Gorton Parks Care Home

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Following this assessment, we found breaches of regulations in relation to person-centred care, safe care and treatment, good governance and staffing. There was a lack of support to engage people and provide stimulus. The provider had not explored strategies to support people to effectively communicate. People told us, staff were kind and caring but the lack of staff had impacted on the quality of care. Relatives and friends visited the home without restrictions. People received reviews from health professionals when required. A health professional told us staff communicated any changes in people’s health to them. However, another health professional told us staff had not been following the instructions for using a pressure relieving device.

This service scored 65 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Kindness, compassion and dignity during this assessment. The score for this quality statement is based on the previous rating for Caring.

We did not look at Treating people as individuals during this assessment. The score for this quality statement is based on the previous rating for Caring.

There was a lack of support for people to undertake any meaningful activities. One person told us, “I just walk about really as there isn’t much else to do.” People and relatives told us there was not a lot for them to engage in. Comments include, “I don’t like the entertainment, it’s boring.” and “I prefer to stay in my room, there isn’t much to do.” We saw one person’s first language was not English and they also had a hearing impairment. The provider had not considered the most appropriate way for staff to communicate with the person which had left them isolated and vulnerable. Staff told us they tried to communicate using sign language, but the individual would wave staff away. We reviewed the communication care plan for the individual and found there was no guidance for staff to follow to enable communication. The provider had not considered the use of photo cards or written language to prompt positive communication. People told us they were able to maintain relationships and with family and friends and visiting was permitted. Relatives confirmed they could visit the home at any time but were asked to avoid mealtimes if possible. We received mixed feedback from people and their relatives regarding staff understanding people’s needs and promoting choices. Some people told us staff gave them choices as to what clothing to wear or where they spent their day while one person told us, “I don’t get to choose what I eat or where to go, the staff choose that.” A relative told us, “I am not entirely sure if the staff understand [Name’s] needs. They do not always listen, and [Name] doesn’t like to go to bed early but has no choice. 7pm is the latest and would prefer it to be later.”

Activity staff told us they worked across the houses, Monday to Friday 9am – 1pm We saw arts and crafts and tabletop activities were completed and a summer fayre had been organised. Staff were responsible for delivering activities in the afternoons and at weekends. Staff told us it was difficult to complete activities in the afternoon due to staffing levels and supporting people who required personal care or emotional support.

We observed lunch times on all of the houses and found on Debdale House, people were offered choice and staff ensured they had the right cutlery and offered condiments. However, on Abbey Hey House, tables were not set, condiments were not offered, and drinks were not offered until after the meal. We did not observe staff always interacting with people unless there was a need, for example, to take medicines or support them to sit down. When staff did speak with people, they were kind and respectful and people appeared to be at ease with them. We did observe some people were in a state of undress. One person was wearing one slipper and one shoe, another person had their continence pad on show and some people generally looked unkempt.

The provider had not effectively planned care to support a person whose first language was not English, and they had not provided staff with the communication resources to support different ways of communicating. Care records lacked evidence of people’s personal choices, likes and dislikes. People were unable to access outdoor spaces which may have proved calming for some people. There was no evidence staff reviewing care records were involving people and their families to ensure they truly reflected current needs and choices. Policies underpinned the right people to have visitors to the home.

People told us they could see a doctor when they needed to, and staff listened to them when they were unwell. Relatives confirmed they were informed when their relation was unwell. A relative told us, “The home works well with the GP and the district nurse. The district nurse was visiting regularly when [Name] had a wound on their foot.” Staff were not always able to respond to people quickly as people told us they often waited for a response when using their call bell. This meant sometimes people had to wait to be supported with continence care, skin care or medicines. Staff did not always have the time to spend with people and we were told, “Staff don’t have the time to chat.” and “The staff do listen but its difficult to get hold of them when you need them.”

Staff told us they completed referrals to health professionals as soon as possible. One staff member told us, “The district nurses and doctors are good. We can self-refer to district nurses and they will refer to the tissue viability nurse. The worst area is mental health as the waiting list is very long.” Staff told us there had been a big push on staff having to wash pots, put laundry away and complete activities which impacted on the time spent with people, observing and communicating. However, following an increase in staffing after the first day of the assessment, they were hopeful it would change. All staff confirmed they reported any concerning information to the person in charge of the shift but were not always confident of any outcomes.

Our observations were staff were visibly busy and didn’t always have the time to spend with people. We observed some people required further support with their personal care and nail care. On Abbey Hey House and Melland House, staffing levels reduced in the afternoons and it was evident staff were struggling to support people who were distressed as well as completing other care interventions. Several health professionals visited during the assessment and all raised concerns around staffing levels, however, they did say senior staff do report any concerning information to them. We observed one person had their bedroom door propped open and their bed was facing the door which allowed staff to see them as they walked past the room. The person often removed their cover which left them exposed to people walking by and this lacked dignity.

We did not look at Workforce wellbeing and enablement during this assessment. The score for this quality statement is based on the previous rating for Caring.