Background to this inspection
Updated
26 October 2018
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.
This inspection took place on 10, 11 and 13 September 2018 and was unannounced. The inspection team consisted of one inspector, a specialist nurse advisor and an expert-by experience. An expert-by-experience is a person who has personal experience of using or caring for someone who uses this type of service.
Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make.
Before the inspection, we looked at the evidence we already held about the service including notifications the provider had sent to us. A notification is information about important events which the service is required to send us by law. We also contacted the local authority with responsibility for commissioning care from the service to seek their view about the service.
During the inspection we spoke with nine staff which included the registered manager, the deputy manager, three care workers, two nurses, the activities co-ordinator, and the chef. We also spoke with six people who used the service and four relatives. We observed care and support provided in communal areas. 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 to us. We reviewed ten people’s care records including risk assessments and care plans and reviewed six staff records including recruitment and supervision. We looked at records relating to how the service was managed including staff training, medicines, policies and procedures and quality assurance documentation.
Updated
26 October 2018
Gable Court 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.
Gable Court can accommodate 50 older adults who may have dementia in a purpose built three storey building. At the time of this inspection, 50 people were using the service.
This inspection took place on 10, 11 and 13 September 2018. The inspection was unannounced. This was the first inspection since the service was registered under the provider HC-One Oval Limited in December 2017.
The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) to manage the service. 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 service is run.
Staff were knowledgeable about reporting safeguarding concerns and whistleblowing. People had risk assessments carried out to mitigate the risks of harm they may face. Building safety checks were carried out in line with building safety requirements. Recruitment checks were carried out before new staff began working at the service. There were enough staff on duty to meet people’s needs. There were systems in place to manage medicines safely. People were protected from the risks associated with the spread of infection. The provider used accidents and incidents to make improvements to the service.
People’s needs were assessed before they began to use the service to ensure the right care could be provided. Staff were supported with regular supervisions, annual appraisal and training opportunities to help them to carry out their role effectively. The provider had communication systems in place for staff to be updated on people’s well-being and changes in care needs. People were supported to eat a nutritionally balanced diet and to maintain their health. Staff understood the requirements of the Mental Capacity Act (2005) and the need to obtain verbal consent before delivering care. However, the provider did not have a system to document people’s consent to receiving care and treatment.
Staff described how they developed caring relationships with people. The provider had a system in place where each person had a named nurse and care worker who had overall responsibility for the person’s care. People and their relatives were involved in decisions about the care. There was a ‘resident of the day’ system where each person had a day dedicated to them to make them feel special. Staff were knowledgeable about equality and diversity. People were supported to maintain their independence and their privacy and dignity was promoted.
Care plans were personalised, contained people’s preferences and were reviewed monthly. Staff understood how to deliver personalised care. People were offered a variety of activities and their communication needs were met. Complaints and compliments were recorded and used to improve the service. People’s end of life care wishes were only recorded when they were nearing the end of their life and were not captured as part of future care planning.
People, relatives and staff gave positive feedback about the management of the service. The provider obtained feedback from people using the service and relatives through regular meetings. Meetings with people using the service and relatives were used to update people on service development and for improvement suggestions. The provider had various quality assurance systems in place to identify areas of improvement. The home worked in partnership with other agencies to improve the service provided.
We have made two recommendations about working within the requirements of the Mental Capacity Act (2005) and future care planning.