A care home in Kettering has been rated inadequate for a third consecutive time by the Care Quality Commission (CQC) and will remain in special measures, following an inspection carried out in June.
Five Gables Nursing Home, run by Jade Country Care Homes Limited, is a residential care home providing personal and nursing care for to up to 43 older people. At the time of the inspection there were 21 people using the service.
The home was previously rated inadequate and placed in special measures following inspections in June 2021 and January 2022. This latest inspection was carried out to assess whether improvements had been made but the service was still found to be inadequate. There were breaches in relation to records management, managing risk, oversight of the service, person centred care and medicine management.
As well as being rated inadequate overall following the latest inspection, the service was rated inadequate for being safe and well-led. It was rated requires improvement for being effective, caring and responsive.
As Five Gables remains in special measures, it continues to be closely monitored by CQC. If significant improvements are not made, enforcement action will be taken which could lead to the closure of the service.
Natalie Reed, CQC head of inspection for adult social care, said:
“Following our last inspection in January, we made clear to Five Gables the action needed to provide better standards of care to people.
“We haven’t seen any significant improvement and our concerns about people’s care and wellbeing still remain.
“At the last two inspections we found staff didn’t always have the necessary information to support people in line with their individual needs. At this inspection we found care plans and risk assessments still held incorrect information which could put people at risk of receiving inappropriate support.
“Medicine management needed urgent improvement. Records weren’t always completed, and staff didn’t have the required information to ensure people received their medicines as prescribed which could put people at risk.
“We found people weren’t always treated with dignity and respect. Many people told us night staff were 'rough'. This was fed back to the manager who agreed to investigate these allegations.
“We have told the provider that it must make urgent improvements. If it doesn’t, we will not hesitate to use our legal powers and take action to keep people safe.”
Inspectors found:
- Systems and processes to ensure oversight were not always effective. Audits completed had not identified and rectified the concerns found with record keeping, missing information, medicine administration and water temperatures
- Care plans and risk assessments did not always contain factual up to date information. People with specific health needs did not always have the information recorded to support staff to safely support them
- Risks had not always been mitigated and records did not evidence care was completed in line with people's needs. Risk strategies had not always been implemented or followed
- Records of staff completing care tasks were not consistent. We found gaps in personal care records, oral care and food records
- Not all staff had the training required to understand and have the knowledge of people's individual needs
- People and relatives did not always feel that all staff were kind and caring. We received mixed views from both people and relatives. The service used a lot of temporary agency staff who did not always know people well.
However:
- People were mostly supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. Mental Capacity assessments required improvement
- The environment had improved, and the provider had a plan in place to continue to update and redecorate the service. Safety mechanisms were in place. For example, window restrictors, radiator and hot pipe covers
- Referrals were made to external professionals to meet people's needs. For example, to speech and language therapists, Falls team and dieticians
- Relationships were supported and families were made to feel welcome when visiting the home
- Complaints were managed effectively. People, relatives and staff all told us they felt comfortable raising concerns
- Feedback was requested from people, relatives and staff. Meetings were arranged to share and discuss information.