About the service:

The Gables is a residential care service. The service provides care and support for up to nine people who have learning disabilities, autistic spectrum disorder or associated physical needs.

The service can also provide personal support and care for people in their own homes. The registered provider confirmed that at the time of this inspection there were no people using this part of service.

The service worked within the principles and values that underpin Registering the Right Support and other best practice guidance. This ensured that people could live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence.

There were two people living at the service at the time of this inspection.

People’s experience of using this service:

Improvements were needed to the way in which governance systems were set out and managed. Additionally, improvements were needed to ensure communications were being maintained consistently with external agencies and professionals.

People were supported to have choice and control of their lives, to be involved in reviewing their care and to make decisions for themselves.

However, peoples care records did not always clearly record how all of the decisions made about care delivery and provision had been agreed.

People continued to receive safe care. Staff understood how to keep people safe from harm and risk assessments were in place to help people and staff manage potential risks within people's day to day lives, whilst also promoting their independence.

There were enough staff who had the right knowledge and skills to meet people’s needs in a personalised way.

People were supported to have access to a varied and nutritious diet.

Information and support provided by external health professionals enabled people to consistently stay healthy.

Staff were caring, and people were treated with respect and kindness.

People, their relatives and staff had a say in how the service was being run.

Rating at last inspection:

The Gables was last inspected on 29 September 2015 and 5 October 2015, (report published on the 13 January 2016) and was rated as good overall.

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

Follow up:

We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If any concerning information is received, we may inspect sooner.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

People using the service were not able to communicate with us verbally. They shared their views through gestures, facial expressions and body language wherever possible.

We observed that the care staff were attentive to people's needs and that their interaction with people was friendly, respectful and professional.

We inspected The Gables on 29 September 2015. This was an unannounced inspection. Our last inspection took place on 18 April 2013. The service provides care and support for up to nine people. When we undertook our inspection there were three people living at the home.

People living at the home were of mixed ages. Some people required more assistance because of physical illnesses.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

CQC is required by law to monitor the operation of the Mental Capacity Act 2005 Deprivation of Liberty Safeguards (DoLS) and to report on what we find. DoLS are in place to protect people where they do not have capacity to make decisions and where it is considered necessary to restrict their freedom in some way, usually to protect themselves or others. At the time of our inspection there was no one subject to such an authorisation.

We found that there were sufficient staff to meet the needs of people using the service. The provider had taken into consideration the complex needs of each person to ensure their needs could be met through a 24 hour period.

We found that people’s health care needs were assessed, and care planned and delivered in a consistent way through the use of a care plan. People were involved in the planning of their care and had agreed to the care provided. The information and guidance provided to staff in the care plans was clear. Risks associated with people’s care needs were assessed and plans put in place to minimise risk in order to keep people safe. There was a great deal of co-operation between the provider and people’s families when people could not make decisions for themselves.

People were treated with kindness, compassion and respect. The staff in the home took time to speak with the people they were supporting. We saw many positive interactions and people enjoyed talking to the staff in the home. The staff on duty knew the people they were supporting and the choices they had made about their care and their lives. People were supported to maintain their independence and control over their lives.

People had a choice of meals, snacks and drinks. And meals could be taken in a dining room, sitting rooms or people’s own bedrooms. Staff encouraged people to eat their meals and gave assistance to those that required it.

The provider used safe systems when new staff were recruited. All new staff completed training before working in the home. The staff were aware of their responsibilities to protect people from harm or abuse. They knew the action to take if they were concerned about the welfare of an individual.

People had been consulted about the development of the home and quality checks had been completed to ensure services met people’s requirements.