We carried out a review of the data available to us about Gables on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Gables, you can give feedback on this service.
We found the following examples of good practice.
There were clear instructions at the entrance of the building to minimise the risk of infection. Information was displayed throughout the service providing guidance on minimising the spread of infection through regular handwashing.
Staff had received training on infection prevention and the correct use of personal protective equipment (PPE). There was a designated area for donning and doffing of PPE and there was adequate stock available.
The service was visibly clean and regular cleaning was undertaken including touchpoints such as light switches and door handles.
Policies and procedures for the effective management of Covid-19 were in place. Audits were undertaken to check on infection control practices and make any improvements necessary.
The provider was following the government guidance on whole home testing for people and staff.
Gables is a residential care home that provides accommodation and personal care support for up to seven people who have a learning disability and or autistic spectrum disorder. At the time of our inspection there were six people living at the service. Accommodation is provided within a domestic dwelling in a residential community setting.
The service has been developed and designed in line with 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.
People’s experience of using this service and what we found
We recommended systems were put in place to ensure staff record alternating the site on the body when applying transdermal patches as per the manufacturer’s guidance.
People were protected from abuse. Staff understood how to recognise and report any concerns they had about people's safety and well-being. There was enough staff to keep people safe and provide them with support that met their needs. Risks to people health and wellbeing were assessed and mitigated.
There were systems in place for the safe storage of medicines. Staff were trained, and competency assessed to administer people's medicines safely.
Staff had access to relevant training, regular supervision and annual appraisal. This equipped staff with the knowledge and skills they needed to fulfil their roles and meet people’s needs.
Nutritional needs were met. People were supported to access healthcare services if they needed them. Health care needs were closely monitored and any changes to people’s health and wellbeing was responded to in a timely manner.
Staff knew people well, were passionate about providing personalised care and treated people with dignity and respect. 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.
Staff demonstrated a good understanding of the people living at the service and created opportunities for maximising their independence and life skills. Staff worked in partnership with other social care and health care professionals to ensure people received the support they needed.
The service consistently applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion.
The registered manager and provider had a range of systems in place to monitor the quality and safety of the service and these were reviewed on a regular basis.
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 2 June 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.
The provider changed their corporate name so they were required to re-register with the Commission under the new name. Although this was the first inspection of The Gables under the new registration, it has been an established service for many years.
The Gables is a residential care home that provides care and support for up to seven people who have a learning disability and/or autistic spectrum disorder. At the time of our inspection there were seven people who used the service.
A registered manager was in post at the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
Quality assurance systems were in place to help to ensure the service delivered was of a high quality, safe and continued to improve. We have made a recommendation about improving aspects of health and safety assessment and monitoring because we identified wardrobes were not secure and posed a potential risk of harm to people if they were pulled over.
People were protected from bullying, harassment and potential abuse. This was done consistently so that people were safe whether they were in the service itself or out in the community. Management and staff had a positive attitude towards managing risk and keeping people safe. Detailed management strategies provided guidance for staff on what actions to take to minimise the risk and provide appropriate and individualised support to people that enabled them to participate in activities of their choice and access the community safely.
The provider had a thorough recruitment and selection process in place to check that staff were suitable to work with people who used the service. People were supported by sufficient numbers of staff. Staffing levels were flexible and supported people to follow their interests and take part in social activities and, where appropriate, education.
Medication was stored safely and administered correctly. The provider had robust systems in place to ensure medication was managed safely and appropriately.
Staff had developed good relationships with people living at the service and respected their diverse needs. They were caring and respectful and had the required knowledge and skills they needed to meet people’s needs appropriately and safely. Staff knew each person’s individual care and support needs well. People’s privacy and dignity was respected and upheld and they were supported to express their views and choices by whatever means they were able to. Staff clearly understood each person’s way of communicating their needs and anxieties.
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 support this.
People had a choice of balanced, healthy and nutritious meals and were able to eat their meal where they wanted. Nutritional assessments were in place which identified what food and drink people needed to keep them well and what they liked to eat.
People received personalised care specific to their individual needs; their independence was encouraged and their hobbies and leisure interests were supported. They received continuing specialist help with any medical condition and had prompt access to healthcare professionals when they became unwell. Each person had a health action plan which detailed how they were being supported to manage and maintain their health.
The provider had arrangements in place to routinely listen and learn from people’s experiences, concerns and complaints. There was a strong emphasis on promoting good practice in the service and there was a well-developed understanding of equality, diversity and human rights and management and staff put these into practice. The registered manager inspired confidence in the staff team, and led by example.