Parkgate Manor

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

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question requires improvement. At this assessment, the rating has changed to good. This meant people’s needs were met through good organisation and delivery.

At our last assessment, the provider was in breach of legal regulations in relation to care planning on the providers new electronic care planning system. Improvements were found during this assessment and the provider was no longer in breach of this regulation.

This service scored 68 (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 did not always make sure a person-centred approach was used to ensure people were offered activities that suited their individual wishes and provided meaningful engagement. People’s individual needs and wishes in relation to activities and how they would like to spend their days had not been assessed fully and individual plans were not in place. People did not have their own activity schedules and there were no person-centred activity boards, for people who understood pictures and symbols.

We did not see the on-site day centre facilities used over 3 separate visits and it was not evident how this space was used. Although we observed some people participating in activities, others were left with very little interaction from staff during the day. Some activities offered were completed by staff and people did not actively engage.

Relatives gave mixed feedback about meaningful engagement with people. A relative said, “There is always one or two staff with one person, but others are left sitting in chairs. Staff should try and do more with them.” There were notice boards available to demonstrate what activities had taken place, but this was not up to date. The provider confirmed that recording of activities that had been carried out needed to improve to demonstrate the activities provided. They were open to feedback and had taken immediate actions to make service improvements.

We also received some positive feedback. A relative told us, “Some people go for fish and chips in Bexhill,” and “[Person] goes out now. In their previous service they didn’t want to go out. Now they are going out and doing things.” The provider had employed an activities staff member for 4 days a week. A scrapbook had been developed detailing what people liked doing. A person told us, “I go to the pub.” A professional told us, “There are a lot of choice of different lounges and areas to access for the people living at Parkgate Manor.” They said, “The people they support access the community; photos are used for social stories and scrapbooking. The manager’s dog is part of the home and provides an additional touch promoting sensory stimulation, emotional wellbeing, and interaction.”

The provider had a minibus for people to go on trips out. Some people visited the local pub, parks, and town to do their shopping. Where some declined to go out, staff told us how they continued to offer opportunities for them. The manager said, “Sometimes it is very difficult to encourage people to go out, especially if they are set in their ways. It took us a year to get one gentleman to go out on the minibus. He really enjoys it now."

The provider understood the diverse health and care needs of people in their local communities, so care was joined-up, flexible and supported choice and continuity. Where needed, the provider supported people to access care and treatment they needed in a timely way. People who lived at the service had a wide range of needs which were covered in the staff training programme. This meant that staff were given the knowledge they needed to support people with diverse health and care needs. When a person's health needs changed, relevant sections of care plans were updated, and a memo was sent to staff informing them of changes. External professionals spoke highly of the level of communication they received from staff which promoted good continuation of care for people. A professional said, “This has been a long-standing care home with good interaction both our with our clinical and non-clinical staff.” They also said that their team visited the service regularly and, “I have observed a constant and high standard of care for people.” To ensure continuity of care, there were a mixture of permanent, agency and bank staff working throughout the service. This helped to ensure there were always staff available who knew people well.

The provider supplied appropriate, accurate and up-to-date information in formats that weretailored to individual needs. Each person's communication needs had been assessed and recorded. Where people had communication difficulties, we observed staff using pictures for meal choices and other people were given two choices and they pointed to what they wanted. Staff knew people well and how they communicated. A staff member said, “We tried a picture exchange communication system (PECS) with 1 person using 1 or 2 symbols. When they want more, they would point to the picture. The person will not respond to everyone as they are wary of new people. We are hoping they will in time.” The manager was aware of accessible information standards (AIS). AIS provides the legal framework to support people with their communication needs. The manager told us, “Staff use a variety of methods such as pictures, Makaton (signs and symbols to aid communication) and reading the person’s body language. Some people have yellow plates for meals to help them see it.” Easy read literature was used for some people to explain specific hospital procedures.

The provider did not always make it easy for people to share feedback and ideas. People had not always had regular keyworker reviews or meetings to give feedback about their goals and aspirations. Relatives had not always been asked to share their views about the care provided or any improvements the service could make. They were not always contacted about the person’s wellbeing or activities. Comments included, “I am kept in the loop by social services but not the home. They don’t get in contact unless it is about something medical,” “We feel we don’t get calls from them. No updates unless we call and ask.” One relative told us, “They are pretty good. If they say they will ring me back and then forget, they apologise.”

The provider had audio and easy read information for people about how to raise a complaint. Whilst most people would not formally raise a concern, staff told us they would know if people were unhappy through how they expressed their emotions. Relatives told us they would feel comfortable raising concerns if they had any. A relative said, " As far as things go, I’m quite happy with Parkgate Manor and [person] seems happy. If I did have a concern, I would speak to them." The provider had a complaint’s policy and procedure. There was also a suggestions/comments box at the front door to enable anyone to give feedback if they chose to. Although the provider had dealt with individual concerns and complaints as they arose, they had not analysed the information to identify any themes or trends to make improvements or share learning with staff. The provider had been open to feedback and taken immediate actions to make service improvements. However, this will take time to embed in the service.

The provider made sure that people could access the care, support, and treatment they needed when they needed it. People’s needs were assessed before moving into the service. The manager told us people would only be turned down for a place if they thought staff did not have the appropriate skills to provide safe care to an individual. Care plans detailed any reasonable adjustments required to ensure people’s specific health conditions and communication needs were met. People were supported to access healthcare services in a timely way. External professionals spoke positively regarding staff promoting people’s access to services. The manager said, “Our GP surgery has been great providing support.”

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support, and treatment in response to this. Staff had completed training around Equality, Diversity and Human Rights (EDHR), which helped to recognise, promote and protect people's protected characteristics. Staff showed a good awareness of what discrimination meant and how to challenge any concerns. They supported people to go out, they made referrals to health services, and they encouraged people to take part in social activities. The manager told us, “There were volunteers from the local church who offered to take people, but no-one wanted to go. People still take part in the annual church fete and a photography competition. Everyone won a prize. At the local pub, all the artwork in the bathrooms is done by the people who live here.”

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life. The service was not supporting anyone at the end of their lives at the time of assessment.Care plans referred to Respect forms that were included in care plans. These forms contained information relating to future emergency care if needed.People’s care plans contained vital and personalised information about their end of life wishes, including what flowers, pictures, or music they wanted.

The manager told us that when one person was in receipt of end of life care the person returned from hospital to die at Parkgate in line with their wishes. The family were told what to expect at the final stages of life. When people living at Parkgate were asking about the person, staff explained they were poorly and when the time came, supported them with the loss of their friend. The service worked with the hospice at home and frailty team for another person and shared the person’s wishes with these teams. The manager told us they would, “always stay with a person at the end of their life so they wouldn't be left alone.”