28 February 2023
During an inspection looking at part of the service
Gabriel Court Limited is a residential care home without nursing, providing personal care for up to 44 older people, including those living with dementia and mental health needs. At the time of the inspection 36 people were being supported.
Gabriel Court has accommodation across two floors, in one adapted building (Bluebell unit) and one purpose-built building (Foxglove unit).
People’s experience of using this service and what we found
We observed there were insufficient staff to meet people’s needs safely, particularly in the Bluebell Lounge which was the high dependency unit.
The registered manager had left, and the provider had recruited an interim manager swiftly to ensure the smooth running of the service. They were being supported by the operations manager to continue to drive improvement at the service. Recruitment for a new permanent manager was taking place at the time of our inspection.
Improvements had been made to the systems for safe medication administration. However, further information was required to ensure the PRN protocols guided staff to administer ‘as required’ medicines safely and consistently.
The provider's quality assurance systems and processes had been overhauled and improved to ensure they were more effective. This meant the managers and the provider had better oversight of the service. Many of these systems were newly implemented and needed time to become embedded into staff practice so they could be assessed for their effectiveness. Not all systems in place had been effective and had failed to identify staff deployment issues.
Improvements had been made to the fabric of the building to ensure it was conducive to effective cleaning. We saw flooring had been replaced and areas repainted, so they were more easily cleanable. The environment had been improved to ensure it was safe for people.
Staff understood safeguarding procedures and were confident in reporting any concerns. Risks to people's safety were assessed and well managed, and people’s care plans detailed current risks and individual needs.
Staff were appropriately recruited to ensure people were suitable to work at the service.
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.
People's care needs were assessed before they went to live at the service, to ensure their needs could be fully met. Staff received an induction when they first commenced work at the service, and we found improvements had been made to staff training to ensure they had the skills and knowledge to provide effective care.
People were supported to eat and drink enough and staff supported people to live healthier lives and access healthcare services.
Staff felt well supported and said the management team were open and approachable. The service worked in partnership with outside agencies.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
The last rating for this service was Requires Improvement (published 15 November 2022) and there were 3 breaches of registration in relation to Safe care and treatment; Adapting service, design, decoration to meet people’s needs and Good Governance. Continued conditions were applied to the provider's registration. This service has been rated requires improvement for the last 4 consecutive inspections.
The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of 2 regulations but remained in breach of regulation 17 Good Governance. We also found a breach of Regulation 18 Staffing, at this inspection.
Why we inspected
We undertook this focused inspection to check that the provider had followed their action plan and to confirm they now met legal requirements. This report only covers our findings in relation to the Key Questions of Safe, Effective and Well-led which contain those requirements.
The ratings from the previous comprehensive inspection for those key questions, not looked at on this occasion were used in calculating the overall rating at this inspection. The overall rating for the service has remained Requires Improvement.
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.
Enforcement and Recommendations
We have identified 1 continued breach of regulation in relation to Good Governance and a new breach of regulation in relation to staffing at this inspection.
Follow up
We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.