Turning Point - Parkview

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.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

This service scored 42 (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 people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them. People’s needs were assessed on admission however staff did not always update their records if their needs changed. For example, the care plan and risk assessments for 1 person had not been updated for several weeks following an emergency medical incident. This put them at risk of ineffective care that did not meet their current needs. Following our assessment, the provider told us peoples' care records had all been updated and audited. We saw an example of an audit which confirmed this for 1 person.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them. Staff did not keep consistent and detailed records of the support they provided to people. This meant they did not have good information to help them assess whether the support was effective.

We observed people were supported to have enough to eat and drink during our site visits, although records did not always clearly demonstrate this. There was a lack of planning to ensure people ate a healthy diet or were involved in deciding what meals to eat in advance. We saw staff offered people a choice of two pies at lunchtime on our second site visit. However, a person who did not appear to understand the difference between the two pies had the decision made for them by staff. We saw where people had modified consistency food and fluids, staff had completed training and understood how to prepare these.

The provider did not always work well across teams and services to support people. For example, the service had not continued to advocate on behalf of 1 person when external professionals discharged them from their care several years ago. This had resulted in the person continuing to live in a way that put them at risk of harm. The new team leader had started to challenge perceptions impacting the approach to supporting the person and had referred the person to external professional to seek further input.

People had access to external professionals and had annual health checks with their GP. Relatives confirmed people were supported to attend health related appointments.Following this assessment, the provider assured us that risks assessment have been updated and staff have received refresher training in relation to positive risk taking.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Feedback from relatives about whether people’s healthcare needs were met was mixed. Most agreed the staff contacted healthcare professionals and supported them to attend appointments as required, although some felt the service did not always advocate effectively and make sure the person’s needs and preferences were considered. A relative said, “I think the care home should fight for them more”. However, another relative said, “[Family Member] always looks really well – has put on weight since been there.”

Following this assessment, the provider told us they have made improvements to advocacy processes, including clearer escalation protocols and staff training to support them to improve how they advocate on behalf of people in relation to health and well-being.

The provider did not routinely monitor people’s care and treatment to continuously improve it. They did not ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves. For example, where people had positive behaviour plans in place, the service was unable to demonstrate how these had been implemented because insufficient monitoring had been completed to show whether strategies had a positive impact on people’s lives. Where structured and consistent schedules, along with a stimulating environment, were recommended there was no evidence of this happening. People had little to do and the lack of structure meant people did not know what was happening in their day. The lack of monitoring meant the service did not have sufficient information to know how to support people in the most effective way.

The service did not always consider people’s rights around consent and did not always respect their rights when delivering care and treatment. We saw staff did not always seek people’s consent or explain what they were going to do before providing care. Although most people living at the service lacked capacity for many decisions in relation to their care, it is good practice to ask for their consent before providing care such as putting on clothing protectors before meals.. Staff completed mental capacity assessments and where it was found a person lacked capacity for a decision, these were made in their best interests with those close to them where appropriate. However, we noted these had not been completed in relation to decisions about how some people took their medicines. Where restrictions on liberty were necessary to ensure safety and care, appropriate applications had been made.