CQC report explained · a residential care home
What the CQC found at The Gables
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Requires improvement
- Inspectors were assured about testing, visiting arrangements, PPE, hygiene, social distancing, admissions and outbreak management. They also signposted resources to help develop the home's approach.
- Effective?
- Good
- Not assessed in this targeted inspection.
- Caring?
- Good
- Not assessed in this targeted inspection.
- Responsive?
- Good
- Not assessed in this targeted inspection.
- Well-led?
- Good
- Not assessed in this targeted inspection.
What inspectors found, April 2021
Inspected but not rated; inspectors were assured about infection prevention measures, but this visit did not assess the wider quality of care.
This was an announced, targeted inspection during the COVID-19 pandemic. Inspectors looked at infection prevention and control in the home.
They were assured that the home was managing visitors, testing, personal protective equipment, social distancing, hygiene and possible outbreaks. Staff had received infection control and COVID-19 training.
The home was not given an overall quality rating. The Safe question was inspected but not rated, and the other areas of care were not assessed during this visit.
Regular testing
People living in the home and staff were tested regularly. Visitors also had rapid lateral flow tests before entering.
“People living in the home and staff were tested regularly for COVID-19 at the intervals stipulated by government guidelines.” from the report
Controlled visiting
Visits were booked at suitable times and spaced out. Visitors were given protective equipment and could not enter other areas of the home.
“The service was booking visitors in at a time that suited people and was spaced out to avoid potential infection transmission with other visitors.” from the report
PPE and staff training
The home had good stocks of protective equipment, and staff had training in infection prevention, COVID-19 and using PPE correctly.
“Staff employed at the service had received training on infection prevention, COVID-19, and the correct use of Personal Protective Equipment (PPE).” from the report
Keeping relatives informed
People were supported to stay in contact with relatives and friends by telephone and video calls. Weekly newsletters included information about COVID-19 and visiting procedures.
“The provider issued weekly newsletters to relatives and friends, which contained details about their COVID-19 status, and visiting procedures.” from the report
Inspectors raised no specific concerns in this report.
- 01Which inspection date is correct, as the report gives both 25 March 2021 and 18 March 2021?
- 02How are people and staff tested now, and how are visitors tested before entering?
- 03How are visits currently arranged, and what protective equipment must visitors use?
- 04What changes were made after CQC signposted resources to strengthen internal systems and processes?
- 05What are the home's current ratings for Effective, Caring, Responsive and Well-led?
This was an announced, targeted inspection of infection prevention and control, with Safe inspected but not rated; the other questions were not assessed. This explanation was written from the published report of 29 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.
What inspectors found, July 2019
Rated Good overall; inspectors found kind, effective care, but safety needed improvement, including medicines records and risk plans.
The inspection was unannounced and took place on 04 June 2019. Inspectors spoke with people living in the home, relatives, staff and a healthcare professional. They reviewed care records, medicines records, staff files and the home's quality checks.
The home was rated Good overall. Caring, effective, responsive and well-led were all rated Good. Staff were described as kind and caring, and people generally received support that met their needs.
Safe was rated Requires Improvement. Inspectors found gaps in medicines records, one missed medicine, incomplete risk guidance and staffing levels that did not always meet people's needs. The home took some action promptly after the inspection, including adding an extra night staff member.
Kind and respectful staff
People consistently described staff as kind, patient and respectful. Inspectors also observed reassuring and helpful interactions.
“Respectful and patient. That describes the staff here. It's a difficult job to do.” from the report
Good healthcare support
Staff made prompt referrals to healthcare professionals and kept information available for visiting professionals.
“Very timely referrals, and staff always know what is going on and are available.” from the report
Responsive management
The manager and provider accepted feedback and acted quickly on several issues found during the inspection.
“They took immediate action to address issues identified at our inspection and contacted us the day after our visit to update us on actions taken.” from the report
People's involvement
Residents and relatives could share their views through meetings and surveys. Inspectors saw examples of action being taken in response.
“Regular resident and relative meetings were held in the service. We saw that action was taken in response to people's feedback via these meetings.” from the report
Medicines were not always recorded or supplied safely
seriousTwo of the five medicines records checked had gaps. One person had not received one medicine for three days, and variable doses were not always recorded clearly.
“one person had not received one of their medicines for three days.” from the report
Risk information was incomplete
seriousSome identified risks, including choking, falls and diabetes, did not have matching care plans to guide staff. Steep staircases had also not been risk assessed for the need for gates.
“some assessed risks did not have a corresponding care plan so staff had clear guidance.” from the report
Staffing levels needed review
needs fixingInspectors found that staffing did not always meet people's needs, with some people waiting for support. An extra night staff member was added after the inspection.
“Staffing levels did not always meet people's needs.” from the report
Some restrictions lacked decision records
seriousFor some people, restrictions such as bed rails or room sensors did not have the required capacity assessments and best-interest decisions recorded.
“we did not always see that restrictions such as bed rails or room sensors had associated capacity assessments and best interests decisions.” from the report
End of life wishes were not fully recorded
needs fixingCare plans did not always explain people's personal end of life preferences in enough detail. Staff had also not received end of life care training.
“People's care plans contained a section on their preferred priorities for end of life care. However, these were not always person centred.” from the report
- 01How have you checked that medicines are now delivered on time and that every dose is recorded correctly?
- 02How do you make sure each person's current risks, including falls, choking and diabetes, are covered by an up-to-date care plan?
- 03What are the current staffing levels at night and during the day, and how do you respond when people have to wait for help?
- 04Do all restrictions, such as bed rails and room sensors, now have capacity assessments and best-interest decisions?
- 05How are people's personal end of life wishes recorded, and what end of life training have staff completed?
This was an unannounced inspection covering all five key questions; the previous inspection in 2016 had rated the service Good overall. This explanation was written from the published report of 16 July 2019 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
2 rated inspections over 3 years: the service has held its Good rating throughout.
- April 2021Inspected but not ratedcurrent ratingSafe: Inspected but not rated
- July 2019Goodstayed GoodSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2016GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- May 2014
Report published without a new overall rating.
- December 2013
Report published without a new overall rating.
- March 2013
Report published without a new overall rating.
- May 2011
Report published without a new overall rating.
- December 2010
Registered with the Care Quality Commission on 23 December 2010.
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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13 live-in carers within about an hour of Norfolk
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Most charge £990 to £1,120 a week. 9 can care for a couple. 14 years' experience on average.
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