Gables Manor

Updated 12 July 2023

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 carried out by 1 inspector. An Expert by Experience made telephone calls to relatives to request feedback about the care and support their family member receives. 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

Gables Manor 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. Gables Manor is a care home with 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 on 26 April 2023 and 9 May 2023. We gave a short period notice on 10 May 2023 to ensure the registered manager would be available to support the inspection.

What we did before the inspection

We reviewed information we had received about the service since the last 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 requested feedback from the local authority and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

We used all this information to plan our inspection.

During the inspection

We spoke with 3 people who used the service and 9 family members about their experience of the care provided. We spoke with 6 members of staff including the registered manager and the deputy manager.

We reviewed a range of records. This included 5 people’s care records and 4 medicine records. We looked at 3 staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including policies and procedures were also reviewed.

Updated 12 July 2023

About the service

Gables Manor is a nursing home providing personal and nursing care for up to a maximum of 19 people. The service provides support to people with a learning disability, physical disability and autistic people. At the time of our inspection there were 19 people using the service. The service is a large, adapted building across 2 floors with access to the second floor by stairs or a lift.

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

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

Right Support:

People were supported to have choice and control of their lives; however, it was not always possible to ascertain from records whether staff were supporting them in the least restrictive way and in their best interests. Risks to people were assessed and monitored, however risk assessments and care plans did not always reflect the most important and up to date information. Staff supported people to access health and social care support in the community and supported people to be involved in maintaining their own health and wellbeing where possible. People could communicate and understand information given to them because they were receiving consistent support from regular staff. Staff were recruited safely and had the necessary skills, knowledge, and experience to provide safe and effective care. There were enough staff to meet people's needs. People were able to choose activities and pursue volunteer work that was tailored to them.

Right Care:

Staff were appropriately trained and understood how to protect people from poor care and abuse, however unexplained injuries were not always reported to management when required. Care records contained risk assessments with guidance for staff to follow, however they did not always contain all the relevant information found in other sections of care plans. Medicines were managed safely, although care plans had not always been updated following changes. Some areas in the premises were not clean and there were some concerns relating to the environment that posed an infection, prevention control risk. Support was person-centred and promoted people's dignity, privacy, and human rights, however staff had used informal language in some people’s care plans that could be seen as disrespectful. People had a choice about their living environment and were able to personalise their rooms. The service worked together with healthcare professionals and relatives to ensure people's assessed needs were met.

Right Culture:

The registered manager promoted a person-centred environment and people spoke positively about the management team and staff; however, the providers quality monitoring systems were very informal and had failed to mitigate the risks in relation to incident reporting and post-incident analysis reviews. Care plan audits were not effective in ensuring they contained the most relevant and up to date information about people to keep them safe. Some records needed to be reviewed to ensure all information was written respectfully. Staff were responsive to people's needs and evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate.

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 11 May 2020. The last focused inspection (published 14 October 2020) meant the service did not receive an overall rating.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

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 found evidence that the provider needs to make improvements. Please see the safe and well-led sections of this full report.

You can see what action we have asked the provider to take at the end of this full report. The provider has taken action to mitigate risks following our inspection.

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

Enforcement and Recommendations

We have identified breaches in relation to safe care and treatment and good governance at this inspection.

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.