This inspection took place on 24 and 25 November 2016 and was unannounced. The previous inspection was carried out on 25 October 2013 and there had been no breaches of legal requirements at that time. We had no previous concerns prior to this inspection.

The Gables Residential Home provides accommodation and personal care for up to 20 people. At the time of our visit there were 20 people living at the home.

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 of the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The registered manager and staff understood their role and responsibilities to protect people from harm. Risks had been assessed and appropriate assessments were in place to reduce or eliminate the risk. Staffing numbers on each shift were sufficient to ensure people were kept safe.

All medicines were stored, administered and disposed of safely. The home had policies and procedures for dealing with medicines and these were adhered to.

The home was meeting the requirements of the Deprivation of Liberty Safeguards. Staff had received appropriate training, and had a good understanding of the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards.

People were supported with their dietary and nutritional needs. People had access to a range of healthcare professionals when they required specialist help. Care records showed advice had been sought from a range of health and social care professionals.

The registered manager assessed and monitored the quality of the service provided for people. Systems were in place to check on the standards within the home. These included regular audits of care records, medicine management, health and safety, infection control and staff training and supervision.

There was an open culture at the home which was promoted by the registered manager who was visible and approachable. People and staff spoke positively about the registered manager.

We visited the Gables Residential Home in July 2013, when we identified that medicines had not always been kept secure and some people had been put at risk because they had not always been given their medicines at the right time with a true record of the medicines given.

We returned to follow up the action plan sent to us, setting out how people were to be protected from the risks associated with the administration of medicines. We found improvements had been made in the way medicines were managed, with safer arrangements in place to help ensure people were kept safe.

During our visit we spoke with four people who lived in the home, two relatives and four members of staff. People we spoke with told us that staff were respectful and caring and we observed staff to be knowledgeable about people's support needs. It was evident that staff enjoyed their role in supporting people and with the routines of the day. People had been involved in their care with care plans that reflected each person's needs and preferences.

People we spoke with told us that they were happy living at the Gables. Comments included “Exceedingly good”, “can’t fault”, “glorious food”, "people friendly” and “The best place I could possibly be in”. People told us they felt safe and comfortable.

We were given a tour of the home and found the home to be fit for purpose, fresh and clean through out and had been well maintained.

Staff understood how people should be protected from harm and knew how to report incidents of abuse. However, people had not always been supported safely with their medicines.

There were clear processes in place that monitored the quality of care people received. These included asking people and their families for their views about the service. All aspects of the management of the home had been monitored on a regular basis. People we spoke with told us they knew who to complain to if they were unhappy about any aspect of their care.

We spent time observing care practices, talking to people and looking at records.

People we spoke with told us that they were happy with the service and said that they were involved in their care. Everyone was complimentary. One person told us it was ‘Five star’ there, whilst another said ‘You can't fault it’. People told us that they felt safe and were able to talk to staff if they had any concerns.

People who used this service received a good quality of care and support. People were encouraged to express their views and were involved in their care. One person told us ‘staff ask me what I need all the time and explain if I don’t understand’.

We saw that staff were respectful and caring. People’s wishes were promoted at all times and staff were knowledgable about people’s support needs.

Care plans clearly reflected each person’s needs and preferences. Families were encouraged to be involved as much as possible.

All complaints and concerns were listened to and acted upon straight away.

People told us that they were very happy living at The Gables Residential Home. They said that staff were kind and respectful and that services provided were very good. People told us that they had a choice to participate in activities or decline. Below were also some of the things that people said:

"The home is very good"

"Before I came here my relative took me to some other homes but they were not as good"

"I came here and stayed two weeks before I finally decided to stay".

"The home is one of the best. "

"Staff listen and respect my opinion. I could not fault them"

"I am lucky to be here."

"I don't want to go any where else.

"I am very happy here"

"I do a lot of reading in my room. I am happy doing that"

People said that they had a choice of when to get up and retire. They told us that staff always asked them before assisting them with personal care. They said that they always had a choice to agree to have any type of treatment. We observed staff knocking on the door and waiting for an answer before going to assist people with personal care. The said that they were never under pressure to do anything that they did not want to do.

People told us that they knew about their care plan and that they signed it. They told us that they were registered with a General Practitioner (GP) and that the doctor came to see them when they felt unwell.

People told us that they had a choice of what to eat, where to eat and when to eat. They said that they had a variety of meals every day. They described the food as 'excellent'.

People told us that staff would always inform them before their information was shared with anybody. They said that they felt safe at the home. They said that staff were very good and polite. People told us that they knew who to talk to if they had any concerns

People told us that staff give them their medication at the right time. They said that staff were polite and explained the medication before giving it to them. People said that the doctor told them about a new medication before giving it to them.

People told us that they were happy with their rooms. They said their rooms were always clean and comfortable and no unpleasant odours.

People told us said that there was adequate supply of equipments to meet their needs. they were supported to use the equipments for their own safety and to maintain their independence. They said that they were satisfied with the services provided, they would complain to the manager if the had any complaints.

They said that they had confidence that their records were stored securely. They said that they had access to their records whenever they wanted to.