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

The majority of people were unaware of the care planning process and told us they had limited input into this process. People were not always supported in a person centred way and care records did not contain enough person centred information. People were not always supported during mealtimes and there was limited interaction from staff members. Where people required support from external health professionals, referrals were not always made. People gave mixed feedback on being involved and listened to by the provider. Staff told us they had not had much communication or meetings with the provider.

This service scored 46 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The majority of people and their relatives were unaware of the care planning process and told us they had limited input into this process. A person said, “We were involved when my relative first came, but not since” whilst another commented, “We have had no involvement in any plans.” People at the service told us they were unaware of having a care plan in place. One person said, “I don’t know anything about them.”

Staff on one of the floors, described a routine in place, whereby they supported everyone to have their breakfast when they first came on shift in a morning, and then moved on to support people with washes and showers. This did not promote a flexible and person-centred approach.

We undertook an observation during lunchtime. We saw that one person was struggling to eat their soup. A staff member came and provided some brief support, however they continued to struggle to eat all the soup. The support provided did not effectively meet the person’s needs in an individualised way. We observed people being left in the dining areas without staff support. There was limited to no interaction during mealtimes. People who were struggling during mealtimes did not have the adaptive aids to support them to remain independent.

People were unable to give detailed feedback on the subject of care provision, integration and continuity. However, from looking at care records we observed referrals to external health professionals were often delayed or not completed.

Staff told us if they had any concerns they would report to the nurse in charge. However, despite management telling us they were involved in people reviews and care plans we could not be assured that essential information was being recorded that was accessible. For example, we saw that one person had recorded they had any allergy in their care file but this was not recorded anywhere else, and the management team were not totally sure how this information had been sought and recorded.

Partners confirmed the service did not always accept free training and support from them, in order to allow staff to support people with continuity of care. Partners also confirmed the provider had significant issues with technology, resulting in difficulties in ordering prescriptions for people.

Referrals were not always made when required. We identified a recommendation for one person was to be referred to the dietitian due to weight loss this referral had not been made. Hospital passports were utilised to share information with hospital regarding a persons care needs, we identified these were not always accurate and reflective of peoples needs. We identified one person did not contain their allergy and another person’s had the wrong diet modification.

People did not give any detailed feedback in this area. However, people told us they had not seen or been involved in constructing or reviewing their care plans. They told us, "We have had no involvement in any plans" and "I don't know anything about them [care plans]. I think someone else does it."

During the assessment we were unable to obtain any evidence for this quality statement.

Information was not always presented in a way that was accessible to all. We identified one person required the use of communication cards to support them with communication, not all staff were aware of this. Information was not always displayed in a format for people to understand.

People gave mixed feedback in this area. A relative confirmed they attended a ‘relatives meeting’ every few months. However, we noted from records that these were infrequent at times. Although 'resident meetings' were taking place, people we spoke with were unable to tell us how the provider involved them in making other decisions about their care.

Staff told us they had not had much communication or meetings with the provider. Staff said that the deputy manager listened to staff and the registered manager was sometimes available to give feedback.

The provider did hold residents and relatives meeting however, these were not regular and were only if there was an identified need for example, the implementation of CCTV and the sale of the service to another provider There were no follow up actions identified. Concerns were raised during these meetings however feedback was not provided.

People were unable to provide us with feedback regarding this quality statement. However, from looking at people's records we observed people were not supported to attend the dentist where required, and referrals to external health professionals were not always completed.

Staff understood the importance of listening to people and involving them in decision making as much as possible. However, they told that since the new provider had taken over the service it had been a negative one for the home and nothing had changed.

Partners told us people did not always access external health services in a timely way. On occasions, there were delays in seeking input and assessments from health professionals.

Not all staff had received training in relation to equality diversity and inclusion. Due to limited opportunity for people to provide feedback there was no evidence to demonstrate the provider was listening to people to enable them to access care and support they required or wanted. The home was not designed to support and promote independence particularly for those people living with dementia. The provider did not ensure that all people, regardless of their communication abilities, had a voice in their care and could access advocacy services if needed.

People were unable to provide direct feedback regarding this quality statement. However, we observed from people's care records that they were not supported to achieve meaningful outcomes. Whilst outcomes for people were recorded, these were not monitored or maintained to ensure people's care was improving over time.

Staff were not aware of anyone with any cultural needs, including anyone with religious preferences. Due to lack of personalised information within care plans this was not documented.

Care plans did not demonstrate that people were actively involved in their own care planning or in establishing meaningful goals and outcomes. As a result, we could not be confident that the provider effectively empowered people to express their perspectives.

People we spoke with were not able to give any direct feedback regarding this quality statement. However, people's end of life records needed to be reviewed and information regarding effective end of life care needed to be implemented.

Staff described to us times when they had been informed when people were at the end of their life. Staff told us about where to find all the relevant end of life information for supporting people in line with their wishes at the end of their life. However, only one staff member told us they had completed end of life training.

Processes were not effective in monitoring people who had a Do not attempt cardio-pulmonary resuscitation order (DNACPR) in place. We identified one person’s DNACPR had expired before another application had been made. Not all staff were trained in end-of-life care. The provider was part of the 6 steps end of life pathway however, care plans did not always evidence these were being implemented.