The Gables

Ratings

• Overall

  Requires improvement

• Safe

  Inadequate

• Effective

  Requires improvement

• Caring

  Good

• Responsive

  Good

• Well-led

  Requires improvement

Our view of the service

Date of assessment 21 May 2024 to 17 June 2024. This was a responsive inspection following the identification of ongoing risks at the service. The service remains inadequate in safe and requires improvement in effective. The key question of well-led has improved from inadequate at the last inspection to requires improvement. Just before this assessment began, the registered manager left, and they were replaced on an interim basis by a registered manager from the provider’s second service. People were still not receiving a safe service; they were not adequately protected from the risk of harm. Staff had not always identified or mitigated risks to people and people did not receive their medicines safely. The environment was not safe, nor was it completely clean. Staff did not have a sound understanding of legislation and good practice in relation to the use of any restrictions. Staff were not fully supported in their role. People’s consent to their care was not always sought or legal requirements met where they could not consent. People experienced a lack of choice for their meals and lacked sufficient input into decisions about the home. Staff did not understand the purpose of the service and lacked sufficient guidance and leadership. We found 5 continuing breaches of regulations in relation to consent, safe care and treatment, safeguarding, governance and staffing. We identified 2 new breaches in relation to premises and lack of a statement of purpose. However, the new interim manager was motivated to make the required changes to improve the standard of care people received. They were already taking action to engage with people, relatives and staff about the required changes and to seek their feedback. They wanted to support the new registered manager once appointed to continue to make and embed change in the service.

People's experience of this service

While the people and relatives we spoke to expressed that they were generally happy with their care, our assessment found elements of care did not meet the expected standards. Some people and relatives reported issues in relation to aspects of the service such as managing risks, the environment, medicines, assessing needs, meals, consent, and partnerships. We were told a person’s item of equipment was broken. All the people we spoke with on-site told us although the meals were alright, there was a lack of choice. People had mixed experiences about being involved in their care planning, some reported they had been involved and others had not. Relatives whose loved one’s were living with dementia liked the fact they were accommodated with people who were not living with dementia, but they were not always assured their needs were met if they could not communicate their wishes verbally. However, people and relatives said overall they were satisfied with the care they received. They felt safe with staff and said they could raise concerns with them. They told us staff were kind and had time for them. They felt there were enough staff. People felt supported to attend any appointments which were arranged. Relatives told us they could visit freely and take their loved ones out.