The Gables

Updated 5 February 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 Care Act 2014.

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 carried out by two inspectors on day one and one inspector on day two. An Expert by Experience spoke with relatives remotely. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

The Gables is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with CQC. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced on the first day. We told the registered manager we would be visiting on the second day.

What we did before inspection

We reviewed information we had received about the service. We sought feedback from the local authority and professionals who work with the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.

During the inspection

We spoke with nine people that use the service and 12 of their relatives. We spoke with 19 staff including the registered manager, supervisors, care workers, domestics and chef. We gathered feedback from one health and social care professional that regularly visits the service. We reviewed a range of records. This included 15 people’s care records, multiple medicine records, two staff recruitment files and three staff supervision and appraisal records. We looked at records relating to the management of the service, including staff rotas, quality assurance checks and accident and incident records.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at a sample of the provider’s policies and procedures.

Updated 5 February 2022

About the service

The Gables is a residential care home providing personal care to 43 people at the time of the inspection. The service supports younger adults, older people, people with physical disabilities and people living with dementia. The service can support up to 60 people.

The Gables accommodates people in one adapted building with five separate units, each of which has separate adapted facilities. The service has a central hub with a café, hairdressing salon and shop.

People’s experience of using this service and what we found

People were at risk due to a lack of consistent record keeping and oversight by the registered manager and provider. The provider’s quality assurance checks had not been sufficiently robust to identify issues we found on inspection. This included with assessments and care plans not always being in place. The provider gave assurances lessons would be learnt following the inspection. The registered manager showed us examples of the improvements they had started to make to records.

Despite the shortfalls we found with health and safety and risk record keeping, people and their relatives told us they felt safe at the service. Staff knew how to respond to any safeguarding concerns and acted immediately in response to any emergencies. Medicines were managed and administered when needed. Appropriate measures were in place to support infection prevention and control to keep people safe.

Care staff provided effective care; they were knowledgeable about people’s care needs and had the skills to support them. The provider did not always complete assessments or care plans to guide staff in delivering people’s care and ensure they received consistent care. We made a recommendation that the provider risk assesses the external environment at the service.

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 and their relatives consistently praised the caring approach by care staff, which made people feel at home at the service and part of The Gables family. Care staff made time to support people’s emotional wellbeing. People’s privacy and dignity were respected.

Care staff provided person-centred care, they knew people’s needs and preferences. People were able to join in with a wide range of activities, developed according to their needs and abilities. Relationships between people, their family and friends were supported via in-person visits, video calls and telephone calls. People had not felt the need to raise any complaints as they were able to discuss their care and any improvements needed to their care arrangements with care staff. We made a recommendation about end of life care planning.

For more details, please see the full report which is on the Care Quality Commission (CQC) website at www.cqc.org.uk.

Rating at last inspection

This service was registered with us on 01/05/2019 and this is the first full inspection.

Why we inspected

This was a planned inspection based on when the service was registered.

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 have identified breaches in relation to person-centred care and good governance. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.