Archived: Parkhill Nursing Home

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring – this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect. At our last assessment we rated this key question requires improvement. At this assessment the rating has remained requires improvement. This meant people did not always feel well-supported, cared for or treated with dignity and respect.

The service was in breach of legal regulation in relation to dignity and respect.

This service scored 40 (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 ensure people were treated with kindness, empathy and compassion, or ensure their privacy and dignity was respected.

We observed staff were mostly kind, respectful and gentle when providing care and support. We found improvements since the last inspection as most people now appeared appropriately dressed. However, on day one of our inspection we found one person was moving around the home dressed in an undignified way and this was rectified on the second day.

We noted in a sample of daily care notes and observed on our site visits, most people were not receiving sufficient hygiene and personal care relating to showering, hair washing, oral care and nail care. We saw that people’s skin, hair and nails were not always clean and it was clear from malodour that some people had not had a shower for some time. Our concerns were reiterated by people who told us they did not get regular showers and hair washes. One person told us, “I go weeks and weeks without a shower.” Another person told us, “They say the ratio of staff is correct, but they haven’t got time to give me a regular shower.” Our review of daily records further corroborated our concerns about a lack of showers, hair washing and oral care. One person told us they really wanted a shower, a hair wash and a haircut as they had not had one for a significant period of time. Through a review of records, our observations and the person’s malodour, we were assured this person had not received personal hygiene care for a long time and we arranged for this to happen for them during our inspection. Some people told us their clothes were not always respected and had raised complaints about their laundry provision, for example, clothes shrinking, going missing or having other people’s clothes in their room.

On the first day of our inspection, we observed 5 people in the dining room who needed assistance to eat their lunch; however, there was only 2 staff present and this meant people had to wait for help and their food went cold. We also noted there was several people in their rooms waiting a long time to be served their lunch. We observed on both site visits in dining rooms that all people present had large, bright blue disposable clothes protectors placed around them at mealtimes, this was undignified for people. This was raised at the last inspection as an undignified and unpersonalised blanket approach used by staff.

The provider did not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. They did not always take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

Since the last inspection, the provider had received significant support from local authority teams to ensure care plans included more information about people’s needs and preferences. As a result, some care plans had improved in relation to information about the person’s life and background to inform staff of people’s individual characteristics and life history. However, our observations of day-to-day care provision for people demonstrated this improved information had not always led to a subsequent improved people’s experience of individualised care. We found people were not always treated as an individual and care delivery was still found to be reactive and task-based due to staff being so busy and not having quality time to spend with people and provide personalised care. We noted people in their rooms did not receive any planned, personalised 1:1 activities of their choice.

We found 3 people had their bedrooms in a separate part of the building that was secured with a keypad. All 3 people required staff assistance each morning to leave this part of the building and join the main units of the home where communal areas were situated. We found these people were not assisted in a timely manner and were left unattended each morning of our inspection. On the first day of inspection one person told us, “I can’t manage myself because there are a lot of doors and it’s difficult with the frame. I’m ready about 7.30 am and they say give us a buzz when you’re ready but sometimes I’m up here till 10 am and today it was 9-9.30 am.” This meant 3 people were isolated and unattended in this area of the home and they had no access to fresh food or drink until staff attended to assist them to join the main building units.

The provider did not always promote people’s independence, so people did not always know their rights and have choice and control over their own care, treatment and wellbeing.

There was still use of agency staff at the home with significant agency use on night shifts. We found some agency staff had a language barrier. On the second morning of the inspection, we found an agency carer was alone overseeing people on the first and second floor units and we found their understanding of English language was very poor and we were unable to communicate effectively. This meant people, especially those people with sensory impairments, may find it difficult to make their needs and preferences known to staff when faced with such a language barrier. People told us of their concerns relating the ability of some staff to communicate effectively. One person told us, “I can’t understand some of the agency [staff] sometimes.” Another person told us, “Staff are lovely, but are quite difficult to understand sometimes.” We spoke with the provider about our concerns relating to some staff’s language barriers and their ability to understand people and meet people’s needs and preferences. They told us they were in the process of setting up extra support for staff where English was not their first language.

We found people were not always supported to remain independent and make decisions about their daily lives. People mostly chose where to spend their time on the unit they were based; however, they were not always able to easily access other areas of the home and the outside space and the people based off the units had to wait for assistance. People’s preferences around personal hygiene were not always respected and facilitated, as staff did not have the capacity to support people when requests were made. One person told us, “I don’t get many baths or showers. You have to ask. Like last week, I wanted my hair washed and they [staff] say you can have one if we aren’t busy, so I had to wait a day or two. I don’t get my hair washed as often as I should do and I’ve not had it cut for 5 or 6 weeks.”

The provider did not listen to or understand people’s needs, views and wishes. Staff did not respond to people’s needs in the moment or act to minimise any discomfort, concern or distress.

People mostly had to wait for assistance for all aspects of care and support, including food and drink, personal care and assistance to use the toilet. People gave multiple comments throughout the inspection in relation to staff taking too long to answer call bells when they needed assistance. One person told us, “I do use the buzzer if I need to go to the toilet, but sometimes they take too long and I have an accident.” This meant that people were left in a distressing and undignified manner when there was not enough staff to answer people’s calls for assistance in a timely manner.

We observed multiple instances throughout the inspection where staff were absent from units as they were providing care in other areas such as bedrooms; people were left alone in communal areas and we could hear unanswered call bells for long periods of time. We received many examples from people and their visitors relating to a lack of staff response when people needed immediate assistance and call bells went unanswered. Some people told us they regularly had to shout out loud for staff to assist them as they had no access to a call bell and staff were not present in communal areas. One person told us, “They [staff] are hardly in the lounge when you want them and at night it’s even worse. There are no buzzers in the lounge down here so people have to shout for someone if the carers aren’t here.”

The provider did not always care about and promote the wellbeing of their staff. They did not always support or enable staff to deliver person-centred care.

Staff told us they were happy in their role and felt supported by the provider. They did not raise any concerns with us during our inspection about their employment or the management of the home. However, we found staff were regularly asked to work extra hours and they told us they did not always want to do this. We observed staff were extremely busy throughout their 12 hour shifts and found staff absence was not backfilled leaving existing care staff to pick up additional work.

Staff were very helpful, kind, accommodating, and positive during our site visits and feedback from people and visitors was mostly positive.