Background to this inspection
Updated
19 December 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.
Inspection team
The inspection team consisted of one inspector.
Service and service type
The Gable 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 Gable 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 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
The inspection was announced. We gave the service 48 hours’ notice of the inspection. This was because it is a small service and we needed to be sure that the provider or registered manager would be in the office to support the inspection and to enable the person using the service to be informed.
What we did before the inspection
The provider was not asked to complete a Provider Information Return (PIR) prior to this inspection. A PIR is information providers send us to give some key information about the service, what the service does well and improvements they plan to make. We reviewed information we had received about the service since registration with us. We sought feedback from the local authority and professionals who work with the service and person living there.
During the inspection we spoke informally with the person who used the service. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.
We spoke with 5 staff which included the registered manager, team leader and 3 support workers. We reviewed the environment, medicine practices and records relating to people's care, which included health appointment records and medicine competency assessments for staff.
After the inspection we continued to review information sent to us, which included the person's care plan, medicine records, audits, policies, training records, rotas, 6 staff recruitment files and health and safety records.
We spoke with a relative by telephone after the inspection and requested feedback from 3 professionals involved with the service.
Updated
19 December 2023
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 assessment and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
About the service
The Gable is a residential care home registered to provide the regulated activity of accommodation and personal care to 1 person. The service provided support to people with learning disabilities. At the time of our inspection there was 1 person living at the home.
People’s experience of the service and what we found
Right Support:
Safe care and treatment was not consistently provided, which meant risks to people were not identified and mitigated. Medicine practices were not in line with best practice guidance.
Recruitment practices were not safe to safeguard 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, the environment was not sufficiently adapted and designed to meet people’s needs. This contributed to restrictions being placed on the person.
Right Care:
Whilst training records showed staff had been trained, the provider did not ensure staff had the required skills and knowledge to ensure people received appropriate care at the point of them coming to live at the service.
People were not safeguarded from abuse to promote right care.
Sufficient staff were provided to support the person and enable them to engage in community activities. Supportive care was provided with staff having a positive relationship with the person.
Right Culture:
Good governance was not established. This resulted in the service and records not being effectively managed and monitored to promote positive outcomes for people. As a result, risks to people had not been identified and mitigated. Systems to manage staff's breaks practice and the handling and recording of accidents/ incidents did not promote a positive culture to empower people.
People, their relatives and health professionals were involved in planning and reviewing their care, to ensure people received positive outcomes.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The service was registered with us on 30 March 2023, and this is the first inspection.
Why we inspected
The inspection was prompted in part due to concerns received about risk management and staff training. A decision was made for us to inspect and examine those risks.
Enforcement
We have identified breaches in relation to safe care and treatment, safeguarding, recruitment practices, auditing, and record management.
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.