CQC report explained · a nursing home
What the CQC found at Gables Manor
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
- Safe?
- Requires improvement
- Fluid and bowel charts were not reliably completed, some health guidance was missing from care plans, injuries were not always reported, and there were infection-control concerns. Medicines were generally stored and administered safely, but some PRN medicine information was wrong.
- Effective?
- Good
- Staff were trained and knew people's needs. People's nutrition, healthcare access, communication, choices and mental capacity arrangements were generally supported effectively.
- Caring?
- Good
- People were treated with kindness, dignity and respect, and were encouraged to make choices and remain independent. Some care-record wording was not respectful.
- Responsive?
- Good
- Care was personalised and people took part in activities, relationships and volunteering suited to their interests. Communication needs were assessed and accessible information was used.
- Well-led?
- Requires improvement
- Incident checks, post-incident reviews and care-plan audits were not effective enough to identify risks or support learning. The management team was open to feedback and staff said they felt supported.
What inspectors found, July 2023
Gables Manor is Requires Improvement overall; inspectors found kind, personalised care but serious gaps in safety records and oversight.
Inspectors visited on 26 April, 9 May and 10 May 2023. They spoke with people living in the home, relatives and staff, and reviewed care, medicine, recruitment and management records.
The home was caring, effective and responsive. People were treated kindly, supported to make choices, helped to access healthcare and offered activities suited to their interests. There were enough staff, and staff had suitable training.
Safety and leadership were Requires Improvement. Records did not always give staff the latest information about risks, health needs or restrictive practices. Unexplained injuries were not always reported, some areas needed cleaning, and checks on incidents and care records were not reliable.
The overall rating means the home was not consistently safe or well managed. The provider was in breach of Regulations 12 and 17, and warning notices were issued. The provider had taken some action after the inspection, but CQC requested an action plan and will monitor progress.
Enough trained staff
There were enough staff to meet people's needs. Recruitment checks were completed and staff received training, induction and regular supervision.
“There were enough staff to meet people's needs.” from the report
Personalised activities
People were supported to follow their interests, maintain relationships and take part in activities, including volunteering.
“People were supported with a range of activities.” from the report
Healthcare support
People were helped to access doctors and other healthcare professionals. Families said healthcare was arranged when needed.
“People were supported to access external healthcare services when needed.” from the report
Incomplete safety records
seriousFluid and bowel charts were not reliably updated. In one case, there was no recorded action after a person had not had a bowel movement for more than seven days.
“People's fluid and bowel charts were not reliably updated by staff.” from the report
Risk and injury reporting
seriousCare plans did not always contain the latest risk information. Unexplained marks or injuries were not always reported to senior staff or outside safeguarding agencies.
“Unexplained marks or injuries had not always been reported to the local safeguarding team and the Care Quality Commission were not always notified.” from the report
Restrictive practice oversight
seriousIncident records did not contain enough detail to show whether physical or chemical restraint was justified and safe. Post-incident reviews were not consistently recorded or used for learning.
“Actions taken by staff were not always reviewed appropriately by the registered manager following incidents.” from the report
Cleanliness and infection control
needs fixingSome areas needed cleaning and the cleaning rota did not support good hygiene. Inspectors said this could increase the risk of infection.
“The environment did not always promote good infection control practices which put people and staff at risk of cross infections.” from the report
Care-plan and medicine updates
seriousSome health-professional guidance and medicine instructions were not added or corrected in care plans. One PRN protocol gave the wrong maximum daily dose.
“Information in people's care plans were not always in line with the protocols for 'as required' (PRN) medicine.” from the report
Informal record wording
minorSome care-plan language was not dignified or respectful, although inspectors observed staff speaking to people respectfully.
“Some language used in care plans was not always dignified.” from the report
- 01What has changed since the inspection to make sure fluid and bowel charts are completed and acted on promptly?
- 02How are unexplained marks or injuries now recorded, reviewed and referred to safeguarding agencies when needed?
- 03How do you record and review physical or chemical restrictive practices, including the required post-incident checks?
- 04Have all medicine protocols and health-professional instructions been checked and updated in people's care plans?
- 05What cleaning improvements have been made, and how do managers now check that they are maintained?
