Parkfield Grange

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

This is the first assessment for this service. This key question has been rated good.

This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 75 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Electronic care planning system was used to record people's health, wellbeing, preferences and support needs. Care plans were generally personalised and included information about people's interests, routines and how they wished to be supported. Risk assessments were completed and reviewed regularly, with some records providing clear guidance on managing specific health conditions and individual risks. However, others lacked personal centred detail to guide staff. For example, records relating to catheters and other health conditions did not always contain detailed personal guidance. We fed this back to the provider who advised they had already taken action to rectify these records. Relatives told us they were involved in assessing and reviewing care needs. One relative said, "[Person] has a detailed care plan, regularly reviewed with us." Another told us, "[Person's] care plan is reviewed frequently, and I can catch up with a supervisor regularly." Overall, there was good evidence the service was working with people and their relatives to review care and ensure support continued to meet people's needs.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards.

People’s dietary needs, preferences and associated risks were assessed and recorded, with staff able to access up-to-date information to support effective care. Dietary guidance was available within care records and kitchen staff had access to information about people’s nutritional requirements. Recommendations from speech and language therapists were shared with relevant staff, helping to ensure people received food and drinks in line with their assessed needs. Fluid intake was monitored where required, and appropriate referrals were made to specialist professionals to support people’s health and wellbeing.

Where people were at risk of weight loss, referrals were made to dietitians, weekly weights and Malnutrition Universal Screening Tool (MUST) assessments were completed, and fortified foods, snacks and milkshakes were used to support nutritional intake.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services.

Staff worked effectively with other teams and healthcare professionals to support people’s health, wellbeing and safety. Care records demonstrated specialist advice was sought and followed when needed, helping to ensure people received coordinated and responsive care. The service worked closely with a range of professionals. For example, staff followed guidance relating to pressure care, used sensor equipment and welfare checks to reduce falls risks, and supported healthcare professionals during visits such as insulin administration. Staff made referrals to external professionals when required and acted on the outcomes of assessments and recommendations.

The provider supported people to manage their health and wellbeing to maximise their independence, choice and control. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People were supported to maintain and improve their health and wellbeing. Care records contained information about people's healthcare needs, associated risks, signs of deterioration and the actions staff should take in response. We found care plans were reviewed to ensure information was more detailed and personalised. Despite this, staff demonstrated a good understanding of people's health needs and worked proactively to support positive outcomes.

People and relatives spoke positively about the support provided. One relative told us, “[Person] eats well in the dining room, has put on much needed weight.” Another said, “[Person] is seen by GP and district nurse, and any needs catered for.”

The registered manager described how people were encouraged to make healthier lifestyle choices where this had been recommended by healthcare professionals or requested by people and their relatives. Opportunities for physical activity and meaningful engagement were available to support people's overall wellbeing.

The provider routinely monitored people’s care and treatment to continuously improve it. They ensured that outcomes were positive and consistent, and that they met both clinical expectations and the expectations of people themselves.

Staff consistently reviewed information relating to people's health, wellbeing and safety. For example, fluid intake was monitored against individual targets, weights were checked regularly where required, and food and fluid charts were used to monitor nutritional intake.

Staff acted when concerns were identified and worked with relevant healthcare professionals to support positive outcomes. We observed measures such as fortified foods, snacks, milkshakes, and regular fluid prompts were used to reduce identified risks and improve people's wellbeing.

People's care was planned around their individual preferences, interests and routines, which was reflected in both care records and personalised living environments.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment.

People and those important to them were involved in decisions about their care and treatment. Care reviews were completed with people and, where appropriate, their relatives, and the service considered important legal arrangements such as Lasting Power of Attorney (LPA), Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) decisions and wider advance care planning. People's wishes, preferences and choices, including those relating to future care and end-of-life support, were discussed and recorded within care records.

Records demonstrated the service worked in line with the principles of the Mental Capacity Act 2005. Capacity assessments and consent records were in place where required, and documentation showed staff recognised people’s right to make decisions about their care, including the right to refuse support. For example, records acknowledged some people may choose to decline personal or continence care and provided guidance for staff on how to respond appropriately. Where appropriate, people were also supported to self-administer their medicines, promoting independence and choice.