Parkfield House Nursing Home

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 inspection we rated this key question good. At this assessment the rating has changed to requires improvement. This meant the service management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

The service was in breach of Regulation 17 (good governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

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.

Not all staff treated people respectfully or as individuals. This meant that their experience was not always a positive one. However, the provider aimed to create a culture of inclusivity and respect. They had clear values which were shared with the staff, and they provided training and support to enable staff to work towards these. Staff told us they felt happy and supported working at the service.

There were capable and inclusive leaders. The registered manager was a qualified nurse and experienced at managing care services. They were responsive when things went wrong. People using the service, relatives and staff knew who the registered manager was and had opportunities to meet with them. Comments from people using the service included, “I find the manager responsive’’ and “The manager is very good, if there is a problem [they] will listen and try to put it right.’’ Staff felt well supported and told us the registered manager gave them clear direction and guidance.

There were systems to enable staff and others to speak up when something was wrong. Staff understood this and told us they felt confident doing so.

The provider supported staff to feel included and treated them with equity, taking account of their individual needs. Staff were supported to have time off for religious festivals and caring responsibilities when needed. The registered manager explained staff had individual work plans which reflected their requirements when needed. Some staff received extra support with training and understanding information to reflect learning needs. Staff told us their diversity and individual needs were respected.

The provider had systems for monitoring and improving quality. However, these were not always effectively implemented. The provider’s systems did not ensure that care plans and risk assessments were always detailed enough, personalised or accurate. Whilst senior managers told us they had identified this, they had not taken enough action to mitigate the risks of people receiving inappropriate care and treatment because of this. The provider’s systems for monitoring and mitigating risk had not identified risks relating to medicines management. People did not always receive good quality care and treatment because the staff did not always respect their privacy and dignity. The provider had started to take steps to improve quality governance before our assessment and sent us evidence of further improvements after our visit to the service.

The provider worked in partnership with others. The registered manager was part of a group, and attended meetings, with other care managers, a workforce development organisation and the local authority. This helped them to discuss best practice and learning with others. The provider worked with local healthcare teams to help make sure people received the support they needed from these services. In particular, they had links with therapy and palliative care teams. External professionals told us they worked well with the provider. Their comments included, “We provide support for patients and help with training if needed. We obtain feedback from patients and staff’’ and “We have excellent communication with the team at Parkfield House. They contact us promptly and we work together as a team.’’

There were systems for learning and making improvements at the service. These included a range of audits and checks. These had not always been effective at identifying when things were wrong and therefore improvements had not always been made. Following our visit to the service, the registered manager created an action plan to state what they were doing to address the issues we had identified. The provider explained a number of initiatives and systems they had which were designed to monitor and improve quality. These included audits from external organisations and developing the service in line with good practice guidance.