Red Gables

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right Support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

This service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture. This was because concerns raised by staff had not always been appropriately responded to. Staff and records did not always refer to people in a respectful way. The interim manager and provider took appropriate action during the inspection to address these concerns.

Staff described how they supported people to have maximum choice and control over their lives. However, there was not always evidence they were supported in the least restrictive way possible. There were times when people had limited access to their kitchen for health and safety reasons. We discussed this with the interim manager and provider who said they would explore options for people to have more control over access to food and drinks.

Staff were positive about the people they supported. People told us they liked the staff and felt listened to. People had access to their local community. The staff were supporting people to move on to more independent living settings, where this was appropriate.

There were enough suitable staff to meet people’s needs. Staff were recruited safely. People’s medicines were managed safely. There were suitable infection control procedures in place. Risks to people were assessed and mitigated. There were a range of health and safety checks in place, however some of these had not been consistently completed in April 2021.

We received some mixed feedback from staff regarding the culture of the service, staff told us this had improved. Staff told us their teamwork was good. An interim manager had been appointed to cover the service until a new manager was inducted. The interim manager had identified improvements required and had a range of action plans and audits in place. People and staff commented positively about the interim manager. There were systems in place to engage people and staff.

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

Rating at the last inspection.

The last rating for this service was Good (published 16 November 2017).

Why we inspected

The inspection was prompted in part due to concerns received about safeguarding incidents, medicines management and the culture of the service. A decision was made for us to inspect and examine those risks.

The information CQC received about the incident indicated concerns about safeguarding. This inspection examined those risks along with infection control.

We inspected and found there was a concern with safeguarding incidents, so we widened the scope of the inspection to become a focused inspection which included the key questions of safe, effective and well-led. Please see the safe, effective and well led sections of this full report.

The overall rating for the service has changed from good to requires improvement. This is based on the findings at this inspection.

During the inspection the interim manager and provider gave assurances and describe the action they had taken to mitigate the concerns we identified.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Red Gables on our website at www.cqc.org.uk.

Follow up

We requested 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 to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

We found the following examples of good practice.

A sanitising station had been set up inside the front door so that hands could be cleaned before people entered the building. Contact tracing and health declaration forms were completed on arrival at the home and staff checked visitors’ temperatures.

When staff started their shift, they recorded their temperature, sanitised their hands and disinfected their shoes before entering the building.

Staff had received training in infection control, including how to safely put on and take off personal protective equipment (PPE) such as gloves, aprons, and face coverings. The home had adequate supplies of PPE and we saw staff wearing PPE appropriately.

An allocated area was used in the garden for visits. Staff also supported people to keep in touch with their relatives via video calling, phone calls and letters. Changes had been made to the inside of the home to enable social distancing such as spacing out tables and chairs.

Additional cleaning had been implemented throughout the home. This included staff cleaning frequently touched areas such as light switches and handles, four times a day.

There were currently no vacancies in the home. There was a procedure in place for new admissions should they occur in the future. No one would be admitted without a negative test first and they would isolate for 14 days.

The registered manager ensured regular Covid-19 testing was carried out, weekly for staff and monthly for people living in the home. At the time of the inspection, no one was testing positive and we were assured the provider was keeping people safe.

A business continuity plan was in place, to reduce the effects of potential disruption to people's care. There were policies and procedures to provide guidance for staff on safe working practices during the pandemic. The provider had a range of effective communication systems in place.

Staff we spoke with were confident and knowledgeable about how to protect people from the risk of infection and the environment was clean and well maintained.

Further information is in the detailed findings below.

At the last inspection in June 2015 the service was rated Good.

At this inspection we found the service remained Good.

Why the service is rated Good:

Without exception people’s lives had been improved through the skills and expertise of the registered manager and support staff, who people liked and trusted. People were supported to lead interesting and fun lives. The range of activities people accessed was very broad and enriched their lives. There was a ‘can do’ attitude.

People’s safety was promoted through safe recruitment, staffing, safeguarding from abuse, well maintained premises and arrangements should there be an emergency. Individual risk was managed in the least restrictive way. Medicine management was of a high standard.

Staff received training and support which provided them with the skills and competence to support people effectively. People’s health care needs were well met. People received a healthy and varied diet and were involved in choosing the menu, buying the food and preparing it.

People’s legal rights were upheld.

The service was caring. People were given choice and their views and choices respected. People received care and support in a dignified way and their privacy was upheld. People were treated with respect and sensitivity.

The organisation’s values and objectives, to improve people’s lives, were met. People, people’s family members and professionals associated with the service spoke highly of the registered manager. The registered manager said they provided consistency without complacency.

There were effective arrangements in place to monitor safety and the quality of the service, including listening to people’s views and responding to any complaints or suggestions.