Parkwood House

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 outstanding. At this assessment the rating has changed to requires improvement.

This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

The provider was in breach of legal regulation in relation to safe care and treatment and good governance.

This service scored 61 (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 ensure that systems and processes supported them to effectively achieve their vision and values for the service. For example, ensuring the premises was managed in line with a safe culture.

One person told us that staff could sometimes appear task-focused and did not always take opportunities to check how they were feeling. This was not always consistent with the provider's stated value of delivering person-centred care.

However, the provider and registered manager promoted a culture based on transparency, equity, equality and human rights.

Leaders described a clear focus on relationship-centred working, staff development and open learning. Staff and relatives gave positive feedback about the culture, and relatives described the service as caring, supportive and well run. One relative described the service as a “Parkwood family” and another said, “They talk about a Parkwood family, this includes friends and families”.

The provider had inclusive leaders at all levels and acted with integrity, openness and honesty. However, leaders did not always recognise relevant national guidance.

Leaders had not identified or acted effectively on some risks before the assessment. These included weekly fire testing, some fire doors did not close correctly, window restrictors, missed medicines, topical cream records, and records not always reflecting people’s assessed needs. The registered manager responded to feedback and started to put new processes in place, but these shortfalls showed leadership oversight was not always fully effective.

People, relatives and staff described the registered manager as approachable, visible and supportive. Staff said they felt able to raise concerns, and leaders described investment in coaching, nursing development, assistant practitioner training, dementia training and career progression.

The provider fostered a positive culture where people felt they could speak up and their voice would be heard.

People, relatives and staff told us they knew who to speak to and felt able to raise concerns. The registered manager was described as accessible and helpful, and the service used surveys, meetings, an open-door approach and QR codes to gather feedback. Staff said the registered manager was approachable and that suggestions were listened to.

The provider valued diversity in their workforce. They worked towards an inclusive and fair culture by improving equality and equity for people who worked for them.

Leaders described a culture where staff could talk openly, reflect on different experiences and raise concerns.

The provider had an equality and diversity policy in place.

We found no evidence staff were treated unfairly or workforce equality and inclusion concerns were not acted on, staff we spoke to did not identify any concerns in relation to this area.

Some systems had not always identified or resolved shortfalls found during the assessment. We found missed or unavailable medicines, PRN protocols were not always person-centred, and topical cream records did not always reflect care plans. Records were not always accurate, complete or contemporaneous, which reduced assurance people consistently received care in line with their assessed needs. There were occasions of repositioning records not always evidencing support in line with the persons assessed needs. The registered manager told us for one person their care plan was not up to date and did not fully reflect the person’s current needs. We identified some environmental risks including fire doors, fire checks and window restrictors, these shortfalls had not been identified within the provider’s auditing and monitoring systems. We discussed these concerns with the registered manager, who started to create a plan and take action to address these concerns.

There were some effective governance arrangements in place, including provider visits, clinical meetings, incident reviews, and call bell audits.

The provider understood their duty to collaborate and work in partnership, so services worked seamlessly for people. They shared information and learning with partners and collaborated for improvement.

Professionals who provided feedback described the service as responsive and proactive in involving healthcare services and supporting people living with dementia. An advocacy professional said people appeared appropriately supported and staff transfers appeared safe. A social worker described staff as caring and said the service was proactive in involving healthcare professionals.

The service also worked with GPs, chiropodists, opticians, dentists, social workers, therapists and other healthcare professionals. Leaders described involvement in wider care forums and sector networks, and relatives gave examples of people being supported to access the park, cafés, pubs, school links and community activities.

The provider did not always focus on continuous learning, innovation and improvement across the organisation.

Some issues had already been identified through audits or meetings but were still found during the assessment. This included medicine storage and stock concerns, documentation gaps, repositioning records, topical cream recording and environmental risks. This meant improvement work was happening, but it was not always effective or embedded enough to prevent repeated shortfalls.

The service encouraged creative ways of delivering equality of experience and actively contribute to safe, effective practice and research. Leaders and staff described a positive learning culture, and records showed learning from incidents, audits, meetings and quality assurance feedback. The provider used training programmes, dementia approaches, clinical meetings, action plans and staff development programmes to improve practice. After the assessment, the provider held a clinical governance meeting and set actions to improve medication stock control, PRN protocols, bowel monitoring, and documentation.