We carried out a review of the data available to us about Parkwood House on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Parkwood House, you can give feedback on this service.
Parkwood House is registered for a maximum of 45 people. Many people using the service live with dementia or have a physical disability. The home provides accommodation over three floors. It occupies a cul-de-sac position directly opposite a level access park with café. There were 36 people using the service at the time of this inspection.
The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
This inspection took place on 7 and 12 September and was unannounced.
At the last inspection in February 2016 the service was rated Good. At this inspection, we found the service had improved to Outstanding.
Why the service is rated Outstanding.
People had contacted the Care Quality Commission with compliments about the service prior to our inspection and every comment during the inspection also praised the service, with comments including, “They are most caring towards their clients and nothing is too much trouble and they are always ready to listen to relatives and friends. Hopefully when my time comes this is the place I would choose”.
People were at the heart of everything the service did. Staff had an excellent understanding of people's needs and provided person centred care to a very high standard. The passion to provide people with love and a life of value, regardless of their disability, was led by the provider, registered manager, and was the overarching ethos of the service. The provider said the registered manager showed great leadership and the registered manager said, “I couldn’t ask for more provider support.”
People said they felt safe. Recruitment, medicine management and infection control standards promoted people’s safety. The premises were kept in a safe state and there were plans for continuing improvement, of the toilets and shower rooms, as two examples. Risk management was robust whilst not placing undue restriction on people. Any restriction was with people’s consent or following meetings to establish what was in their best interest.
The service was very well staffed, which meant people had constant attention paid to their needs and wishes. Nursing and care staff were supported by equally enthusiastic ancillary staff, such as activities, catering, housekeeping and administration. Staff were skilled and knowledgeable, with exceptional knowledge in how to protect people’s legal rights and how to safeguard people from abuse, as two examples. Training ensured staff understood the dementia care model used at the service, which enhanced people’s emotional wellbeing. This provided feelings of value to people using the service and gave pride to staff that they were providing such good care. One staff member said, “The wellbeing of residents is the top of our list.”
Nursing and personal care was of a very high standard and in line with detailed, comprehensive care plans. An electronic care planning and recording system ensured information was available to all management and staff at different levels according to their role. Failsafe, ‘red flag’ signals highlighted any important task not performed within a set timescale, repositioning being one example.
The service had achieved awards for the care provided. The service was working towards, and now seeking the Dementia Care Matters Quality of Life ‘Quality Mark’. Meaningful activities were a constant theme and included musical events, quizzes, outings, arts and crafts, board games, films and ball games. Very popular were visits by different animals, and connections with a local primary school. The children from this school visited the service and some people visited their school. This had included helping the children with a World War 2 project. The registered manager said, “All this has had a positive emotional impact on our residents and the team, building and forging loving relationships throughout the generations”.
People received kindness, compassion, respect and were treated with dignity. Staff understood and met people’s emotional needs. When a person died the mood between residents and staff was sombre and so music played was used to reflect the sadness, being respectful of people’s feelings at that time. The service was inclusive of people’s families, arranging regular meals for visiting family and always offering a room to family should a person be receiving end of life care. One person’s end of life care plan included the recognised needs of their spouse, who devoted much time to visiting them.
Every aspect of the service was monitored and audited to ensure the best possible service delivery. This included surveying opinion of the food, activities, and potential staff. A director of nursing for the provider organisation ensured best practice was used and took responsibility to “Audit the audits”. Feedback questionnaires to people using the service, family and friends, staff and professional contacts were meaningful and showed a genuine desire to promote improvement. For example, staff were asked if they received appropriate praise for their work. Staff said they were “Very happy” working at Parkwood House. Staff rarely left except to progress in their career, which the service fully supported.
The service fully met their legal responsibilities and kept themselves appraised of changes in legislation and good practice.
The inspection took place on the 2 and 3 February 2016 and was unannounced. We last inspected the service on the 1 September 2014 and we had no concerns.
Parkwood House can accommodate up to 51 older people who may be living with dementia or have a physical disability. The service provides both nursing and residential care. On the day of the inspection there were 39 people living at the service. We spoke with the registered manager about the numbers of people living at the service and they stated they were unlikely to accommodate many more people than they were now. This was due to the issues in reaching the third floor for people with mobility issues. In that case, they are going to consider reviewing the maximum number of people they will have registered with us.
A registered manager was employed to oversee the service locally. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The registered manager was supported by an administrator and clinical lead to manage the service
People told us they were safe and happy living at Parkwood House and were looked after by staff who were kind and treated them with respect, compassion and understanding. Parkwood House had been awarded the Eden Alternative status and were working towards the Butterfly award. Both of these are national awards only given to services who achieve recognised standards of care. They had also had their local authority Dementia Kitemark status renewed in 2015. This demonstrated the provider, registered manager and staff were working to a high level of improving the experience of people living at the service. All staff expressed a commitment to values of providing only good care and to continue to improve the service.
People felt in control of their care. People’s medicines were administered safely and they had their nutritional and health needs met. People could see other health professionals as required. People had risk assessments in place so they could live safely at the service. These were clearly linked to people’s care plans and staff training to ensure care met people’s individual needs. People’s care plans were written with them, were person centred and reflected how people wanted their care delivered. People’s end of life needs were planned with them. People were supported to end their life with dignity and free of pain.
