The Care Quality Commission
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Archived: Five Gables Care Home

Overall: Good read more about inspection ratings

113 Victoria Road, Kirkby-in-Ashfield, Nottingham, Nottinghamshire, NG17 8AQ (01623) 752512

Provided and run by:
Mr & Mrs A Pearce

Important: The provider of this service changed. See new profile

All Inspections

4 August 2015

During an inspection looking at part of the service

We carried out an unannounced comprehensive inspection of this service on 18 and 19 November 2014. One breach of the legal requirements was found. This was because the provider had not always ensured the proper and safe management of medicines.

After the comprehensive inspection, the provider wrote to us to say what they would do to meet the legal requirements in relation to the breach. We undertook this focused inspection on the 4 August 2015 to check that they had followed their plan and to confirm that they had now met the legal requirements. This report only covers our findings in relation to those requirements. You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for Five Gables Care Home on our website at www.cqc.org.uk

Five Gables Care Home provides accommodation for up to 16 people who require nursing or personal care. On the day of our inspection 12 people were using the service. Some of the people were living with dementia or other mental health conditions.

There was a registered manager in place. 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.

At the focused inspection on the 4 August we found the provider had not followed all parts of their plan which they had told us would be completed by the 17 April 2015. All parts of the legal requirements had therefore not been met.

The three people we spoke with did not raise any concerns with us that they did not receive their medicines or received them in a way that did not meet their needs. However, people’s medicine administration records were not always fully completed to show when they had taken or refused to take their medicines. Protocols were not always in place for staff to follow when administering medicines that had been prescribed on an ‘as required’ basis. The reasons for staff administering these types of medicines was not always recorded nor reviewed by the registered manager. People’s care plans did not always reflect people’s current needs for their medicines. This was a continued breach of this Regulation.

You can see what action we told the provider to take at the back of the full version of the report.

18 to 19 November 2014

During a routine inspection

We carried out an unannounced inspection of the service on 18 and 19 November 2014. Five Gables Care Home provides accommodation, personal care and the treatment of disease, disorder or injury for up to 16 people. On the day of our inspection 15 people were using the service and there was a registered manager in place.

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.

The Care Quality Commission (CQC) is required by law to monitor the operation of the Mental Capacity Act 2005 (MCA) and the Deprivation of Liberty Safeguards (DoLS) and to report on what we find. The DoLS are part of the MCA. They aim to make sure that people are looked after in a way that does not restrict their freedom. The safeguards should ensure that a person is only deprived of their liberty in a safe and correct way, and that this is only done when it is in the best interests of the person and there is no other way to look after them. The registered manager had applied the principles of the MCA and DoLS,

The registered manager had ensured Mental Capacity Assessments were completed where needed but some were too general in their content and did not always contain information relevant to the specific decision being made for each person.

The provider had not ensured that medicines prescribed on an ‘as required’ basis were appropriately monitored. There was conflicting information provided for staff in relation to the administration of these types of medicines which could result in people receiving an inappropriate dosage of their medicine, placing their safety at risk.

This was a breach of Regulation 13 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2010.

You can see what action we told the provider to take at the back of the full version of the report.

There were enough staff with the knowledge and skills to provide safe and appropriate care and support. There were systems in place to protect people from the risk of abuse.

Staff had received Equality and Diversity training and when we observed staff interacting with people who use the service, they spoke to them in a respectful way that maintained their dignity at all times. People told us staff were respectful and caring and respected their privacy.

Staff felt supported by the management and each staff member received an induction and training programme that provided them with the necessary skills to provide effective care for people.

People had risks in relation to the decisions they made explained to them by staff. People were encouraged to make independent decisions and could move freely around the home.

The premises were secure and well maintained.

There were appropriate procedures in place to ensure that staff employed to work at the home had undergone the required checks prior to their employment commencing.

People’s dietary needs were catered for. People spoke highly of the food. We observed lunch being served and people told us they enjoyed their meal.

