Park House

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 the last inspection this key question was rated good. At this inspection, this key question was rated requires improvement as people’s needs were not always being effectively met.

The provider was in breach of regulation related to person-centred care.

This service scored 57 (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 were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

People’s care and treatment were not always effective due to their care and communication needs not always being robustly documented for staff to follow to support them. People’s care plans were not kept up to date with important information from external health teams, to ensure people received wrap around care. This left people at risk of staff not knowing how to react if people experienced a change in their condition or required ongoing monitoring of an existing health need. This meant staff were not always aware of their preferences and therefore, these were not being respected in a person-centred way. People's individual needs were not being met by the adaption, design and decoration of the premises. The environment was not clean and tidy. Areas of the service required repairs and deep cleaning, especially people's bedrooms and communal spaces.

The provider reviewed and replaced pressure cushions which were not fit for purpose after our inspection, but these risks had not been identified prior to our site visit. This left people at risk of harm.

The management team understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

The service worked well with external health and social care partners. We saw prompt referrals had been made to support people who might need specialist equipment for managing falls or good skin integrity.

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

Support plans and records required some improvement to ensure they met people’s requirements for meaningful communication and decision-making. For example, records for staff to enable positive communication with people about their choices when they did not use verbal communication needed improvement. For example, by the use of objects of reference, sign language, or visual aids.

Care plans detailed people’s individual communication needs, such as glasses or hearing aids. The service produced literature for people in different font sizes to assist in sharing information for people.

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 tell them what had changed as a result.

Although the management team had a clearly displayed complaints process and followed freedom to speak up principles, some people did not always feel empowered to have their say about things that were important to them. We received a mixed response related to people and relatives feeling listened to and confident their views would be acted on. People all told us they would raise any concerns with the management team. One relative told us, “I would speak to everybody and then it would be communicated at all levels; otherwise, information does not get through.”

There was limited information available in alternative formats, for people who could not verbally communicate or understand generic documents.

We saw that where appropriate, there were independent advocates involved in people’s lives.

The management team made sure that people could access the care, support and treatment they needed when they needed it. Staff and leaders listened to information about people who were most likely to experience inequality in experience or outcomes. This meant people’s care was tailored in response to this.

People were supported to access their community, understand voting and be part of activities which had meaning for them. One person said, “I am supported to be independent. I am going into Bulwell this morning. The activity coordinator is taking me. I need a top up for my phone. I can do what I like. I usually watch TV or walk around. I can go outside when I want to.”

People were supported to maintain relationships with those who were important to them. Although some relatives felt communication with them could be improved. We saw family and friends of people were able to visit when they wished and were made welcome by the staff team. One relative told us, “They are all very friendly, and my family member seems happy.”

People were not always supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

Some people’s care plans were not robust enough regarding their spirituality and communication of end of life wishes. For example, there was conflicting information in one person’s plan regarding their religious beliefs which was concerning, as this person was receiving palliative care. There was no reference to supporting access to a place of worship or a visiting faith lead in this care plan. Another person had an advanced decision in place regarding the end of their life. This person had no details completed in their end of life care plan, or records to show this had been discussed with them.

Staff we spoke with showed compassion and empathy regarding caring for people at the end of their lives. One staff member told us, “I like the nurturing side, the hands on. End of life care, it’s a privilege at the end of the day; that’s something that will happen to us all. It’s not just about eating, drinking and being clean, it’s giving people the best of every day, being positive. It’s making people feel cared for and loved.”

If people did not wish to discuss their end of life wishes, we saw processes had been established for what to do in an emergency medical situation.