Gables Manor is a care home providing accommodation and nursing care for up to 20 people who have learning difficulties and who require nursing care.

At the last inspection the service was rated Good. At this inspection we found the service remained Good.

People continued to be protected from the risk of abuse and felt safe. Staff had a good understanding of their roles and responsibilities if they suspected abuse was happening. The manager shared information with the local authority when needed.

People received their medicines as prescribed and the management of medicines was safe.

People continue to be supported by sufficient numbers of staff who had received adequate training for their role.

People were supported to have maximum choice and control over their lives and staff supported them in the least restrictive way possible; the policies and systems in the service supported these practices.

People were protected from the risks of inadequate nutrition. Specialist diets were provided if needed. Referrals were made to health care professionals when needed.

People who used the service, or their representatives, were encouraged to contribute to the planning of their care. People were treated in a caring and respectful manner and staff delivered support in a relaxed and considerate manner.

People received individualised person centred care from staff who had a good understanding of their needs. They were supported to take part in a range of social activities of their choice.

People who used the service, or their representatives, were encouraged to be involved in decisions and systems were in place to monitor the quality of service provision. People also felt they could report any concerns to the management team and felt they would be taken seriously

Further information is in the detailed findings below

We inspected Gables Manor on 30 June 2015. The inspection was unannounced. The last inspection took place on 16 July 2013. At that inspection we asked the registered provider to take action to improve the way they would ensure people continued to receive appropriate care and support if they could not live in the service due to events such as a fire or flooding. During this inspection we found that the registered provider had taken appropriate action to resolve this issue.

Gables Manor provides support with nursing and personal care needs for up to 18 people who experience learning disabilities. There were 17 people living in the service at the time of the inspection.

There was not a registered manager in post at the time of the inspection. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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. The service had not had a manager in post since March 2015 and the deputy manager was providing day to day management cover. A new manager was due to take up post shortly and we were told that they would apply to become registered with the commission.

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. At the time of the inspection two people who used the service had their freedom restricted and the registered provider had acted in accordance with the Mental Capacity Act 2005 (MCA).

Staff knew how to recognise and report any concerns so that people were kept safe from harm and background checks had been completed before new staff were appointed. Staff helped people to avoid having accidents. There were arrangements in place for ordering, storing, administering and disposing of medicines.

Staff had been supported to assist people in the right way. People had been helped to eat and drink enough to stay and they were provided with a choice of meals. When necessary, people were given extra help to make sure that they had enough to eat and drink. People had access to a range of healthcare professionals when they required specialist help.

Staff understood people’s needs, wishes and preferences and they had been trained to provide effective and safe care which met people’s individual needs. People were treated with kindness, compassion and respect.

People and their relatives had been consulted about the care they wanted to be provided. Staff knew the people they supported and the choices they made about their care and people were supported to pursue their hobbies and interests.

There were systems in place for handling and resolving complaints. People and their relatives knew how to raise a concern. The service was run in an open and inclusive way that encouraged staff to speak out if they had any concerns. The deputy manager and the registered provider regularly assessed and monitored the quality of the service provided for people.

We previously inspected this service on 16 July 2013 where we identified concerns with regard to the procedures that the provider had in place to ensure people's safety and wellbeing in the event that the home had to be evacuated in the event of an emergency such as fire or flood.

We received an action plan from the provider that told us the steps they would take to rectify the identified problems.

At this visit we looked at the contingency and emergency plans that the provider had put in place and we spoke to staff.

We found that the provider had in place good policies, procedures and clear instructions to staff to be followed in the event of a foreseeable emergency.

Due to the complex needs of the people who lived at Gables Manor we used a number of different methods to help us reach a judgement on the quality of service provision. These included talking with three people who used the service, the acting manager, two nurses and three care staff.

We looked at records. These included care plans and information about how the service was managed. We conducted a tour of the building and observed the interactions between the care staff and people residing at the home.

Records we looked at showed that people’s needs had been assessed and appropriate support provided to care for their needs. However the provider did not have the necessary arrangements in place to help ensure that people would be cared for and supported in the event of a foreseeable emergency such as fire or flooding.

We found that people were provided with a choice of suitable and nutritious food and drink. One person living at the home told us, “The food is alright. If I don’t like it I tell them and they get me something else. I tell the cook the way I like chicken to be cooked and she does it that way.”

We saw the building was undergoing a major project of refurbishment and extension and that the work was coming to an end.

We saw that there were sufficient numbers of suitably qualified and experienced staff to ensure good quality, safe support and care was maintained.

People were cared for in a safe environment that was well led and managed.

Prior to completing our inspection of the home we reviewed the action plan that the provider had sent us in response to our concerns.

We carried out an inspection of the home and observed what changes had been made.

We spoke with a member of staff and the Business and Corporate Services Manager for the provider and discussed with them the planned improvements to the premises.

We visited the service on the 18 April 2012 and spoke with three people who live at the home.

One person told us, “I like living here, the staff are nice. I get support from the staff when I need it.”

Another person said, “I like it here. I go to drama and go out to the shops to buy things.”

We spoke with a relative who told us, “My son settled in here very quickly, he is very well looked after. The staff that are here are absolutely excellent, I can’t fault them.”

We saw that people looked well cared for and their health and social care needs had been met. Staff treated the residents with kindness, dignity and respect.

The people we spoke to told us they liked living at Gables Manor, enjoyed the food they were given and felt safe with the staff.