Staff knew how to keep people safe from harm and abuse. Staff were recruited safely and underwent training to ensure they were able to carry out their role effectively. Staff were trained to meet people’s specific needs. Staff promoted people’s rights to be involved in planning and consenting to their care. Where people were not able to consent to their care, staff followed the Mental Capacity Act 2005. This meant people’s human rights were upheld. Staff maintained safe infection control practices.
Activities were provided to keep people physically and cognitively stimulated. People’s faith and cultural needs were met. The service was adapted to meet the needs of people so they could live as full a life as possible.
There were clear systems of governance and leadership in place. The provider and registered manager ensured there were systems in place to measure the quality of the service. People, relatives and staff were involved in giving feedback on the service. Everyone felt they were listened to and any contribution they made was taken seriously. Regular audits made sure aspects of the service were running well. Where issues were noted, action was taken to put this right.
Information we gathered during the inspection helped answer our five questions. Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?
Below is a summary of what we found. The summary describes what we observed, the records we looked at and what people using the service, their relatives and the staff told us.
If you wish to see the evidence supporting our summary please read the full report.
Is the service safe?
From the outcomes we looked at during this inspection of Parkwood House we saw evidence to support a judgement that this service was safe.
We observed that people were treated with dignity and respect by the staff. During our inspection we spoke with eight people living in the home, two relatives and two visiting health professionals. People told us they were happy living in the home and they felt safe.
We found there were enough qualified, skilled and experienced staff to meet people's needs. The service regularly monitored people's needs and adjusted staffing levels to meet people's needs if they changed. There was no evidence staff did not respond appropriately to people who used the service, or did not answer call bells promptly.
The home was safe, clean and hygienic and this meant people who used the service, staff and visitors were protected against the risks of unsafe or unsuitable premises. People we spoke with told us they thought they home was well maintained and they were happy with their rooms. Comments made by people included: 'the home is beautiful' and 'the home is lovely'. There was no evidence of unpleasant odours.
Is the service effective?
From the outcomes we looked at during this inspection of Parkwood House we saw evidence to support a judgement that this service was effective.
People's health and care needs were assessed and specialist dietary, mobility and equipment needs had been identified in care plans where required. The service had taken into account relevant research and guidance in relation to how the environment could be adapted to assist people with dementia to orientate themselves around the home. The adaptions included signage on bedroom and toilets doors and some people's bedrooms had been decorated in colours designed to help them recognise their rooms. Staff we spoke with and observed showed they had good knowledge of the people they supported.
We spoke with two visitors and they told us they visited the home most days and were always made to feel welcome.
Is the service caring?
From the outcomes we looked at during this inspection of Parkwood House we saw evidence to support a judgement that this service was caring.
We spent time in the communal lounge and dining room to observe how staff responded to people's needs. We observed staff responded to people in a kind and sensitive manner. For example we observed staff assisting some people to eat their lunch. We saw staff assisted each individual in a relaxed and unrushed way, talking with the person throughout to reassure them and explain what was happening.
People we spoke with told 'staff are lovely' and 'staff always treat me with respect'.
Is the service responsive?
From the outcomes we looked at during this inspection of Parkwood House we saw evidence to support a judgement that this service was responsive.
The home employed an activities co-ordinator who worked between four and five days a week. People were given the opportunity to take part in a range of group and individual activities. The activities co-ordinator was not working on the day of our inspection. However, we saw pictures of various outings and activities that had taken place and craft work was displayed around the home.
We observed staff spending one-to-one time chatting to people and staff checked people regularly in their rooms and communal areas to ask if they needed any assistance. It was clear from staff we spoke with that care and support was provided in an individual way and was not task orientated.
Is the service well-led?
From the outcomes we looked at during this inspection of Parkwood House we saw evidence to support a judgement that this service was well-led.
The home worked with other services to ensure people's health needs were met. This included professionals such as GPs, dieticians, occupational therapists and tissue viability nurses.
Staff told us they were clear about their roles and responsibilities. It was clear staff understood the ethos of the home and worked together to provide personalised care and support to people living at Parkwood house.
The two visitors we spoke with told us they were satisfied with the care their relative received and would feel confident raising concerns if they needed to.
We spoke with two people living at Parkwood House. One person told us 'It is a very good place. It is a home, staff here help you to feel contented'. We spoke with two family members on the day of our inspection who told us that they were kept informed of their relatives care and treatment. One person said 'there is good communication, we are kept informed.' They went on to say 'If I was unhappy about anything I would feel comfortable about talking to the manager, they listen to what you have to say'.
We sat with people at lunch time and saw that they were not rushed and staff spoke respectfully to people. Staff checked if people wanted anything else to eat and asked if they had enjoyed their meal. A relative we spoke with said 'they have good meals and snacks, healthy food; it is amazing how they cope with it all'.
We saw that a range of audits were undertaken and action plans were developed and followed to improve the quality of the service provided.
During our observations we saw staff help two people to mobilise. We also saw staff conversed with people when they were laying up tables for lunch. We observed staff assisted people to eat their lunch. We saw people talked to each other at lunch.
We witnessed staff interactions with people which were generally positive. People told us staff answered call bells promptly. One person said the staff were 'polite and friendly'. Another person said, 'I am very happy here, no complaints'. People told us the food was good and they were offered choices.
We heard care workers ask people what they would like to do and they gave them ideas if people could not make a choice.
We found staff were recruited in a robust way.
We found staff received appropriate professional development and supervision.