CQC report explained · a residential care home
What the CQC found at The Gables Care Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Risk assessments, fire arrangements, infection controls, recruitment checks and financial safeguards had improved. Inspectors still asked the home to keep reviewing night staffing, and found that instructions for some as-needed medicines were not always detailed.
- Effective?
- Good
- People's needs and choices were assessed, care plans followed professional advice, staff training had improved, and people were supported with food and healthcare. Inspectors recommended further review and updating of the living environment.
- Caring?
- Good
- This key question was not covered by this focused inspection. Its previous rating was carried forward when calculating the overall rating.
- Responsive?
- Good
- Care plans had been revised and people were involved in reviews as far as they wished. The home supported activities, community access, relationships and contact with relatives, although some care plans still needed more detail.
- Well-led?
- Good
- A new registered manager had introduced better checks, records, staffing arrangements and staff involvement. Inspectors recommended an audit process independent of the manager's own quality systems.
What inspectors found, October 2021
The Gables Care Home is rated Good; inspectors found substantial improvements, with some staffing, environment, care plan and medicines work still needed.
This was an unannounced focused inspection on 20 September 2021. One inspector reviewed records, spoke with three residents and three staff, and checked infection control arrangements. The inspection followed an earlier report that found several legal breaches.
The home had improved in keeping people safe, managing infection risks, recruiting staff, supporting people's choices and checking care quality. Care plans were more detailed, people were supported with their health and activities, and relatives were encouraged to stay involved.
Safe, Effective, Responsive and Well-led were all rated Good. The report says the home was no longer in breach of regulations. However, inspectors made recommendations about night staffing, the building's decoration and condition, and independent checks by the provider. Caring was not assessed during this focused inspection.
Improved infection control
The home had introduced new infection control processes, appropriate protective equipment and safer visitor checks. Areas such as the kitchen and bathrooms had also been improved.
“New infection control processes were in place and staff were wearing appropriate levels of PPE.” from the report
More personalised care plans
Care plans had been rewritten to include people's care needs, health needs, preferences and choices. Staff showed a good understanding of how people should be supported.
“Care plans had been revised and now reflected people's care needs and their choices and wishes.” from the report
Activities and community links
People were supported to take part in activities, go into the local community and maintain relationships. One person was supported to gain a food hygiene certificate linked to their interest in cooking.
“People told us a range of activities had been organised by the new manager and plans were being made for trips and holidays” from the report
Safer financial arrangements
New processes helped keep people's money and bank details safe while allowing people to manage their finances as much as possible. Spending records and audits were in place.
“Detailed records were kept of expenditure, including all receipts, and regular audits were undertaken.” from the report
Night staffing needs review
needs fixingNight staffing arrangements had improved, including having two staff on duty in some circumstances and an on-call system. Inspectors still wanted staffing levels at night to be monitored and reviewed.
“We recommend the provider continues to monitor staffing at the home and, continues to review effective staffing levels during the night-time period.” from the report
Environment still needs updating
minorSome improvements had been made to the building, but further decoration and work to the environment were still planned.
“We recommend the provider continues to review the living environment and further refresh the decoration to improve the ambiance of the service.” from the report
Some care plans lacked detail
needs fixingCare plans had improved, but some still needed further review and additional information. Advice from professionals was not always placed directly in the care plan.
“Some plans required further review and some additional detail to make them more comprehensive.” from the report
Independent quality checks
needs fixingThe manager had introduced more audits and checks, but the provider had not fully formalised independent oversight of the service.
“We recommend the provider establish a regular audit process, independent of the registered manager's quality systems, to ensure effective oversight of the service.” from the report
As-needed medicines instructions
needs fixingMedicines were generally managed safely, but instructions for some medicines taken when needed were not always detailed. The manager agreed to review and update the documents.
“We found protocols for supporting people with 'as and when required' medicines were not always detailed.” from the report
- 01How many staff are on duty overnight in all circumstances, and how do you review whether this is enough?
- 02What work remains to update the building and refresh its decoration, and when will it be completed?
- 03How do you make sure every care plan includes the latest advice from health and social care professionals?
- 04How are instructions for as-needed medicines checked and updated?
- 05What independent audit process has the provider introduced to oversee the registered manager's quality checks?
This was a focused inspection of Safe, Effective, Responsive and Well-led; Caring was not covered, and ratings from the previous comprehensive inspection for key questions not looked at were used in calculating the overall rating. This explanation was written from the published report of 21 October 2021 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, April 2021
The Gables Care Home was inspected but not rated; its previous Requires Improvement rating remained, with a breach over infection control.
This was a targeted inspection on 1 March 2021. It followed concerns about infection control. One inspector spoke with one person and three staff, and checked records and procedures.
Inspectors found that people were not always protected from infection. Staff did not always use or dispose of protective equipment correctly. Cleaning records were incomplete, the home still needed more cleaning, and some cleaning chemicals were not locked away.
The inspection found some positive measures. People and staff were tested regularly for COVID-19, and most had received their first vaccination. However, the home had not made enough improvement since its previous inspection, which was rated Requires Improvement.
This targeted inspection did not assess the whole service. It was marked inspected but not rated, and the previous overall rating remained Requires Improvement.
COVID-19 testing
People and staff were tested regularly in line with national guidance.
“People and staff at the home were subject to regular testing for COVID-19 in line with national guidance.” from the report
Vaccination
Most people and staff had received their first COVID-19 vaccination at the time of the inspection.
“The majority of people and staff had received their first COVID-19 vaccination.” from the report
Protective equipment was not used consistently
seriousStaff did not always follow national guidance for wearing protective equipment. Inspectors saw a mask worn incorrectly on four occasions, and used equipment was not always put into suitable clinical waste bags.
“Staff members were not always following national guidance on the safe and effective use of PPE.” from the report
Cleaning was not reliably checked
seriousCleaning records for high-risk areas were incomplete, so inspectors could not be assured that cleaning had been thorough. A planned programme of deep cleaning had also not taken place as described.
“Records relating to the cleaning of high-risk areas, such as door handles and light switches were not well completed and we could not be assured this cleaning had been thoroughly undertaken.” from the report
Problems remained after the previous inspection
needs fixingIssues identified at the previous inspection had not all been fixed. Communal cloth towels were still being used in some areas.
“Infection control issues that we had found at the previous inspection had not been fully addressed.” from the report
Cleaning chemicals were not secured
seriousCupboards containing bleach and other potentially hazardous products were left unlocked. Inspectors said this created a risk to people living at the home.
“This presented a risk to people who lived at the home as potentially hazardous chemicals were not stored securely.” from the report
- 01How do you check that every staff member wears and disposes of protective equipment correctly?
- 02How are cleaning of high-risk areas, such as door handles and light switches, recorded and checked?
- 03What action has been taken to address the Regulation 12 breach and the urgent condition?
- 04How are bleach, turpentine and other cleaning products kept securely away from people?
- 05What has changed since the previous inspection, and when will CQC review the improvements?
This was a targeted inspection of specific infection-control concerns under Safe; it did not assess the other key questions, and the previous overall Requires Improvement rating carried over. This explanation was written from the published report of 15 April 2021 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 The Gables Care Home
4 rated inspections over 6 years: the service has improved, from Requires improvement to Good.
- October 2021Goodcurrent ratingSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- April 2021Inspected but not ratedSafe: Inspected but not rated
- November 2020Requires improvementdown from GoodSafe: Requires improvementEffective: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- May 2017Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- March 2016Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- August 2019
Registered with the Care Quality Commission on 1 August 2019.
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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