This inspection took place on 29 September 2016 and was announced. Four Gables is a residential home providing personal care and accommodation for up to five people with learning disabilities, autistic spectrum disorder, physical disability and /or sensory impairment. At the time of our inspection visit, there were five people living there.
The service was last inspected on 27 May 2014, when we found the provider was complaint with the essential standards described in the Health and Social care Act 2008 (Regulated Activities) Regulations 2010.
The home had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the home. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the home is run. The registered manager had recently been moved to work lon a temporary basis in another area of the country by the provider. Day to day running of the home was being undertaken by the assistant manager, who we refer to as the ‘manager’ in this report.
People were comfortable with staff and relatives were confident people were safe living in the home. Staff received training in how to safeguard people, and had access to the provider’s safeguarding policies and procedures if they had any concerns. Staff understood what action they should take in order to protect people from abuse. Systems were used to identify and minimise most risks to people’s safety. These systems were flexible so people could take risks if they were able to do so and build their independence.
People were supported with their medicines by staff that were trained and assessed as competent to give medicines safely. Medicines were given in a timely way and as prescribed. Regular checks of medicines helped ensure any issues were identified and action was taken as a result. There were enough staff to meet people’s needs.
The provider conducted pre-employment checks prior to staff starting work to ensure their suitability to support people who lived in the home. Staff told us they had not been able to work until checks had been completed.
Staff asked for consent before providing people with support. People’s ability to make decisions had been assessed and information was in place so staff knew how to support people with decision-making. Staff and the manager understood their responsibility to comply with the requirements of the Mental Capacity Act 2005, and the provider had ensured applications to deprive people of their liberty under the Deprivation of Liberty Safeguards, had been made as required.
Staff treated people with dignity and respect, and mostly respected their privacy. We also saw this in interactions between people at our inspection visit, and it was reflected in care records. People were supported to make choices about their day to day lives. For example, they could choose what to eat and drink and were supported to maintain activities, interests and relationships that were important to them.
People had access to health professionals whenever necessary, and we saw that the care and support provided was mostly in line with recommendations. People’s care records were written in a way which helped staff to deliver personalised care, which focussed on people being supported in ways they preferred. Staff tried to ensure people were fully involved in how their care and support was delivered, and people were able to decide how they wanted their needs to be met.
Relatives told us they were able to raise any concerns with the manager, and they would be listened to and responded to effectively, and in a timely way. Staff told us the management team were approachable and responsive to their ideas and suggestions.
There were systems in place to monitor the quality of the support provided in the home. However, these systems had not always identified gaps and inconsistencies in records, designed to keep people with specific health conditions safe, neither had they identified where care plans were not up to date.