The Gables

The provider had a quality assurance policy. However, the organisational governance processes were not always effective in identifying shortfalls.

Staff told us they did not receive regular testing for COVID-19. The provider failed to demonstrate on several occasions a testing programme was in place, in line with government guidelines for staff and people using the service. However, since the inspection the provider has supplied documents demonstrating a regular COVID-19 testing programme.

Risk associated with COVID-19 had not always been identified, assessed and mitigated effectively. Care plans were not in place to enable staff to support people safely. Staff did not always wear the correct personal protective equipment (PPE) which posed a risk of infection. However, since the inspection the provider has taken action to resolve these concerns.

The provider did not always follow or act in accordance with the Mental Capacity Act (MCA). The provider failed to demonstrate best interest decisions in place, this was addressed with the provider, they acted upon this putting in place capacity assessments. Further improvements were required to ensure all capacity assessments were carried out.

People were 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 supported this practice.

People received prescribed medicines. There was a process in place to inform staff of when they may need to seek additional medicines on a as needed basis such as pain relief."

Staff were positive about their experience of working in the service. Most people and relatives also provided positive feedback on the caring, friendly nature of staff and the provider.

The registered provider had accessed professional development resources and actively encouraged staff to improve their skills.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the guidance CQC follows to make assessments and judgements about services providing support to people with a learning disability and/or autistic people.

The service was not able to demonstrate how they were meeting some of the underpinning principles of Right support, right care, right culture. Attitudes and behaviours of leaders led to external agencies being unable to become fully involved in people's lives. There is a risk of limiting access to opportunities, support and guidance from professional bodies to enhance people's lives.

Right support: • Model of care and setting maximises people's choice, control and Independence

Right care: • Care is person-centred and promotes people's dignity, privacy and human Rights

Right culture: • Ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives