Archived: Parkhill Nursing Home

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture. At our last assessment we rated this key question inadequate. At this assessment the rating has remained inadequate. This meant there were widespread and significant shortfalls in leadership at provider level. Leaders and the culture they created did not assure the delivery of high-quality care.

The service was in breach of legal regulation in relation to governance at the service.

This service scored 36 (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 have a clear shared vision, strategy and culture which was based on transparency, equity, equality and human rights, diversity and inclusion, and engagement. They did not understand the challenges and the needs of people and their communities.

Shortfalls in the provision of safe and effective care had not always been fully identified and actioned. Some improvements within key areas, driven partly by the input of the local authority, had been made since the last inspection; however, the service remained in breach of legal regulations. The insufficient staffing levels were of particular concern during this inspection and this impacted the delivery of safe and effective care. It was evident good, effective and safe provision of dementia care and person-centred care was not always implemented by the staff team and staff did not have time to spend with people. Although staff were kind and gentle, care delivery was often generic and task-led without any reference to good therapeutic strategies to provide meaningful interventions to people with dementia and other conditions.

Not all leaders understood the context in which the provider delivered care, treatment and support. They did not always embody the culture and values of their workforce and organisation. Leaders did not always have the skills, knowledge, experience and credibility to lead effectively, or they did not always do so with integrity, openness and honesty.

The provider is required to have a registered manager to oversee the delivery of regulated activities at Parkhill Nursing Home. There had been a turnover of several managers since the home was rated requires improvement in 2023; however, there had not been a manager registered with the CQC during this time and the current home manager of Parkhill had been absent for 3 months at this time of this inspection. The home was being managed by the deputy manager, who had been in post for only 5 months. We noted there was a lack of visible management support for the deputy manager around the home, which had been in special measures for over a year at the time of this inspection. People and their visitors told us they were aware of a large turnover of managers at the home. One visitor told us, “They [Provider] seem to have changed managers a lot recently. I don’t know where [Home Manager] is. [Deputy Manager] is very good and easy to speak to, seems very helpful and you see them walking about the place.”

The deputy manager was very helpful, knowledgeable and informative throughout the inspection and it was evident they knew people and staff well. They acted quickly when concerns were raised during the site visits and provided information via email. Feedback from people and their visitors was very positive in relation to the deputy manager and the positive impact they were having on the implementation of improvements at the home. Staff told us they felt supported by the deputy manager and there had been many improvements with communication between the team. Staff told us they felt teamwork was now good. One staff member told us, “[Name] is good for the home and has plans for the future. They are always willing to go through stuff. I’ve just had a supervision and found this helpful and supportive.”

People did not always feel they could speak up and that their voice would be heard.

People and staff told us the deputy manager was very approachable and easy to talk to. One person told us, “If there are any problems, I just speak to [Deputy Manager]. One relative told us, “I can speak to [Deputy Manager] and ask them anything.”

The provider had not ensured everything possible was done to facilitate a person’s communication needs to be able to speak up through different ways and means and ensure their voice was heard. The deputy manager told us it was not always easy to gain feedback from visitors to the home. However, feedback from people told us there had been no residents’ meetings for some time and we saw no evidence to demonstrate people and their loved ones being involved in decisions about the home.

The provider did not value diversity in their workforce. They did not work towards an inclusive and fair culture by improving equality and equity for people who worked for them.

Staff rotas demonstrated some staff often regularly worked a significant number of hours over their contracted hours. For example, we noted one care staff member had worked 42 additional hours in one week and another staff member had worked 7 consecutive 12-hour shifts without a break. Staff told us they had to complete extra tasks when other staff members were absent and this was over and above their daily tasks. One staff member told us they were put under significant pressure to pick up extra hours to cover staff absences when they had other commitments outside of their work role.

The provider did not have clear responsibilities, roles, systems of accountability and good governance. They did not act on the best information about risk, performance and outcomes, or share this securely with others when appropriate.

We found repeated concerns at this inspection which demonstrated a failure to ensure improvements were embedded and sustained. We found continued concerns relating to the environment, staffing levels, treating people with dignity and respect and the provider’s oversight of the home. Although audits and reviews were taking place, they had not identified the concerns the inspection team found and where concerns had already been identified, these had not always been addressed and actioned. Despite the provider already working to an action plan and working closely with the local authority quality teams, concerns raised at the last inspection and set out in the inspection report and the enforcement action, had not been fully addressed.

The provider did not always understand their duty to collaborate and work in partnership, so services worked seamlessly for people. They did not always share information and learning with partners or collaborate for improvement.

There was some evidence staff worked effectively with partner agencies such as the local authority and health care services, but there was limited evidence of full engagement with other aspects of the community. We saw no evidence of efforts made to fully engage the home and the people living there with meaningful and specific community engagement. We saw no evidence people were regularly supported to leave the home and access the community.

The provider did not focus on continuous learning, innovation and improvement across the organisation and local system. They did not encourage creative ways of delivering equality of experience, outcome and quality of life for people. They did not actively contribute to safe, effective practice and research.

There was limited evidence of how the service learnt from incidents and feedback from people and visitors and made subsequent improvements. The home was already subject to an improvement action plan; however, we found several areas of continued shortfall which had been noted at previous inspections and not yet been addressed or embedded. For example, people not always treated with dignity and respect, environmental concerns, governance and oversight and insufficient staffing levels.

Parkhill Nursing home has been rated requires improvement or inadequate for the last four inspections, and at each inspection since the organisation was purchased. There has been a continued insufficient investment to enable the home to make sufficient improvements to both the environment and staffing levels. We have identified multiple and repeat breaches of regulations. This is evidence of a history of failing to respond adequately to serious concerns and shortfalls set out in inspection reports and enforcement action.