Background to this inspection
Updated
19 July 2019
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 Care Act 2014.
Inspection team
This inspection was carried out by one inspector on both days of the inspection.
Service and service type
The Gables is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
The service had a manager registered with the Care Quality Commission. 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.
Notice of inspection
This inspection was unannounced.
What we did before 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. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used all of this information to plan our inspection.
During the inspection
We spoke with seven people who used the service and one visitor about their experience of the care provided. We also spoke with five members of staff, which included the registered manager.
We reviewed a range of records. This included two people’s care records and five people’s medication records. We looked at two 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 reviewed.
Updated
19 July 2019
About the service
The Gables is registered to provide accommodation and personal care for up to 13 people with a learning disability or autistic spectrum disorder. People living at The Gables have their own flat which consists of a living room, kitchen, bedroom and bathroom. There are nine flats, some single, some double. There is a small communal kitchen/dining area and living room. At the time of our inspection nine people were using the service.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
The service was a large home, bigger than most domestic style properties. This is larger than current best practice guidance. However. the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.
People’s experience of using this service and what we found
People received exceptional care from the registered manager and their team of support workers. Outstanding practice had been developed to provide people with care that was truly compassionate, caring and inclusive. Exceptional caring values were evident as well as a desire to provide person centred care focused around each individuals' needs and wishes.
People were empowered to be in control of their daily living. Support workers made opportunities accessible to people to fulfil their daily living as well as aspirational needs.
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.
There were sufficient numbers of staff who had been safely recruited. They received a regular programme of support through training, supervision and appraisal.
People’s health needs were met through a range of healthcare professionals who were involved in their care. Extremely positive outcomes were seen for people.
People were supported to maintain relationships with family, friends and other loved ones. Staff provided training and guidance for people on sexual relationships.
People were able to purchase and prepare food in their own flats, although they could access meals prepared by support workers.
Medicines were received, stored, administered and disposed of safely. Staff involved in handling medicines had received recent training around medicines and had their competency checked.
Care plans were sufficiently detailed and staff demonstrated their knowledge of people’s care needs and how risks to people were to be mitigated.
The service was well-led by a registered manager who was noted as an effective communicator who genuinely cared for the staff team. Relevant audits and other systems of governance were effective. Complaints were found to be suitably managed.
We have made a recommendation about the registered provider’s guidance relating to handling allegations of abuse.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good when we inspected (published in November 2016).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.