Parkhill Support Services Ltd

Parkhill Support Services Ltd is a supported living service providing personal care for up to 5 people living with learning disabilities and/or autistic people. At the time of our inspection 1 person was using the service.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

People’s experience of using this service and what we found

We found the outcomes for people using this service reflected the principles and values of Right support, right care, right culture. These included promotion of choice and control, inclusion and independence. People’s support focused on them having as many opportunities as possible for them to gain new skills and become more independent.

Right support

People’s independence was promoted. Care and support needs and risks to people had been assessed to ensure their needs were met safely. Staff supported people to achieve their aspirations and goals. People were encouraged to take part in activities and pursue their interests in their local area. There was a complaints procedure in place in formats that people could understand.

Right care

People received kind and compassionate care. Staff protected and respected people’s privacy and dignity. They understood and responded to people’s diverse needs. The person using the service had a choice about their living environment and they were able to personalise their room. They had access to health care professionals when they needed them.

Right culture

People received person centred care, support and treatment because staff were trained in areas related to their care and support needs. Staff they received regular supervision from the manager. People and other people important to them were involved in planning their care. People and staff views were considered through surveys and meetings.

Rating at last inspection and update

The last rating for this service was inadequate (published 23 March 2022). The service was placed into Special Measures. During this inspection the provider demonstrated that improvements had been made. The service is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is no longer in Special Measures.

Since the last inspection we recognised that the provider had failed to notify the Commission without delay of an incident specified in Regulation 18(2) of the Care Quality Commission (Registration) Regulations 2009 which occurred whilst services were being provided in the carrying on of a regulated activity or as a consequence of the carrying on of a regulated activity. This was a breach of the regulation, and we issued a fixed penalty notice. The provider accepted a fixed penalty and paid this in full.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Parkhill Support Services Ltd on our website at www.cqc.org.uk.

Why we inspected

This inspection was carried out to follow up on action we told the provider to take at the last inspection.

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found improvements had been made and the provider was no longer in breach of regulations.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Follow up

We will continue to monitor information we receive about the service, which will help inform when we next inspect.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

About the service

Parkhill Support Services Ltd is a supported living service providing personal care for up to five people living with learning disabilities, autistic spectrum disorder and complex health needs. At the time of our inspection there were four people using the service.

People’s experience of using this service and what we found

The service was not able to demonstrate how they were meeting some of underpinning principles of “Right Support, Right Care, Right Culture.

Right support:

People were not supported to have maximum choice and control of their lives and staff did not support them in the least restrictive way possible and in their best interests; the policies and systems in the service did not support this practice. Care and support was not planned to meet individual needs and ensured that people were consistently supported to have a fulfilling and meaningful everyday life that included achieving aspirations and goals. People and their relatives were not always informed and encouraged to make decisions about the care and support in place.

Right care:

Medicines were not safely managed in a way that ensured it was effective and achieved best possible health outcomes. The service had not fully explored how to present information in accessible ways to meet individual needs. Assessments of people's needs had been completed but did not consider best outcomes for people as individuals or as a group. The service did not always ensure that risks faced by people had been assessed and planned for. Not all staff were committed to providing an individualised care and support, and there was not enough staff to ensure assessed needs were met. .

Right culture:

The provider did not have effective oversight of the service. An effective quality assurance system was not in place. Staff did not receive support through training, supervision and meetings to ensure they had the knowledge and skills to meet people's needs. The service did not work effectively with other agencies to drive improvement. Lessons were not learnt from accident and incidents, safeguarding and complaints to drive improvement. There was an organisational structure in place, but staff did not always know of their individual roles and responsibilities.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection:

This service was registered with us on 20/03/20 and this is the first inspection.

Why we inspected

This inspection was prompted by a review of the information we held about this service.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have found breaches in relation to regulation 9 (Person centred care), Regulation 11 (Need for consent), Regulation 12 (Safe care and treatment), Regulation 13 (Safeguarding service users from abuse and improper treatment), Regulation 16 (Receiving and acting on complaints), Regulation 17 (Good governance) Regulation 18 (Staffing) and Registration Regulation 18 (Notification of other incidents) at this inspection.

We have made recommendations about staff recruitment records, access to healthcare services, respecting and promoting privacy, dignity and independence and meeting people’s communication needs.

Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.

The overall rating for this service is inadequate and the service is therefore in special measures. This means we will keep the service under review and will re-inspect within six months of the date we published this report to check for significant improvements.

If the registered provider has not made enough improvement within this timeframe and there is still a rating of inadequate for any key question, we will take action in line with our enforcement procedures. This usually means we will start processes that will prevent the provider from continuing to operate the service.

For adult social care services, the maximum time for being in special measures will usually be 12 months. If the service has shown improvements when we inspect it, and it is no longer rated inadequate for any of the five key questions, it will no longer be in special measures.

Follow up

We will meet with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.