Date of assessment 19 September to 19 November 2024. Gable Healthcare Service Ltd is a domiciliary care agency and a supported living service to people in their own homes. At the time of our assessment there was 1 person using the service. An assessment has been undertaken of a service that is used by autistic people or people with a learning disability but is not registered as a specialist service. We have assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted. As part of our assessment activity, we undertook an on-site visit on 19 September 2024, we visited a person in their home on 19 November 2024. This assessment was prompted by information we held about this service. During this assessment, we found several concerns with the quality and safety of care. The model of care and setting did not always maximise people’s choice, control and independence. Care was not always person-centred to promote people’s dignity, privacy and human rights. The ethos, values, attitudes and behaviours of leaders and care staff did not always ensure people using services lead confident, inclusive and empowered lives. We identified three breaches of the legal regulations in relation to safe care and treatment, staffing and governance.
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Date of assessment 19 September to 19 November 2024 Gable Healthcare Service Ltd is a domiciliary care agency providing personal care to people in their own homes. At the time of our assessment there were 9 people using the service. As part of our assessment activity, we undertook an on-site visit on 19 September 2024 and we visited people in their homes on 15 and 17 October 2024 and 19 November 2024. This assessment was prompted by information we held about this service. We assessed a total of 15 quality statements. At our last inspection the service was rated good. During this assessment, we found several concerns with the quality and safety of people’s care. We identified three breaches of the legal regulations in relation to safe care and treatment, staffing and governance. The overall rating of this service has changed to requires improvement.
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Gable Healthcare Services Limited received an overall Good rating across all five key questions at its first inspection as a newly registered domiciliary care agency supporting 15 people, including those with learning disabilities and autism. One minor gap was identified around documenting follow-up of specialist training competencies, which the provider committed to address.
Concerns (1)
minorStaff competency: “it was not evident how specialist training was followed up to check staff had gained the knowledge and competency required when working with people with a learning disability or autistic people.”
Strengths
· People were consistently supported by the same staff with very few changes, which people preferred.
· Robust safeguarding training in place; staff knew how to recognise and report abuse and could apply it.
· Medicines administration records were completed correctly and staff competency in medicines was regularly assessed.
· Highly positive feedback from health and social care professionals regarding end of life care delivery.
· Person-centred care plans included communication support, pictorial aids and accessible information in line with the Accessible Information Standard.
Quality-Statement breakdown (24)
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and managementGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
safe: Learning lessons when things go wrongGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Staff working with other agencies to provide consistent, effective, timely care; Supporting people to live healthier livesGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: End of life care and supportGood
responsive: Meeting people's communication needsGood
responsive: Supporting people to develop and maintain relationships to avoid social isolationGood
responsive: Improving care quality in response to complaints or concernsGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: Engaging and involving people using the service, the public and staffGood
well-led: Continuous learning and improving careGood