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 one legal regulation in relation to how the provider ensured people were treated with dignity and respect.

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 treat people with kindness, empathy and compassion, or respect their privacy and dignity.

People spoke very highly of the staff team. One person told us, “The staff are very pleasant, very good and effective.” A family member told us, “The current crew of staff is the best it’s been in the time here. They [staff] all love [family member] and really take care of them.” However, the provider had not ensured staff had a good understanding of person-centred care, and we observed several examples of institutional practice. This included getting people up very early to manage the demands of getting people washed and dressed and getting people ready for bed similarly early. We observed several blanket approaches to care, such as bringing people down to one communal lounge for meals, even though there was insufficient seating for people to sit at a dining table if they wished, and placing plastic clothes protectors on people without obtaining consent. These matters had been noted at previous inspections, and the ongoing concerns had not been identified or addressed by the provider at the time of our visit.

We found people received shower approximately once a week, regardless of their preference. We found several people with long dirty nails and poorly cleaned teeth. We were not assured people’s personal care was being consistently maintained to a high level.

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

There was limited evidence people were treated as individuals. While the activity worker described a range of ways they engaged people, including one-to-one activities, this was not reflected in records. The activity worker was also not supported by the provider with resources to enable regular access to community activities.

Care plans contained some person-centred details, although the quality and depth varied, and these plans and preferences were not always followed. Permanent staff generally knew people well and understood their care and support needs.

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

Some information about how to support independence was included in people’s care plans, but this was not consistently followed. For example, one person’s care plan stated they should be given finger foods to encourage eating independently. However, staff consistently provided full assistance instead. People were not always allowed to move freely around the unit, and we observed occasions where individuals were placed in a set position which made it difficult for them to get up if they wished.

To maintain oversight, the provider required everyone to go to the ground floor communal areas every morning for breakfast and lunch. This meant people could not always return to their bedrooms if they wanted to and had limited options about where to spend time due to restricted space.

Records showed people had limited access to showers, often only once a week, even when their preference was daily. There was no accessible bath, so people with mobility issues could not have a bath if they wished.

The deputy manager was keen to support independence and discussed this with staff during a flash meeting. People who had capacity and wanted to remain in their bedroom were supported to do so.

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

Insufficient staffing levels impacted on staff’s ability to respond to people's care needs. One person told us, “There is definitely not enough staff though. I do have to wait for their assistance a lot of the time. They do get me up, wash me and dress me. It’s good care, just have to wait a lot longer for it as there is not enough staff.”

We observed examples where people did not receive care in line with their care plans, including timely support to eat and drink. People were sometimes left with food in front of them which went cold because staff were too busy to provide encouragement, prompts, or oversight.

The provider did always not prioritise staff wellbeing and did not consistently support or enable staff to deliver person-centred care.

Staff spoke highly of the deputy manager, who was taking the lead in many areas of managing the home. However, they told us they rarely saw anyone from the provider’s senior management team, including the senior manager who had stepped in to manage the service in the months before our inspection. Staff were not always given regular supervision, and appraisals were overdue. There were no records to show night staff were supported, and no night checks had been completed prior to our inspection.

Most staff cared deeply for the people they supported, but they reported not being paid for breaks or for any training completed outside their shift hours. Staff had experienced backlashes from the local community in the past due to the failings of the provider but remained committed to supporting the people living at the home.

We saw some evidence of staff appreciation through an employee of the month scheme.