Background to this inspection
Updated
23 December 2022
The inspection
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.
Inspection team
The inspection was completed by one inspector.
Service and service type
St Gabriel’s House - Apartments is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. St Gabriel’s House - Apartments is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Registered Manager
This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.
At the time of our inspection there was not a registered manager in post. A manager had been employed and been working at the service for a month.
Notice of inspection
We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection.
Inspection activity started on 17 October 2022 and ended on 20 October 2022. We visited the service on 17 October 2022.
What we did before the inspection
We reviewed information we had received about the service since registration. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We met all the people living at the service and we spoke with one person and two relatives about their experience of the service. We observed staff interactions with people in the communal areas. We spoke with six members of staff including the manager, head of service, carers and agency staff.
We reviewed a range of records. This included three people’s care plans and all the medication records. We reviewed a variety of records relating to the management of the service, including checks and audits.
Updated
23 December 2022
About the service
St Gabriel’s House - Apartments is a residential care home providing personal care to seven people at the time of the inspection. The service can support up to eight people. People’s accommodation was on the first floor of the building and split into two flats including communal areas.
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
People’s experience of using this service and what we found
Right Support
People were supported by mainly agency staff who were not trained to support people to pursue their interests in their local area and achieve their goals. People were not consistently supported to lead fulfilling and meaningful everyday lives. Staff did not always have the skills to communicate with people in the way they preferred.
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 able to personalise their rooms. Staff supported people to play an active role in maintaining their own health and wellbeing. Staff supported people to make decisions following best practice in decision making.
Right Care
People had not always been protected from abuse, incidents between people living at the service had not been reported to the local safeguarding authority as required. The service did not have enough appropriately skilled permanent staff to meet people’s needs such as activities.
People’s care, treatment and support plans reflected their range of needs. People were treated with kindness, staff respected people’s privacy and dignity. Staff who knew people well understood people and responded to their needs.
Right Culture
People were supported by two permanent staff, regular agency staff and a rotation of new agency staff this did not provide people with the opportunity to lead inclusive and empowering lives. Staff did not always know people and understand their needs.
Staff responded to people’s wishes on a daily basis and respected people’s choices in how they wanted to spend their time.
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 6 July 2021 and this is the first inspection.
The last rating for the service under the previous provider was Good, published on 25 January 2020.
Why we inspected
This inspection was prompted by the length of time since the service had registered with CQC.
We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.
Enforcement
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.
We have identified breaches in relation to protecting people from abuse, management of medicines, oversight of the service, training of staff and person centred care at this inspection.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will request an action plan from 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 continue to monitor information we receive about the service, which will help inform when we next inspect.
Special Measures
The overall rating for this service is ‘Inadequate’ and the service is therefore in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the registration.
For adult social care services, the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.