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.
What inspectors found, December 2023
Rated Inadequate and placed in special measures; inspectors found people at risk from unsafe care, weak medicines systems and poor oversight.
This was an unannounced focused inspection. Inspectors visited on 6 and 9 November 2023, spoke with people, relatives and staff, and checked care, medicines, recruitment and management records.
The inspectors found serious problems with safety. Risks such as falls, skin damage, nutrition and diabetes had not always been assessed. Safeguarding concerns were not always investigated or referred, and medicines were not always given or recorded safely.
The home was mostly clean and there were enough staff. People and relatives spoke positively about the care staff, the food and the manager. However, the systems meant to identify problems, learn from incidents and check care were not reliable.
The overall rating fell from Good to Inadequate. The home is in special measures, so CQC will keep it under review and normally re-inspect within six months. If it does not improve enough, CQC may take action to prevent the provider from operating the home.
Kind and familiar staff
People and relatives were positive about the care staff. People said staff knew them well and responded when they used the call bell.
“People told us they were happy and had their care needs met by care staff who knew them well.” from the report
Enough staff
Inspectors found enough staff to meet people's needs, and recruitment checks had been completed safely.
“Staff had been recruited safely into the service and there were enough staff to meet the needs of the people living at The Gables.” from the report
Food and choice
People had a choice of food and their dietary needs were catered for. The cook understood people's nutritional needs.
“People spoke positively about the food and drink they received at The Gables.” from the report
Clean communal areas
The communal lounges and bathrooms were mostly clean on the inspection days, although infection-control systems still had important gaps.
“The home was found to be mostly clean in communal lounges and bathrooms on the days of our inspection” from the report
People were at risk of harm
seriousIncidents including falls, injuries and a high-risk medicines error were not always investigated or referred to safeguarding authorities. The home did not have a reliable process for learning from incidents.
“People had been harmed or placed at risk of harm without external scrutiny of the home.” from the report
Unsafe risk management
seriousRisk assessments were missing for areas including falls, skin integrity, nutrition, oral hygiene and diabetes. Inspectors also found an exposed sharp metal pipe and an uncovered radiator in areas people used.
“People had been placed at risk of avoidable harm.” from the report
Medicines were not always safe
seriousInstructions and records for as-required medicines, sedatives, creams and eye gels were incomplete. This meant people could receive medicines late, unnecessarily or after they should have been discarded.
“People had been placed at risk of harm from medicines that were not managed properly and safely.” from the report
Consent and capacity records
seriousRecords did not show that consent had been sought for care. Mental capacity assessments and best-interest decisions were missing for some restrictions, including bed rails and a lap belt.
“The Gables did not ensure it obtained people's consent to care and treatment.” from the report
Staff training was out of date
needs fixingStaff had not received all the training needed for people's care needs, including diabetes, catheter care, pressure care and positive behaviour support. Staff did not always receive supervision.
“Staff had not been provided with the training necessary to meet the needs of the people living at the home” from the report
Poor management oversight
seriousAudits and governance systems did not identify or correct widespread problems. Staff were not always clear who was responsible for key tasks when the manager was away.
“There was a lack of governance and oversight of The Gables, this had led to shortfalls and people had been harmed and were at risk of harm.” from the report
- 01What immediate changes have been made to assess and manage risks involving falls, skin damage, diabetes and unexplained injuries?
- 02How are safeguarding incidents, falls and medicines errors now reported, investigated, referred and reviewed for lessons?
- 03Can you show how medicines such as sedatives, blood-thinning medicines, creams and eye gels are now checked and recorded?
- 04How have you completed decision-specific mental capacity assessments, consent records and best-interest decisions for people subject to restrictions?
- 05What up-to-date training and supervision have staff completed for the needs of the people living here?
This was a focused inspection of Safe and Well-led, prompted by concerns about safe care and governance; the report also gives an Effective rating and discusses consent and staff training, while it gives no separate ratings for Caring or Responsive. This explanation was written from the published report of 21 December 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, November 2018
Rated Good; inspectors found safe, kind and personalised care, with clear improvements since the previous inspection.
This was an unannounced, comprehensive inspection on 4 October 2018. The inspector spoke with people living in the home, relatives, staff, a health professional and the registered manager. They also reviewed care plans, medicines records, staff records, risk assessments and quality checks.
The home was rated Good in all five areas: Safe, Effective, Caring, Responsive and Well-led. Inspectors found enough staff, suitable medicines arrangements, good training, respectful care and personalised support. People and relatives described the home as caring and homely.
At the previous inspection in November 2017, the home was rated Requiring Improvement overall and breached a regulation about monitoring quality. The provider sent an action plan, and inspectors found that improvements had been made, including stronger audits and more detailed records.
Improved oversight
The home had introduced stronger audits and was keeping more detailed records after the previous inspection identified weaknesses in quality monitoring.
“During this inspection we found improvements had been made.” from the report
Safe staffing and medicines
Inspectors found enough staff to meet people's needs and suitable systems for storing, checking and administering medicines.
“People received their medicines at the right time and in the right way to meet their needs.” from the report
Kind, respectful care
Staff built positive relationships with people and supported their dignity, privacy, choices and independence.
“The registered manager and staff developed caring and positive relationships with people and treated them with dignity and respect.” from the report
Personalised support
Care plans reflected people's needs and preferences. Activities, communication support, religious links and end-of-life care were adapted to individuals.
“Care plans and activities were personalised and focused on individual needs and preferences.” from the report
Inspectors raised no specific concerns in this report.
- 01How do you now check that medicines records and medicines audits remain accurate and up to date?
- 02How are my relative's care plans reviewed when their health, risks or preferences change?
- 03What staffing levels will be in place during the day and overnight for my relative's needs?
- 04How will you support my relative's preferred activities, communication needs and important relationships?
- 05How will you involve us in planning end-of-life care and recording our relative's wishes and beliefs?
This was an unannounced comprehensive inspection covering all five CQC questions and the overall rating. This explanation was written from the published report of 23 November 2018 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
4 rated inspections over 8 years: the service has slipped, from Good to Inadequate.
- December 2023Inadequatecurrent ratingdown from GoodSafe: InadequateEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Inadequate
- November 2018Goodup from Requires improvementSafe: GoodEffective: GoodWell-led: Good
- January 2018Requires improvementdown from GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- November 2015GoodSafe: GoodEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Good
- November 2013
Report published without a new overall rating.
- October 2013
Registered with the Care Quality Commission on 1 October 2013.
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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26 live-in carers within about an hour of Hampshire
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.
Most charge £1,020 to £1,260 a week. 23 can care for a couple. 14 years' experience on average.
“I cannot recommend Prisca highly enough, she is one in a million.”
“He stayed with her throughout the pandemic, refusing to visit his own family, who lived nearby, to reduce the risk of infection.”
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.