The Gables

Updated 3 September 2019

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.

Inspection team

The inspection was undertaken by one inspector, one assistant inspector, one Expert by Experience and one specialist advisor on 12 June 2019. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert’s area of expertise was older people and dementia. The specialist advisor was a nursing professional. On the 13 June 2019 one inspector and one assistant inspector returned to the home to complete the inspection.

Service and service type

The Gables is a care home. People in care homes receive accommodation and nursing or personal care as 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 the Care Quality Commission. 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.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. 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 (PIR). 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 four people who used the service and ten relatives about their experience of the care provided. We spoke with two team leaders, one senior, and three care staff, two activities staff, the chef, three housekeepers, the deputy manager, registered manager, and the operations manager. We also spoke with two healthcare professionals who were visiting the home. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We partially reviewed a range of documents and records including the care records for 12 people, 43 medicine records and three staff files and training records. We also looked at records that related to the management and quality assurance of the service.

After the inspection

We continued to seek clarification from the provider to validate evidence found. We looked at training data and quality assurance records.

Updated 3 September 2019

The Gables is a care home providing personal and nursing care for up to 47 people, some of whom were living with Dementia. At the time of the inspection 43 people were living there. The home is divided into two separate units one on the ground floor and one on the first floor. On the ground floor unit, the home supports people with nursing care and dementia needs and on the first floor unit the home supports people with complex needs including Dementia.

The home has four allocated places which are funded by the Local Authority for people that are discharged from hospital and these are called emergency assessment beds. They also have four places which are funded by the Continuing Healthcare team for people discharged from hospital for assessment.

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

People’s privacy was not always maintained as people were seen going into each other’s bedrooms. Feedback from people and relatives told us clothing and footwear often went missing on one of the units. Observations we made supported that staff did not always maintain people’s dignity in a timely manner.

Staff were aware of their responsibilities to keep people safe from harm. People received their medicines as needed. Recruitment processes were in place to ensure staff were safely recruited. Staff wore aprons and gloves to prevent the spread of infections. Systems were in place to analyse any accidents or incidents for patterns and trends, and to enable measures to be put in place to mitigate any identified risks.

Staff knew people’s needs and preferences and had received training which provided them with the skills to support people safely and effectively. People, as much as practicably possible, had choice and control of their lives and staff were aware of how to support them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. People had access to food that met their cultural and dietary requirements. People were supported to maintain their health.

People and relatives we spoke with, described the staff as respectful, caring and friendly. People were supported where possible to maintain their independence.

People and relatives knew how to raise any concerns and had confidence they would be listened to. Complaints had been responded to positively. Information was available to people in an accessible format to support their communication needs.

Some people’s records had not been updated in a timely manner to support changes in their needs to ensure information was available for staff to refer to, and to reflect action that was being taken to escalate concerns about people’s needs.

People, relatives and staff thought the service was managed well and the management team were approachable, open and honest. The service worked well with partner organisations to ensure people’s needs were met. The management team monitored the standards of care provided to people during walk around on the unit and escalated any issues identified.

Rating at last inspection

The last rating for this service was requires improvement following a comprehensive inspection. (Report published 3 February 2017).

Since this rating was awarded the registered provider and the management team of the service has changed and this is the first inspection for this service under the new provider and management team.

Why we inspected

This was a planned comprehensive inspection.

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.

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