About the service The Gables is a residential care home providing personal care for up to 10 people with mental health issues, including both younger and older adults. At the time of the inspection there were 10 people using the service.
The home is a converted house in Bedlington Station. It has accommodation on the ground and first floor. There is no lift or stair lift to access the upper floor. There is a lounge area on the ground floor and a small dining room. People have access to shared bathroom and washing facilities and a shared laundry area. There is a secure courtyard area at the rear of the building which contains a small hut that people can use for smoking.
People’s experience of using this service and what we found
People were not always supported in a safe environment. Risks related to people’s care were not always well detailed or actions identified to mitigate risks. Infection control procedures were not robust and did not meet current recommendations. Staff recruitment processes were not robust and staffing levels were not regularly assessed or reviewed. Systems around supporting people to manage their finances required review. We have made a recommendation about this. People were supported to receive their medicines safely and appropriately.
People’s needs had not always been fully assessed or reviewed. Staff training was being reviewed and updated the manager was over seeing this. People told us they enjoyed the meals at the home and were able to suggest changes to the menu. They were assisted to attend health appointments and maintain their well-being. People were supported to have considerable 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 practice.
People told us they were well cared for and they enjoyed good relationships with the staff. They told us that staff respected their privacy and dignity. There was some evidence people were involved in making decisions about their care, although this was not always well recorded.
Care plans were not always up to date and did not contain the most recent advice from professionals. Reviews of care were not always detailed. People were supported to maintain relationships with friends and family and were able to participate in activities. Staff reminded people about safety procedures when accessing the community during the pandemic. There had been no formal complaints in the last 12 months, but people said they could raise any concerns with the manager or the provider.
The manager at the home was not formally registered with the CQC. There was no evidence on CQC systems to show an application process had been started. People and staff told us the manager had made improvements to the service. Some quality checks and audits were in place, although they were not robust and did not cover significant areas, such as infection control. There was no substantive oversight of the quality of care by the provider. Staff said they were well supported by the manager and were able to raise issues if they wished to.
We found breaches in regulation 9 (Person centred care); regulation 12 (Safe care and treatment); regulation 17 (Good governance) and regulation 18 (Staffing).
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 1 August 2019 and this is the first inspection.
The last rating for the service under the previous provider was good (published on 27 May 2017.)
Why we inspected
We received concerns in relation to several areas of care at the home. We had also twice spoken to the manager whilst undertaking an Emergency Support Framework call (support call during the Covid-19 pandemic) and highlighted that the service required ongoing support. As a result, we undertook a comprehensive inspection to review all the key question areas.
The overall rating for the service is requires improvement. This is based on the findings at this inspection. We have found evidence that the provider needs to make improvement. Please see all sections of this full report. You can see what action we have asked the provider to take at the end of this full report. The provider has taken some action to mitigate immediate risks at the home.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for The Gables Care Home on our website at www.cqc.org.uk.
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 to hold providers to account where it is necessary for us to do so.
We have identified breaches in relation to regulation 9 (Person centred care); regulation 12 (Safe care and treatment); regulation 17 (Good governance) and regulation 18 (Staffing). 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 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 return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.