Park View

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement.

This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The service was in breach of the legal regulation in relation to the way the service gained people’s consent and assessed their mental capacity to consent.

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’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them.

Pre-admission assessments were being carried out prior to people moving into the service. However, the pre-admission assessment viewed identified a risk related to the person’s medical history and indicated a plan needed to be created to support any relapses. There was no plan for this in place placing the person at risk should a relapse occur.

People’s care was not always regularly reviewed with them. The provider had a system in place for regular review, including review of people’s goals which involved them and their representative. However, we did not see evidence of this for everyone. For example, for one person how had been living at the service for over 2 years, there was no evidence this review had been carried out. For another person, the last recorded evidence of this review was in 2023.

While people had some support guidelines in place which were recent, the majority of the care documentation which the provider policy identified as required, had not been updated for a significant period of time.

We saw examples of a recent review of care and goals for one person. This showed evidence of them and their family being involved.

People’s relatives told us they were involved in discussions about their relative’s care. One relative told us; “They always call me before they change the care plan.”

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

People’s records did not show how the service was working in line with Stopping over medication of people with a learning disability and autistic people (STOMP). The provider’s medicine policy was inclusive of this process; however, we did not see evidence of this having been implemented in the service.

People were supported to keep in touch with their relatives and facilitated visits. During our site visits, we observed staff supporting one person get ready for a holiday with their family. The person spoke to us enthusiastically about their plans for the trip. A relative told us; [Relative] Go and see him every 6-8 weeks. [Person] Comes over for an overnight stay every 6 months or so.”

Staff told us that one person’s wish for the future was to live closer to their family and independently, however we did not see evidence in their care documentation of how this was being explored with the person.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services, however not all of people’s care documentation had been reviewed and up to date and robust records maintained.

We saw some evidence of people attending appointments such as heath checks, medicine reviews, dentist and optician, however records of these were not consistent and robust.

Staff worked closely with external professionals, including GPs, chiropodist, massage therapy to support people. One healthcare professional told us; “I've serviced Park Viewforseveral years, now, and I can give nothing but praise - all the way around.” People’s relatives were complimentary about the staff team and the support provided to their loved ones.

During out site visit we observed a conversation between staff and a medical professional arranging the annual vaccinations for people. Staff confirmed that conversation have been had with people and their representatives and asked for the details of the visit so they can create a visual poster to let people know who was coming and why. The staff member explained they used a social story to discuss this with people.

People’s relatives confirmed their loved ones could see a doctor and other healthcare professionals when needed.

The provider did not fully support people to manage their health and wellbeing to maximise their independence, choice, and control. Staff not consistently supporting people fully to live healthier lives and where possible, reduce their future needs for care and support.

Staff in the main supported people with their dietary needs well. People were involved in designing their own menus by choosing from a diverse variety of options organised in a pictorial format by staff so people can have a visual aid of what the food looked like.

One person was being seen by a dietician; however, their care documentation did not evidence the reason for this, or the advice and guidance provided following appointments. Their care documentation referred to restrictions in relation to what the person should not be eating, however there was no documented reason for this.

Most people’s care documentation was not up to date, and positive behaviour plans had not been reviewed in a significant amount of time. However, some of the support guidelines which had been updated more recently included information about how changes in people’s presentation and emotional state or distress which may show a deterioration in their health or wellbeing, were recognised. For example, for one person, their guidelines provided staff with information about their presentation which might indicate they may become anxious, everyday proactive strategies as well as daily routines which were important for them.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

People had allocated keyworkers, which was a designated member of staff who supported them and oversaw their care. Staff told us that they held keyworker meetings with people, but they did not record these.

While we could see evidence of people going out in the community on a regular basis and choosing what they wanted to do daily, the provider’s process to monitor people’s care and support was not consistently followed for everyone. We did not see recent evidence of how people engaged in planning their life ahead to ensure it was a life they chose or needed.

There were some positive outcomes for people using the service. However, we did not see recent evidence for 2 people that their skills, life experience and strengths were discussed with them and those involved in their care, to understand how their short, mid and long-term life choices, goals, ambitions and outcomes could be planned and achieved.

Staff provided examples of how they supported people to identify and plan activities they enjoyed.

The provider did not tell people about their rights around consent or respect these when delivering care and treatment.

During our assessment we found that the correct procedures were not followed where people lacked the capacity to make specific decisions or where there was no reason to believe they lacked mental capacity, consent was sought in line with legislation.

Where people had restrictions in place such as in relation to food or drinks, use of technology or sitting arrangements in the car, there were no documented records of decision specific mental capacity assessments (MCA) and best interest decision (BI) in line with the Mental Capacity Act and Code of Practice.

Some people had Depravation of Liberty Safeguards authorisations in place or applications had been made, however there was no evidence of MCA and BI regarding decision related to care and support.

Information in relation to people’s ability to consent was inconsistent throughout their care documentation. Conclusions were drawn in relation to people’s capacity or lack of, to consent to certain areas of their care and support without the correct process being followed and evidence. For example, related to finances, medicines and aspects of people’s health and healthcare.

Where MCA and BI had been previously completed, these had not been reviewed, some dating back to 2017.

Without thorough and robust mental capacity assessments or formal consent, people were at risk of restrictions, exploitation and receiving inappropriate support.