Parkhill Support Services Brighton Road

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question requires improvement. At this assessment the rating has changed to good.

This meant people were safe and protected from avoidable harm.

The provider was previously in breach of legal regulations relating to safe care and treatment and fit and proper persons employed. Enough improvement had been made, and the provider was no longer breaching these legal regulations.

This service scored 72 (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 had a proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. Lessons were learnt to continually identify and embed good practice. The provider implemented clear systems for staff to raise concerns. Managers reviewed and addressed these concerns promptly. Leaders recorded lessons learned from accidents and incidents and shared them with the staff team.

The registered manager analysed incidents to identify trends and patterns and took action to reduce future risks. Records showed the provider held debriefs with staff following accidents and incidents to support reflection and learning.

Staff told us the registered manager provided emotional support following incidents. Managers encouraged staff to reflect on events and identify improvements to practice. This supported continuous learning and helped maintain safe care.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

The provider had process for new referrals, obtaining a copy of the person’s initial care needs assessment, and then carrying out their own assessment, before deciding whether they would be able to provide support. This helped ensure people’s care was provided in a planned, responsive and organised way.

People’s families were involved in the admission process and helped to provide information about people’s life history when their initial care plans were being created. This helped ensure people were supported to receive continuity of care when they started receiving care from this service.

The provider worked with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. Staff concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm and neglect. The provider shared concerns quickly and appropriately.

Staff understood their safeguarding responsibilities. They recognised the signs of abuse and knew how to report concerns. One staff member told us, “I completed safeguarding training. I would report any concerns to management.” The registered manager made appropriate referrals to the local authority when concerns arose and maintained clear oversight of safeguarding activity.

Relatives told us people felt safe. One relative said, “My relative feels safe and happy at the service. I do not have any concerns regarding their safety.” Another relative told us, “My [relative] is perfectly safe. They cannot go out on their own and are always supported by a staff member when they do.

The registered manager understood their responsibility to notify relevant bodies, including the local authority and CQC, of significant events. Staff knew how to access the whistleblowing policy and felt confident to raise concerns.

The provider ensured staff completed training in safeguarding, the Mental Capacity Act 2005 and consent. Where people lacked capacity to make specific decisions, staff completed mental capacity assessments and recorded best interest decisions appropriately.

Where restrictions amounted to a deprivation of liberty, the registered manager sought the appropriate legal authorisations. Care plans clearly recorded people’s capacity, any DoLS in place and how these affected their support. The provider monitored DoLS applications to ensure they remained lawful and up to date.

Staff involved people in decisions about their care wherever possible and respected their rights.

The provider worked with people to understand and manage risks by thinking holistically. Staff provided care to meet people’s needs that was safe, supportive and enabled people to do the things that mattered to them.

Staff were knowledgeable about risks and were able to explain how they kept people safe. Comments included, “When a person] is distressed, I will distract the [person] and will speak to the [person] calmy and reassure them.”

Relatives told us they were involved in their relative’s care and safety. One relative commented, “When my [relative] have any appointments in the community the staff involve me and or keep me informed of their safety, outcome and follows up”.

Records demonstrated that people and their families were involved in care planning and risk management. People’s risk assessments reflected their individual circumstances and documented written strategies to mitigate risks of falls, risks related to behaviour that communicated distress, or moving and handling. This meant staff always had appropriate documented guidance to manage risk.

The provider detected and controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

Ramps had been built to ensure easy access for people and bathrooms had been adapted to promote people’s independence.

We saw detailed Personal Emergency Evacuation Plans (PEEPs) were completed which showed the support everyone required from staff if they needed to vacate the property in an emergency such as a fire.

There were systems for checking equipment was safe to use. Wheelchairs were tested in line with current guidance to ensure people could safely use them.

The provider ensured there were sufficient numbers of suitably qualified, competent and experienced staff deployed across both supported living schemes. Staffing levels met people’s assessed needs and supported the safe delivery of care.

During our visit, we observed an appropriate skill mix of team leaders and support staff. Staff were visible, attentive and responded promptly when people required assistance. Care was delivered in a calm and respectful manner.

The registered manager maintained oversight of staffing arrangements and ensured management cover was available across day and night shifts when required. Relatives confirmed there were enough staff on duty. One relative told us, “Staff are around and there seems to be plenty of them. If I or my [relative] need anything, the staff are happy to support.” Another relative said, “Staff are very kind and well trained. They are patient and listen, and it’s not an easy job.”

Records demonstrated staff completed induction and refresher training relevant to their roles. The provider ensured staff received regular supervision and annual appraisal, supporting them to reflect on their practice and identify development needs.

The registered manager operated safe recruitment processes. The provider completed appropriate pre-employment checks before staff commenced work to ensure they were suitable for their roles.

The provider assessed and managed risks relating to infection prevention and control. Staff understood their responsibilities in preventing the spread of infection and acted appropriately when risks were identified, including sharing concerns with relevant agencies where necessary.

The environment was clean, tidy and free from malodours. Staff prepared food safely on site and stored it appropriately in labelled refrigerators.

We observed staff wearing suitable personal protective equipment (PPE) and following safe waste disposal procedures and could dispose of this safely. Staff washed their hands regularly, and hand sanitiser was readily available throughout the service.

The provider had an infection prevention and control (IPC) policy in place that staff had access to. There was an IPC lead in the service who carried out regular audits. This meant that IPC was a focus for staff and protected people from the risk of infection.

Medicines and treatments were mostly safe and met people’s needs, capacities and preferences and people were encouraged to self-administer their medicines. However, improvements were needed to ensure records were accurate and up to date.

People were not always protected from risk related to medicines because records were not accurate and up to date.

We found several hand-written entries on the MARs which were not signed. One entry did not include sufficient information such as formulation or dose instructions. One person’s emergency medical emergency data sheet listed a medicine which was no longer prescribed. Another person’s medicines records did not include reference to a prescribed pain relief medicine.

A person was prescribed a painkiller on a ‘when required’ basis. It was unclear in their medication records whether the person was regularly in pain however their medicine records showed that pain killers were regularly administered. We did not see any documents to show staff had discussed this with the prescriber in order for this to be reviewed.

Care plans largely contained sufficient information about people’s risks and medicines information but there were some care plans that listed medicines which was no longer prescribed to people.

Medicines, including higher risk medicines were stored securely and keys to the medicines room were restricted to authorised staff only. Staff carried out regular checks of higher risk medicines. Room and fridge temperature monitoring was taking place daily for the medicines room and persons’ individual rooms where medicines were stored. In line with People’s care plans medicines were administered at set times of the day using paper-based medicines administration records (MARs) which ensured staff to follow the prescriber’s intentions. There was no evidence of excessive use of medicines to control people’s behaviour which protected people’s right and ensured medicines were used therapeutically and in their best interest. Missed doses or refusals were appropriately documented. A running audit of stock quantities was carried out