Archived: Gables Manor

Gables Manor is a residential and nursing home providing personal and nursing care to 19 people with learning disabilities and/or autism at the time of the inspection. The service can support up to 20 people in one adapted building. There are two floors with bedrooms on the first floor and some ground floor bedrooms and communal areas.

The service demonstrated the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.

The service was a large home, bigger than most domestic style properties. It is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were no identifying signs or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.

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

People were happy living at the service. A person said, “The staff are nice; they are good to me.” A relative told us how they could tell from the person’s behaviour that they were content, happy and enjoyed participating in daily activities around the service.

People felt safe at the service and protected from the risk of abuse. Staff assessed risks to people’s health and safety and took action to keep them safe. There were enough staff to support people. Arrangements were in place for the safe management of people’s medicines.

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, although this was not always fully documented.

The service applied the principles and values of Registering the Right Support and other best practice guidance. The outcomes for people using the service reflected these principles and values. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

Staff worked closely with other services to provide effective care and achieve good outcomes for people. People received a balanced diet based on their preferences. We have made a recommendation about monitoring people’s weight and nutritional status.

Staff were responsive to people’s individual needs and wishes and had an in-depth knowledge about each person. People were supported to access services outside the home and to participate in activities within the local community.

There was good leadership and management of the service. The quality of the service was monitored and when improvements were needed, action was taken to address these.

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

Rating at last inspection

The last rating for this service was Good (published 19 April 2017).

Why we inspected

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

At the last inspection the service was rated Good. At this inspection we found the service remained Good.

People continued to be protected from the risk of abuse and felt safe. Staff had a good understanding of their roles and responsibilities if they suspected abuse was happening. The manager shared information with the local authority when needed.

People received their medicines as prescribed and the management of medicines was safe.

People continue to be supported by sufficient numbers of staff who had received adequate training for their role.

People were supported to have maximum choice and control over their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported these practices.

People were protected from the risks of inadequate nutrition. Specialist diets were provided if needed. Referrals were made to health care professionals when needed.

People who used the service, or their representatives, were encouraged to contribute to the planning of their care. People were treated in a caring and respectful manner and staff delivered support in a relaxed and considerate manner.

People received individualised person centred care from staff who had a good understanding of their needs. They were supported to take part in a range of social activities of their choice.

People who used the service, or their representatives, were encouraged to be involved in decisions and systems were in place to monitor the quality of service provision. People also felt they could report any concerns to the management team and felt they would be taken seriously

Further information is in the detailed findings below

We received an action plan from the provider that told us the steps they would take to rectify the identified problems.

At this visit we looked at the contingency and emergency plans that the provider had put in place and we spoke to staff.

We found that the provider had in place good policies, procedures and clear instructions to staff to be followed in the event of a foreseeable emergency.

We looked at records. These included care plans and information about how the service was managed. We conducted a tour of the building and observed the interactions between the care staff and people residing at the home.

Records we looked at showed that people's needs had been assessed and appropriate support provided to care for their needs. However the provider did not have the necessary arrangements in place to help ensure that people would be cared for and supported in the event of a foreseeable emergency such as fire or flooding.

We found that people were provided with a choice of suitable and nutritious food and drink. One person living at the home told us, 'The food is alright. If I don't like it I tell them and they get me something else. I tell the cook the way I like chicken to be cooked and she does it that way.'

We saw the building was undergoing a major project of refurbishment and extension and that the work was coming to an end.

We saw that there were sufficient numbers of suitably qualified and experienced staff to ensure good quality, safe support and care was maintained.

People were cared for in a safe environment that was well led and managed.

We carried out an inspection of the home and observed what changes had been made.

We spoke with a member of staff and the Business and Corporate Services Manager for the provider and discussed with them the planned improvements to the premises.