The Gables Retirement Home

Updated 12 August 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

The inspection was conducted by an inspection manager and an inspector. An Expert by Experience also made calls to people’s families as part of the inspection. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

The Gables Retirement Home 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. The Gables Residential Home 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 service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. 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.

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 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 annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with five people who used the service and the relatives of twelve people. We also spoke with the registered manager, four members of care staff and a member of the housekeeping team. We spoke with the nominated individual and a company director. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of written records including nine people's care plans, staff recruitment and training records and information relating to the auditing and monitoring of service provision. We undertook observations of care and support.

Updated 12 August 2022

About the service

The Gables Retirement Home is a residential care home providing accommodation and personal care for up to 35 people. The service provides support to older adults, some of whom are living with dementia. At the time of our inspection there were 23 people using the service. The registered manager explained that the home had 24 bedrooms, some of which could be used to accommodate people who wished to share, at the time of our inspection no one was sharing a room.

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

Although people and their families told us they felt the service was safe we found several issues related to the safety. People were not consistently protected from risk as care plans and risk assessments were not always in place. Medicines were not always managed or stored safely. Issues with the cleanliness of the environment and equipment increased the risk of infection spreading. Systems were in place to protect people from the risk of abuse. The provider had taken opportunities to learn from incidents and improve care.

There were enough staff to keep people safe, but people’s families told us variations in staffing levels impacted upon the provision of person-centred care. We received variable feedback about the approach of staff and people’s right to privacy was not always upheld. Most people had adequate care plans in place, however some people’s needs were not always assessed in a timely manner and consequently staff were not consistently provided with adequate information to support people.

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, however, some further work was needed with recording in this area.

People were supported with their physical and mental health and referrals were made to external health professionals when required. People had enough to eat and drink and people’s dietary needs were met.

People were supported to maintain relationships with those who were important to them and there were a range of activities for people to take part in at the home. People received person centred, compassionate care at the end of their lives. People’s complaints were responded to swiftly and to their satisfaction.

Systems to ensure the quality and safety of the service were not always fully effective. There had been issues with the culture of the home which impacted upon care. Communication with people’s families was not always effective. The provider was passionate about providing high quality care, they were open to feedback and responsive to issues identified during our inspection. Feedback from people, families and staff was used to improve the quality of the service.

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

Rating at last inspection

This service was registered with us on 1 August 2019 and this is the first inspection. The last rating for the service under the previous provider was good, published on 24 June 2017.

Why we inspected

The inspection was prompted in part due to concerns received about the conduct of staff. A decision was made for us to inspect and examine those risks.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We have identified a breach in relation to governance at this inspection. 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.