proactive in investigating allegations of abuse, including taking immediate action to ensure people’s safety. They had a good working relationship with relevant authorities to ensure safeguarding concerns were reported. Staff were aware of their responsibilities in relation to safeguarding and were supported by relevant training and policies. One staff member told us, “We are focusing to protect our residents from negligence, abuse and any harm.”

People were observed to be comfortable in the presence of staff. Safeguarding information was visible around the service to support people to recognise signs of abuse, and how to report concerns.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Care plans and risk assessments identified and assessed risks to people and provided sufficient and consistent guidance for staff to support people safely. For example, diabetes care plans clearly outlined the signs and symptoms of high, or low, blood sugars for staff to look out for. Where people communicated signs of distress, care plans provided a good level of detail on de-escalation techniques.

People were observed to be supported in line with their care plans. For example, where people needed moving and handling support. Another person was supported to wear or carry their glasses with them at all times as this was identified as a mitigation for falls risks.

Some areas within the home were still visibly worn, tired or in need of refurbishment. For example, floors in need of replacement, chipped paint on walls and woodwork. The provider was continuing to work through their refurbishment plan to update the premises and assured us these would be addressed. Since our last inspection, some rooms had been fully re-decorated, and the outdoor space maintained.

Systems were in place to ensure immediate repairs were reported and fixed promptly.

Improvements had been made in the recording of routine health and safety checks, and we were assured that robust systems were in place to monitor the environment and servicing of equipment.

The provider made sure there were enough qualified, skilled and experienced staff, who received effective support, supervision and development.

Staffing levels were informed by the dependency needs of people using the service. During our inspection, staffing levels were in line with the assessed needs of the service and staff were observed to be deployed effectively. Communal spaces were observed to be supervised during our site visit. Overall, staff and relatives felt staffing levels were safe.

Overall, staff had received training to support them to carry out their roles safely. Some staff fed back that further face to face training would be beneficial. The provider agreed to review and provide this. Additional support and performance reviews were implemented as required. Staff demonstrated a sound understanding of the needs of the groups of people supported, such as those with communication needs. Relative feedback included, “[Staff] have the knowledge and training to look after the residents.”

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly. Overall, the home was clean. People were observed to be supported to maintain good personal hygiene. Staff followed good infection, prevention and control (IPC) practice and this was discussed at staff meetings.

The provider made sure that medicines and treatments were safe and met people’s needs, capacities and preferences. Since our last inspection, medicines had been reviewed, and improvements had been made to the safe storage, administration and management of medicines.

Processes to ensure the safe use and management of controlled drugs were in place. Controlled drugs were stored safely, and regular checks on stock were documented.

Where people required medicines to manage behaviour, an updated protocol was in place to provide appropriate guidance on signs and symptoms which would indicate the medicine was required. Staff demonstrated a good understanding of how to manage signs of distress.

Medicine administration records were fully completed. For example, when codes were used to show people had not had their medicines, notes were made to provide further information. Fridge and room temperatures were regularly completed, and in line with recommended temperatures. Regular medicine audits and checks were completed to ensure effective oversight of medicines. Relevant policies and procedures were in place to support safe medicine management.

Relatives confirmed their loved ones received their medicines as prescribed, and medicines were reviewed. One told us, “No issue with medication, [person] does get it on time. The nurse practitioner comes every Wednesday if needed in between, they will administer pain relief.” And, “When [person] wasn’t well, the nurse from the surgery came. They did another review and the medication was changed. They keep me informed.”