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.

The service was in breach of one legal regulation in relation to how the provider ensured people received care that was personalised and met their individual needs.

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 ensure people were at the centre of their care and treatment choices or work in partnership with them to respond to changes in their needs.

People did not receive care which was inline with their needs, wishes and preferences. Staff told us they had to start getting people up from 5am so that people were washed and dressed for the day staff. Although work had been completed to make care plans person-centred, they did not always contain enough detail or guidance for staff to follow people’s preferences. We observed instances where specific preferences, such as where people wished to spend time, were not always respected. Care plans were not consistently updated to reflect people’s current needs, and information available to staff was inconsistent across communication records, including handover notes, resident snapshots, and flash meeting minutes.

We found examples of institutional approaches to care. We also noted issues with the television aerial, meaning people were unable to watch TV at times. Staff attempted to resolve this by moving a DVD player from a smaller lounge, which left other people without entertainment, and the DVD player did not work.

People could not do the things they wanted to do when they wished to. Care plans indicated some people wanted to go outside, but records did not show action had been taken to support this, even during warmer weather. Another person’s care plan stated they enjoyed walking in the garden, yet there was limited evidence this had happened in the last six months. Records did not demonstrate people who chose to spend time in their bedrooms received targeted one-to-one support for mental stimulation. We observed people sitting with little stimulation, and feedback indicated there was not enough for people to do. One person commented, “They do activities here. [The activity worker] comes in 3 times a week, which to me isn’t enough. We do armchair exercises, make things, I enjoy it. Could just do with their being something to do every day.” Activities were limited when the activity worker, who worked part-time, was not on shift. The activity worker was enthusiastic, took people’s lead regarding choice of activities, and encouraged participation when possible.

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

Staff did not consistently have access to the guidance and information they needed to ensure people’s care needs were met. Medical advice was sought when required, and people were supported to attend appointments. However, there was a lack of consistently accurate and detailed information about people’s needs across records. This meant it was not always clear which information was most up to date, and care was not always delivered in line with assessed needs.

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

There was limited evidence information was adapted for people’s needs, for example through the use of pictorial materials. However, staff were generally patient when communicating with people and supporting their choices.

Resident and relatives’ meetings were held with input from the deputy manager, but there was little evidence the provider proactively communicated updates. For example, people, families, and staff were not fully aware of recent changes and decisions about the management of the service.

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 explain what had changed as a result.

Meetings were in place, and staff did take time to listen and involve people in decision-making. One person commented, “[Deputy manager] is the manager. [They] are good and always make time for me and answer any questions I have.” We also observed the activity worker involving people in choosing activities on the days they were on site. Staff told us residents and families had helped run stalls at the Christmas fayre, which was described as a very positive experience.

However, there were occasions when people’s views were not respected. For example, when the television signal was not working, staff removed a DVD player from a quiet lounge to use in the main lounge. This meant people in the smaller lounge could not watch television or a film if they wanted to. Although these people raised concerns, staff continued to remove the DVD player.

We also noted preferences recorded in care plans were not always followed. For example. one person wanted to go outside, but there was no evidence this had been supported, even during warmer months. A further person’s care plan noted they liked to walk in the garden, but records did not show this was happening regularly, and the garden was not safe or secure for use.

There had been no recent complaints about the service, and people and families told us they did not have any current concerns about the care being provided.

The provider made sure people could access the care, support, and treatment they needed when required.

People told us staff were very good and would seek medical assistance when needed. One person commented, “The care here is good. If you’re not well, they are on the ball.” We observed some staff knew people very well and understood their current needs. However, this was not consistent across all care teams, particularly at night when there was a high use of agency staff and inconsistencies in the guidance and information available to staff.

Staff and leaders did not always actively listen to information about people most likely to experience inequality in care or outcomes. This meant people’s care was not always tailored to meet their individual needs.

People did not always have positive experiences or equal access to care in line with their preferences. For example, people were not consistently supported to have regular or daily showers if they wished, and there were limited opportunities to access the local community. Staff told us work was ongoing to develop community links.

People were not always supported to plan for important life changes, including end-of-life care, so they could make informed decisions about their future.

Care plans did not consistently include people’s wishes for the future or their preferences for end-of-life care. Some records noted people did not wish to discuss these matters, but there was no evidence these conversations were revisited as part of ongoing assessment and review. Staff had completed training in this area.