Archived: 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

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 remained Requires improvement. This meant people’s needs were not always met.

This service scored 50 (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 were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

We found improvements to personalised information included in care plans since the last inspection and they had been written in a more person-centred manner. We found some people now had more information in their records relating to ‘about me’ but this was not the case for everyone and further improvement was needed. It was clear that some permanent staff knew people well and we observed some friendly interactions and evidence of clear relationships. We received mostly positive feedback from staff and visitors about how well staff knew them.

Staff told us the provider did not allocate a budget for the activity provisions and funds had to be raised internally to provide most activities. People were complimentary about the activity co-ordinator; however, we found they had been absent for several weeks prior to the inspection and their post had not been backfilled. This meant that a programme of activities had not been taking place at the home. One person told us, “There’s not much to do here and the person who did organise things has been off for weeks. It is boring here; nothing to do.” The activity co-ordinator had returned to their post on the second day of our inspection.

At the last inspection we raised our concerns that one person’s condition of their DoLS to access the community for 3 hours per week was not being fulfilled. We found this had been implemented for a period after the inspection; however, this had not been happening for several weeks to the absence of the activity co-ordinator. We saw no evidence that people in their rooms had been receiving 1:1 personalised activity that was individual to their needs. We found one person’s preference was to stay in their room and watch television; however, we found their remote control did not have batteries and they had been unable to watch their television. We reported this to the deputy manager who arranged new batteries. We saw evidence that people received input from religious groups and the activity co-ordinator told us a music group had recently visited.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity.

We found continued concerns around the delivery of person-centred and individualised care. Interactions with people were not always effective and we found a lack of meaningful support strategies in place for people with distressed behaviours. We were not assured the staff team fully understood the diverse health and care needs of people with dementia and how to effectively support people and provide meaningful care interactions to ensure a good quality of life. Staff did not have time to always ensure the delivery of person-centred care when assisting people and therefore, people’s preferences for care were not always met.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

There was limited evidence to demonstrate how the service took a person centred approach to meeting people’s specific communication needs or alternative approaches to communication such as the use of visual aids. The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs. We did not see where staff had undergone training specific to communicating with people, particularly those people with dementia. However, we saw permanent staff knew most people well when interacting with people when they were available and present.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not always involve people in decisions about their care or tell them what had changed as a result.

There was complaints and comments information in the reception area of the home and there was a complaints policy and procedure in place. We reviewed the complaints information at the home and found only one recent complaint and this had been responded to by the provider.

The provider had some systems to involve people and seek feedback but we saw no evidence these were being used effectively. We found little evidence recorded in the care plans we reviewed that people or their families had been consulted about and had input in the design of their assessments of need or care plans.

People and their relatives told us they had not attended any meetings at the home recently. We did not see any evidence where information and meaningful input had been sought from people and their relatives and then used to improve the service.

The provider did not always make sure that people could access the care, support and treatment they needed when they needed it.

We were not assured staff and leaders always actively listened to information about people who are most likely to experience inequality in experience or outcomes. There was no evidence of seeking feedback from people or reviewing lessons learnt about access in order to improve how people accessed health services.

Staff and leaders did not always actively listen to information about people who are most likely to experience inequality in experience or outcomes. This meant people’s care was not always tailored in response to this.

People’s human rights were not always upheld as they were living in an environment not conducive to their individual needs and they were not always supported to make decisions for themselves. Although staff had received training in equality and diversity, we found staff were not always able to treat people as individuals and meet their preferences for care due to insufficient staffing levels. We did not see evidence where people had been provided with the opportunity and supported to give their views and achieve their goals.

People were not always 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.

There was no-one at the service experiencing end of life care at the time of our inspection. We were provided with an end of life policy and training information demonstrated staff had received training about end of life care. People did not always have detailed or personalised care plans in relation to their wishes for end of life care. We found people were not always consulted on their preferences and routines on general day to day living at the home; therefore, we were not assured that people would receive person-centred and individualised care at the end of their life.