People had access to external professionals and referrals, when risks to people’s health and safety had been identified, were made in a timely manner.

Information about the service was shared with people. People’s views were regularly requested and where appropriate changes to the service provided were made. People were encouraged to comment on the quality of the service provided and were assured that if a complaint was made it would be investigated thoroughly.

A ‘consultative committee’ has been established where people who use the service, relatives and external professionals meet to discuss the service provided and provide feedback for the management

People were invited to attend reviews of the care and support they received. However we saw some examples where care plan reviews had not been conducted since May 2014 with no explanation recorded why. A new computerised care planning system was being introduced which would address this.

People were asked what they wanted to do and wherever possible staff ensured that people were able to enjoy the things that were important to them.

Recommendations made by the registered manager following an accident or incident were not always reviewed to check whether they had been followed by staff or whether they had been effective.

People were able to access the local community when they wanted to. There were strong links with the local community and school.

26 November 2013

During an inspection looking at part of the service

This inspection was carried out to follow up on our previous inspection in August 2013 where we found the provider had not been compliant with the outcome - "Records".

Prior to our visit we reviewed all the information we had received from the provider, including an action plan detailing how they would comply with the compliance action we set at the previous inspection. During the visit we spoke with the provider and the

registered manager and looked at some of the records held in the service.

We found the provider had made the improvements we required to become compliant and the records we looked at were now accurate and fit for purpose.

16 August 2013

During a routine inspection

During this inspection there were fifteen people using the service. We spoke directly with four people and with three relatives. We also spoke with two staff, a district nurse and the owner.

We saw evidence that people were consulted before receiving care. One of the people who used the service told us, 'Staff speak to me and do not tell me what to do." A relative we spoke with told us, 'I am kept up to date on what is happening.'

The people we spoke with told us they thought the care provided met their needs. One person told us, "The staff are extremely good, they can't do enough for you." .

People were cared for by staff who were supported to deliver care and treatment safely and to an appropriate standard. One person who used the service told us, 'I think the staff are very well trained and do what makes me happy.'

Staff and people who used the service told us they felt their views on the care provided were welcomed and valued. They felt the owner was approachable and listened to their concerns.

The care plan records we looked at were not accurately maintained. We saw gaps in areas such as the monitoring of people's weight and continued assessment of people's ability to carry out tasks such as eating and drinking.

18 September 2012

During a themed inspection looking at Dignity and Nutrition

People told us what it was like to live at this home and described how they were treated by staff and their involvement in making choices about their care. They also told us about the quality and choice of food and drink available. This was because this inspection was part of a themed inspection programme to assess whether older people living in care homes are treated with dignity and respect and whether their nutritional needs are met.

The inspection team was led by a CQC inspector joined by a practising professional.

We spoke with six of the people living in the home and they all told us that everyone was very pleasant there. One person said, "They always speak to me personally and use my first name." Another person said, "The managers and staff know me well now, so they know how I like things."

We observed several occasions where various staff members approached the residents with respect, speaking quietly to individuals when needed.

There was a call bell in the lounge and one person told us. "One of us will use the bell if someone wants something when the staff are not in the room."

We saw that people were offered a choice of two main courses and a further choice of desserts. All those we spoke with said that the food was always good and we saw that people ate all their food. One person chose to take all meals in their own room and another was not well enough to move to the dining room. Both of these told us that the food was always brought to them and was at the right temperature.

We observed staff being very attentive to people, offering choices and giving reassurance. People told us that they felt safe and secure in the home. One person said, "I can't fault anything here. All the staff are very good to us".

People told us that staff were never far away and someone was usually in the lounge. One person said, "We have just enough staff here. There are always a couple of them around and they're very helpful."

A visitor told us, This is a fantastic place. Its very friendly and they have lots of entertainment." A relative said, "Its brilliant here and all the staff treat everyone properly - as people."