Gable Lodge

Updated 9 December 2022

The inspection

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 Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

This inspection was undertaken by one inspector.

Service and service type

Gable Lodge is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Gable Lodge is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We also reviewed the action plan submitted following their previous inspection and other information we hold about the service.

We used all this information to plan our inspection.

During the inspection

We observed care and spoke with one person. We spoke with three staff including the registered manager, a senior care worker and a care worker. We reviewed two people’s care records, people’s medicines management records, staffing records and records related to the management of the home. We reviewed the safety of the environment.

Updated 9 December 2022

About the service

Gable Lodge is a residential care home providing personal care to up to 9 people. At the time of our inspection five older people, some of whom were living with dementia, were using the service. Gable Lodge does not provide nursing care.

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

Whilst improvements had been made to fire safety procedures we found that a safe environment was not always provided and people had not been appropriately protected from the risk of injury from falling from height due to windows not being appropriately restricted. Nevertheless, a homely environment was available and people were able to personalise their rooms. Work had been completed on bathrooms and accessible wet rooms.

There were safe staffing levels and staff received regular training and supervision to ensure they had the knowledge and skills to undertake their role.

Staff were knowledgeable about the people they supported. 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 provided people with support related to their personal care, their nutritional needs and health care. Staff were aware of the risks to people’s safety and how to support people to mitigate those risks. People received their medicines as prescribed. Staff worked with other health and social care professionals to ensure people received coordinated care.

However, we found that care records were not sufficiently detailed meaning there was a risk that people may not get appropriate care if being supported by new staff or agency staff.

There were systems in place to review governance systems however, they had not picked up the improvements required found at inspection. People, their relatives and staff were asked for their feedback about the service and these were used to improve practices. The registered manager attended provider forums and webinars to learn about best practice guidance.

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

Rating at last inspection and update

The last rating for this service was requires improvement (published 18 May 2021) and there were breaches of regulation. The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found the provider remained in breach of regulations. The service remains rated requires improvement. This service has been rated requires improvement for the last three consecutive inspections.

Why we inspected

We carried out an unannounced inspection of this service on 17 March 2021. Breaches of legal requirements were found. The provider completed an action plan after the last inspection to show what they would do and by when to improve their governance arrangements and the delivery of safe care and treatment.

We undertook this focused inspection to check they had followed their action plan and to confirm whether they now met legal requirements. This report only covers our findings in relation to the Key Questions Safe, Effective and Well-led which contain those requirements.

Enforcement and Recommendations

We have identified continued breaches in relation to safe care and treatment and good governance. 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 continue to monitor information we receive about the service, which will help inform when we next inspect.