Parkside

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 inadequate.

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

The service was in breach of legal regulation in relation to need for consent.

This service scored 38 (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 was effective because they did not check and discuss people’s health, care, wellbeing and communication needs with them. We were told people had food and fluid charts. One person was identified by healthcare professionals as needing encouragement for oral hydration. However, the provider was unable to provide evidence of the clinical input on how this would be assessed and monitored. We were told by the registered manager there were no people at risk of choking. However, staff told us they supported people who were at risk of choking. We were told one person had their food, ‘mashed’ and had been assessed by healthcare professionals. However, the staff told us the care plan had not been updated despite this, “being raised a few weeks ago.” Therefore, we were not assured the provider had assessed people’s needs to ensure people’s care and treatment was effective.

The provider did not plan and deliver people’s care and treatment with them, including what was important and mattered to them. For instance, we found one person’s assessment from the local authority recorded they were at high risk of malnutrition. We reviewed this against the providers care records staff used to support the person and found no instructions had been provided to staff to inform them how to support the person in line with best practice guidance. We found no evidence to demonstrate how the person’s nutrition and hydration needs were being met, this had placed them at risk of harm. However, a manager told us if staff report a change in the persons needs, they would contact the relevant professionals.

The provider did not always work well across teams and services to support people. Professionals told us of their concerns relating to continued lack of engagement. Professionals also told us there were concerns relating to communication from the service, record keeping, a missed health appointment and unclear care provision which prolonged the review process for a person. However, leaders told us they worked with GPs, district nurses and speech therapists.

The provider did not always support people to manage their health and well-being, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives. The care records referred to supporting people with their meals and going for a walk. However, for a person who was supported in bed the care records stated to, ‘Encourage Service user to exercise upper limbs’ but there was no guidance to support staff on how to do this. We also received feedback from a person who stated the provider supported them when they wanted to see a GP but also, “They’ve never taken me anywhere I haven’t been out of this house for years nobody really cares.”

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves. One relative told us, “We review [their] care plan annually.” However, our inspection found the provider did not meet the expected standards. We requested the care plan audit and the registered manager told us they could not remember where the care plan audit was. The care plan audit that was subsequently submitted to CQC did not document which person the audit was for and there was no evidence to support any actions identified and monitoring. This was not an overall care plan audit for people being supported by the service. This meant there was no evidence people’s care and treatment was routinely and continuously monitored to improve outcomes. We report more on this under well-led.

The provider did not tell people about their rights around consent or respect these when delivering care and treatment. The provider told us some people did not have capacity we were unable to find the capacity assessments to support this and were told by a manager there were no formally documented capacity assessments on file for these people. Whilst we were told by a manager, “We recognise the importance of this and will ensure they are undertaken as a matter of priority.” We were not assured the registered manager was aware of their responsibilities in relation to the Mental Capacity Act 2005 and this had placed people at risk of being deprived of their legal rights and their liberty being deprived unlawfully. Staff told us about the importance of gaining consent.