Gable Healthcare Services Ltd

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 good. At this assessment the rating has changed to requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 54 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not check with people for accuracy of information on their health and care needs during assessment prior to admission to the service. Assessment tools for identifying risk were either inconsistent, incorrect or not in place in people’s homes. For example, 1 person’s falls risk assessment included that they had diabetes, there was no evidence of this in their records or the initial handover assessment from the commissioning body, it also stated that they used mobility aids when they were in fact immobile and had been since they were admitted to the service. Where people had been assessed with a specific need, information for staff was vague. For example, where 1 person was assessed as at risk of bowel obstruction their nutrition care plan was generic as per other people’s nutrition care plans it stated, “Ensure [person] is eating a varied and balanced diet”. There was no evidence of discussion with the person or a family member to establish any problematic foods that increased the risk of constipation for the person, their normal bowel pattern or what foods and drinks the person found relieved their symptoms. We found 1 person’s care plan contained detailed information on their communication needs. However, this was not available in the persons home for staff guidance.

The provider did not plan and deliver people’s care and treatment with them. They did not always follow legislation and current evidence-based good practice and standards. We were not reassured that people were fully involved in the planning of their care, for 1 person there were no signed care plans in their home to evidence any involvement in planning. It was unclear how often care reviews involving people were taking place as there was no evidence of this. Although dates on records suggest relatively regular reviews of care by staff, the information in the records was mostly either incorrect or inconsistent so we were not reassured people had been involved in the review process. One person’s care plan described countries they had enjoyed visiting, however, on discussion with the inspector they had never been to 1 of the countries listed. This same person was able to tell the inspector what their mobility and continence needs were and the care staff present agreed that this was what was being delivered, but recently reviewed records did not reflect those needs. We found 2 nutrition care plans to be generic, not reflecting a person centered approach and referred to National Minimum Standards that were relevant to care homes had not been part of legislation for over 10 years.

The provider did not always work well across teams and services to support people. The provider had not ensured effective communication and information sharing with Commissioners, safeguarding teams and CQC. The provider had failed to attend a number of meetings with commissioners and had not always shared information on request with stakeholders who were investigating concerns or ensuring contractual agreements were being met. For example, the provider failed to attend follow up site visits and share information when requested on a number of occasions with stakeholders. CQC requested information that was either not provided or did not answer our queries on a number of occasions. Staff told us they had the information they needed to provide safe care and treatment and they were able to have input into care planning. A staff member said, “We help with this [care planning] as we know [person] really well”. However, we found the provider did not always amend records to contain consistent information across documents. Risks to people were somewhat mitigated by having a regular team of staff that knew them well. Staff told us they mostly worked with the same people and people we spoke with confirmed this.

We did not look at Supporting people to live healthier lives during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Monitoring and improving outcomes during this assessment. The score for this quality statement is based on the previous rating for Effective.

We did not look at Consent to care and treatment during this assessment. The score for this quality statement is based on the previous rating for Effective.