This inspection covered all five key questions and included infection prevention and control, care and medicine records, staffing and governance. This explanation was written from the published report of 12 July 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, October 2020
Gables Manor was inspected but not rated overall; inspectors found safe care required improvement, while effective care and leadership were good.
This was a focused inspection on 16 September 2020. It followed concerns about infection control and the use of protective equipment during the pandemic. Inspectors spoke with people, relatives and staff, and checked care records, medicines, staffing and management records.
The home was clean and staff used protective equipment correctly. There were enough staff, people said they felt safe, and safeguarding arrangements were in place. However, some medicine records were incomplete, some as-required medicine guidance was missing, and advice for medicines given secretly in food had not initially been obtained from a pharmacist.
Effective care and leadership were rated Good. People received suitable food and healthcare, staff were trained, and care plans were reviewed. Safe was rated Requires Improvement. The service was inspected but not rated overall because this inspection did not cover all five areas.
Enough staff
Inspectors found enough staff to meet people's needs and saw staff respond to people promptly.
“At this inspection we found there were enough staff available to meet the needs of people.” from the report
Infection control
The home was clean. Staff had access to protective equipment and understood how to prevent and manage infection during the pandemic.
“Staff had access to personal protective equipment (PPE) and used it according to the provider's policy and national guidance.” from the report
Healthcare support
Staff made timely referrals and helped people access doctors and other healthcare professionals.
“Records showed staff were proactive in their approach and made referrals to health professionals in a timely manner.” from the report
Open leadership
Staff described the manager as supportive and said they could raise concerns. Staff also reported improvements in morale.
“The service had an open culture. Staff told us the registered manager was supportive and they felt able to raise issues.” from the report
Incomplete medicine records
seriousSome medicine administration records did not show whether medicines had been taken. This made it harder to monitor medicines and people's wellbeing.
“Some medicine administration records (MARS) had gaps where staff had failed to record whether a person had taken their medicines or not.” from the report
Missing medicine guidance
seriousProtocols for as-required medicines were not always in place. This created a risk that people might not receive medicines when they needed them.
“There was a risk people would not receive their medicines when they needed them.” from the report
Medicines given in food
seriousTwo people received medicines secretly in food. A doctor had given advice, but pharmacist advice and written staff guidance were initially missing.
“Advice had been given by a doctor, but advice had not been sought from a pharmacist as per best practice (Nice guidelines).” from the report
Damaged chairs
needs fixingSeveral chairs had ripped coverings. Inspectors said these would be difficult to clean and could increase the risk of cross infection.
“We observed several chairs had ripped coverings which meant the ripped areas would be difficult to clean and could cause a risk of cross infection.” from the report
Best-interest records
needs fixingWhen people could not make some complex decisions, best-interest decisions were not always recorded as having been made.
“Records showed when people lacked mental capacity to make specific complex decisions, decisions in people's best interests were not always made.” from the report
Tracking improvements
needs fixingQuality checks were in place, but paperwork did not always show whether actions had been completed. This made progress harder to monitor.
“Paperwork did not always indicate when actions had been completed. This meant it was difficult to monitor improvement.” from the report
- 01What has been done to make sure every medicine administration record is completed accurately?
- 02Are protocols now in place for all as-required medicines, and how do staff know when to give them?
- 03For anyone receiving medicine in food, has advice now been obtained from a pharmacist and are written instructions available to staff?
- 04Have the chairs with ripped coverings been replaced, and what other refurbishment work remains?
- 05How are best-interest decisions for complex decisions recorded and checked?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not reviewed. This explanation was written from the published report of 15 October 2020 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of Gables Manor
4 rated inspections over 8 years: the service has slipped, from Good to Requires improvement.
- July 2023Requires improvementcurrent ratingSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2020Inspected but not ratedSafe: Requires improvementEffective: GoodWell-led: Good
- March 2020Goodstayed GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- April 2017Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- September 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2020
Registered with the Care Quality Commission on 11 May 2020.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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9 live-in carers within about an hour of Lincolnshire
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
8 can care for a couple. 10 years' experience on average.
“Martin was more than a carer, he managed the home and became my uncle's best friend, enriching his life during his last few years.”
“Magda was always positive and proactive about trying new things to keep dad busy. She also introduced new ideas for keeping dad healthy.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.