The Gables

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question requires improvement. At this assessment, the rating remains the same. This meant the service management was inconsistent.

The provider and interim manager have since the last inspection made the required improvements to the statement of purpose for the service. However, we did identify issues in relation to audits and medicine records as detailed in safe. Therefore, there is a continuing breach of good governance.

This service scored 62 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The service had a shared vision, strategy and culture. This was based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and understanding challenges and the needs of people and their communities.

The provider has made sufficient improvements since the last inspection and the service is no longer in breach of the requirement to have a statement of purpose.

There was now a clear vision for the service which focused on making the required improvements to the service and empowering staff to take the lead in providing people with person centred care. The provider’s statement of purpose clearly set out the aims and objectives for the service. Staff and leaders told us the team were as a result now “pulling in the same direction” and understood their roles and responsibilities.

The service had inclusive leaders at all levels who understood the context in which they delivered care, treatment and support and embodied the culture and values of their workforce and organisation. Leaders had the skills, knowledge, experience and credibility to lead effectively. They did so with integrity, openness and honesty.

The interim manager who is also the registered manager of the provider's second home has managed the service since the last inspection, with the support of the new expanded senior leadership team. The interim manager has used their experience capability and integrity to change the culture of the service, address risks and drive a significant number of improvements to the service since the last inspection. Staff spoken to said, the manager was “Approachable, fair and balanced." A relative told us, “The people running the place are very good.”

The provider has recently appointed a permanent manager for the service who will be supported during the transition period by the interim manager. This will provide consistency and continuity for both people and staff.

The service fostered a positive culture where people felt they could speak up and their voice would be heard.

Staff and leaders acted with openness, honesty and transparency. The provider had policies and processes in place that supported staff to speak up and raise concerns. Staff spoken with told us they felt able to speak up and records confirmed staff had the opportunity to speak up, provide feedback and to drive improvements.

The service valued diversity in their workforce. They work towards an inclusive and fair culture by improving equality and equity for people who work for them.

Staff spoken with told us they were treated fairly and equitably. Leaders were able to tell us about the adjustments which could be made in order to support staff who required additional support. The provider had policies in relation to equal opportunities and diversity.

Governance systems were in place but were not all fully robust to ensure any new and emerging risks would be identified.

The provider’s clinical governance processes implemented since the last inspection now included a range of audits to assess risks and the quality of the service. Staff did not always complete all of the audits thoroughly and some lacked sufficient detail to make them fully effective.

The provider had not identified the risks we identified in relation to the environment and medicines as detailed in safe. Staff had completed health and safety audits and daily walkarounds but had not identified the risks we found with the fire door, the external fire escape, the night fire drills or the safety checks for the TMV’s. Staff completed a personnel audit, however this did not fully reflect legal requirements for recruitment information, so therefore did not identify the issues we found.

The provider’s governance processes had not identified that 3 statutory notifications had not been submitted to CQC as required. The interim manager ensured these were submitted as soon as this was brought to their attention and this omission had not impacted people’s safety.

The providers polices had not been reviewed since 2023, to ensure they were accurate and reflected current legislation and practice guidance. Staff did not sign and date them, in order to demonstrate who had last reviewed them.

However, the interim manager and staff have, since the last inspection completed the majority of identified actions from the provider’s service improvement plan. There has been strong progress in driving improvements, however, further work is required to ensure all audits completed are fully effective.

Processes were in place to assess the performance of the service monthly against a range of quality indicators. The provider has ensured the additional conditions upon their registration have been met.

The service understood their duty to collaborate and work in partnership, so services work seamlessly for people. They share information and learning with partners and collaborate for improvement.

Staff and the interim manager were open and transparent and had worked with external partners following the last inspection to make improvements to the service. The interim manager understood when referrals were needed and the associated criteria and pathways and there was guidance for staff. The interim manager explained to us to whom and how referrals were made locally.

The interim manager had engaged more external entertainers from the community to provide a greater level and range of activities for people. The local church group visited the service monthly, to meet people’s spiritual needs.

The service focused on continuous learning, innovation and improvement across the organisation and local system.

The interim manager had a good understanding of how to make improvements happen and had made many changes which had improved the service for people. Improvements had been made since the last inspection in relation to safety, the culture, person centred care, staffing, the environment and IT systems. There was a comprehensive action plan in place for the service.

Leaders were responsive when issues were identified for improvement and keen to progress and make improvements. The interim manager applied learning from other settings. For example, actions had been taken as a result of learning they had identified from safety incidents which had in care homes in other parts of the country.