Red Gables

Updated 16 June 2021

The inspection

This was a targeted inspection to check on a specific concern we had about safeguarding incidents, the administration of covert medicines and the culture of the home.

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 one inspector and an assistant inspector who made calls to relatives following the inspection visit.

Service and service type

Red Gables is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a 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 did not have a manager registered with the Care Quality Commission. The registered manager had left in April 2021. The registered manager and the provider are legally responsible for how the service is run and for the quality and safety of the care provided. The provider had appointed an interim manager to cover the service until the newly appointed manager started in post.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we held about the service and we spoke with the local authority. The provider was not asked to complete a provider information return prior to this inspection. This is information we require providers to send us to give some key information about the service, what the service does well and improvements they plan to make. We took this into account when we inspected the service and made the judgements in this report.

During the inspection

We spoke with two people about their experiences of living in the home. We completed observations of staff interacting with people. We spoke with the interim manager and five members of staff. We reviewed a range of records. This included four people’s care records and two people’s medicine records. We also reviewed records relating to the management of the service such as incident and accident records, recruitment records, health and safety records, meeting minutes, training records and audits.

After the inspection

We spoke with three relatives and three members of the night staff team. We continued to seek clarification from the provider to validate evidence found.

Updated 16 June 2021

Red Gables is registered to provide care and accommodation to a maximum of 11 adults who have learning disabilities, physical disabilities and/or autism. At the time of the inspection there were 10 people living at the home. Red Gables is a large residential property with en-suite bedrooms.

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.