Parkhill Nursing Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

People were not receiving care that met their needs and was in line with their preferences. There was a lack of continuity to ensure people received the care they needed and it was not clear people were involved fully with decisions about their care or that affected the home and the way they were supported. People did not receive equal access to care and outcomes for people in how their needs were met varied.

This service scored 36 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People generally spoke about the care positively. However, people’s experience did not evidence personalised care that met people’s specific needs. Some families told us they supported their relative with personal care and bed linen changes to ensure these care needs were met.

Some staff knew people and felt able to provide person centred care but recognised this was not the case for all staff. The senior management team recognised that improvements were needed to ensure people received the care they needed and had recently increased their oversight of the care provided on the units. Leaders were aware improvements were needed to the care plans and records being maintained.

We observed that people were not getting care delivery in line with needs or care plans. Not all staff were aware of people’s specific needs, there was a lack of attention and interaction for people cared for in their bedroom and staff were task focused in how they provided care. There was limited evidence that oversight of care plans and systems to ensure person centred care was delivered were being used effectively.

Plans were not clearly in place to ensure people had continuity of care. People fed back challenges in relation to the use of agency staff who did not know people’s needs and risk. These area of concern for people had not been resolved since our last inspection.

Staff gave mixed feedback and staff understanding of providing appropriate care varied. Some staff had a better understanding of people’s needs and their responsibilities as carers than others.

Partner agencies had some concerns about how care was being provided. There was concern that improvements were slowly being made but this was very recent and had not been embedded within the home.

Processes were not effective in ensuring continuity of care. Care plans were not in place for everyone and the service was still in the process of moving from paper to electronic care plans. This process had been ongoing for several months. There was a lack of consistency in how care plans were implemented to cover people’s needs and risks and a lack of consistent review to ensure information was accurate and relevant. Provider oversight to ensure accurate records was ineffective. Handover processes between staff were brief and did not ensure agency staff understood people’s needs.

People were not aware of who was managing the service and talked about numerous changes of management within the home. People generally told us they felt able to raise concerns but were not clear on how these had been resolved. People were not always effectively communicated with when being provided support and we observed a lack of interaction when people were receiving support including to eat and drink and with mobility.

Staff were not always clear on how to meet people’s communication needs and there was limited evidence that staff were effectively communicating with people. Some staff raised concerns about communication barriers, particularly in relation to the agency staff.

There was limited evidence to demonstrate processes to ensure information was provided in practice. There had been a recent meeting with people and families, completed with the support of other stakeholders, but there was lack of consistent engagement with people. Records did not demonstrate how people were involved and information was provided to them or their families.

People were not clear how they were involved and listened to. People generally told us staff were responsive but this was not supported by our observations, During our visit we found people were not effectively supported with their preferences and choice was not promoted.

Staff were not always clear on how to meet communication needs and there was limited evidence that effective communication was used by all staff. Leaders told us they recognised the importance of listening and involving people and had plans to take action to involve people in the development of their care plans.

There was a lack of evidence that a consistent approach was taken to involving people in their individual care and within the service more widely. There was a lack of consistent meetings to involve people and limited opportunities to develop agreed care plans and review these.

People did not have concerns about how they were supported. However, people in their bedrooms did not always get the same level of support and people with specific needs, such as a dietary requirement, did not get the same amount of choice and variety of snacks as others.

Staff told us they supported people to have regular checks with the doctor and other services they may need and that the doctor visited the home regularly. The activity worker told us they would be looking at developing further work for people cared for in bed.

Partners recognised that not everyone was receiving the same quality of care and support and were working with the provider to make the improvements needed.

Processes were not effective in ensuring the people all received good quality care. People in bedrooms were often disadvantaged in how they were supported and did not get the quality of care they needed.

People’s experience of care varied. We found that people who chose to stay in their bedroom or who were cared for in bed did not get the same level of interaction, access to food and drink or access to activities as those who spent their time in communal areas or who were able to verbalise their needs more easily.

Staff told us they supported people to have regular checks with healthcare services. However, there was a limited understanding of aspects of care and the impact they had for people and staff were not always proactive, for example with ensuring sensory equipment was maintained and used to support people including access to glasses or hearing aids.

There were no clear systems of oversight to ensure people had equal opportunities, experiences and outcomes. Records were insufficient in detail to allow easy identification of any shortfalls. The provider had limited oversight on how care was being provided by the staff team. Shortfalls in experience highlighted by partner agencies had not always led to a robust action being embedded to ensure people had access to drinks, personal care and repositioning.

People were not clear that any discussions had been undertaken to plan for the future and records indicated that such conversations had not been undertaken.

Staff had a limited understanding of people’s needs around plans for the future and lacked the knowledge of who had made decisions about resuscitation in the event of a medical emergency.

Some people had care plans in relation to support for the end of their life. However, where these were in place they were task focused and lacked person centred details. It was not evident that processes to involve people or families had been undertaken. Staff had not all completed training in areas such as delivering end of life care and there was a lack of knowledge and information about people to support staff to identify if and when people were becoming unwell.