CQC report explained · a nursing home
What the CQC found at The Gables Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Requires improvement
- Inspectors found the entrance door was open and a medicines trolley was accessible on the first day. Some cream instructions and medicine competency checks were not fully consistent, although the immediate security issues were addressed by the second day.
- Effective?
- Good
- Care plans were detailed and up to date. Staff were trained and knowledgeable, people's nutritional needs were monitored, and the home worked closely with health professionals.
- Caring?
- Outstanding
- Staff treated people with kindness, dignity and respect. Inspectors saw strong relationships, individual support and many examples of people being involved in choices about their care.
- Responsive?
- Good
- Care was personalised and people's communication needs, activities, faith and end of life wishes were supported. Inspectors found that complaints and concerns were recorded and acted on.
- Well-led?
- Good
- The home was organised and had an accessible management team. Audits, feedback and partnership working were used to monitor and improve care.
What inspectors found, August 2019
The Gables Nursing Home was rated Good overall, with exceptionally caring support but safety improvements needed.
Inspectors visited on 30 May and 5 June 2019. The first visit was unannounced and the second was planned. They spoke with people, relatives, staff and health professionals, and reviewed care records and management records.
People and relatives gave very positive feedback. Inspectors found staff were kind, knew people well and provided personalised care. The home offered many activities, supported people's choices and worked closely with health professionals.
The main concerns were about safety. On the first day, the entrance door was not secure and a medicines trolley was left open. These issues were addressed by the second visit. Some medicines instructions and repositioning guidance were also not always clear.
The overall rating was Good. Caring was Outstanding, while Safe was Requires Improvement. Effective, Responsive and Well-led were all rated Good. The overall rating was unchanged from the previous inspection in September 2016.
Kind and respectful care
Inspectors found staff knew people well and treated them with kindness, dignity and compassion. People and relatives gave unanimously positive feedback.
“We saw staff treating people with kindness and compassion.” from the report
Personalised support
Care plans described people's individual needs and preferences. Staff followed this guidance and supported people to make choices and remain independent.
“We saw people received personalised care from staff who knew them well.” from the report
Activities and involvement
The home provided a wide range of individual and group activities. People were supported to take part in outings, music, gardening, faith activities and family events.
“There were a very wide range of positive one to one and group activities available to people who lived in the home.” from the report
End of life care
The home had a recognised end of life care accreditation and worked with people and families to plan care around their wishes.
“We saw the home had assessed the needs of people living at the home and worked with people and their families to discuss their preferences and plan care on that basis.” from the report
Experienced staff team
Staffing levels were maintained and staff turnover was low. Inspectors found people received consistent support from an experienced team.
“Staff turnover was very low which meant people received consistent and experienced support.” from the report
Entrance security
seriousThe entrance door was open when inspectors arrived, allowing them to enter without staff knowing. The home dealt with this by the second visit, but inspectors recommended better monitoring systems.
“On our arrival on the first day of the inspection we found the entrance door of the home was open.” from the report
Medicines security
seriousA medicines trolley was left open in an accessible area on the first day. The home said it took immediate action, but inspectors recommended systems to monitor this.
“On the first day of the inspection we saw a medicines trolley was open in an accessible area.” from the report
Medicine instructions and checks
needs fixingInstructions for applying creams were not always clear. Medicine competency assessments were not being completed annually in line with best practice guidance, although systems were being introduced.
“Instructions for the application of creams were not always consistently recorded.” from the report
Repositioning guidance
needs fixingSome care plans did not clearly state how often people at risk of pressure sores should be repositioned. The plans were updated after inspectors raised this, and no impact on people was found.
“We saw care plans were not always clear about the frequency people needed to be repositioned.” from the report
- 01What checks are now used to make sure the entrance door stays secure at all times?
- 02How are medicines trolleys kept locked or supervised, and how is this checked?
- 03How are cream application instructions recorded and reviewed for each person?
- 04How often are medicine competency assessments completed for staff?
- 05How do care plans clearly record and monitor repositioning for people at risk of pressure sores?
This inspection looked at all five key questions and assessed the overall quality and safety of the home. This explanation was written from the published report of 13 August 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.
What inspectors found, November 2016
The Gables Nursing Home was rated Good overall, with Outstanding caring, although some records and dementia-friendly features needed improvement.
This was an unannounced inspection on 21 September 2016. One inspector observed care, spoke with people living in the home, visitors, staff and health professionals, and checked care files, medicines records, staff files and management records.
Inspectors found people were safe and received effective, kind and personalised care. Staffing, recruitment, medicines, cleanliness, nutrition and access to health professionals were all found to be good. Staff were described as respectful and compassionate, and activities included trips into the local community.
Caring was rated Outstanding. Inspectors found the support at the end of life was exceptional. The overall rating and the ratings for Safe, Effective, Responsive and Well-led were Good.
Kind and respectful staff
Staff treated people with dignity, patience and compassion. They offered reassurance, explained care and supported personal choices.
“Staff approach was observed to be extremely caring and compassionate.” from the report
End of life care
Everyone had an advanced care plan about where they preferred to be cared for at the end of life. Inspectors found strong planning, symptom control and support for relatives.
“The support staff provided to people at the end of their life was exceptional.” from the report
Staffing and safety
Inspectors found enough staff on duty during the day and night. Recruitment checks, risk assessments and safeguarding arrangements were in place.
“There was sufficient staff on duty to support people's assessed needs.” from the report
Activities and inclusion
People could take part in varied activities and trips into the community. The activities reflected different interests and helped people stay socially involved.
“There was a wide range of activities provided to people that responded to their needs and interests.” from the report
Medicine management
People received medicines as prescribed. Medicines were obtained, stored, administered and recorded through established procedures.
“Staff managed medicines well by obtaining, storing, administering and recording them appropriately.” from the report
Best-interest records
needs fixingRecords of decisions made for people who lacked capacity were not always clear. Inspectors recommended getting advice about better documentation tools.
“We recommend the registered provider seek advice regarding specific documentation tools to record best interest decisions.” from the report
Wheelchair cleaning
minorSome wheelchairs needed cleaning. This was raised with the manager during the inspection.
“We saw some of the wheelchairs required cleaning and this was mentioned to the registered manager to address.” from the report
- 01What changes were made after the minor medicines recording issues and the medication records coming loose?
- 02How are best-interest decisions and Deprivation of Liberty Safeguards now recorded and reviewed?
- 03Have the extra picture signs and pictorial menus been introduced for people living with dementia?
- 04How will staffing levels be matched to my relative's nursing, night-time and personal care needs?
- 05How are advanced care plans discussed with people and relatives, including their preferred place of end of life care?
This was an unannounced inspection covering all five key questions and the overall quality of the home. This explanation was written from the published report of 29 November 2016 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 Nursing Home
2 rated inspections over 3 years: the service has held its Good rating throughout.
- August 2019Goodcurrent ratingstayed GoodSafe: Requires improvementEffective: GoodCaring: OutstandingResponsive: GoodWell-led: Good
- November 2016GoodSafe: GoodEffective: GoodCaring: OutstandingResponsive: GoodWell-led: Good
- November 2013
Report published without a new overall rating.
- May 2012
Report published without a new overall rating.
- January 2012
Registered with the Care Quality Commission on 16 January 2012.
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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