Parkhill Nursing Home

Updated 18 May 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by 2 inspectors and 1 Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Parkhill Nursing Home is a ‘care home’. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Parkhill is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post. A new manager had been in post for 2 weeks and was in the process of applying for their registration.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 4 people who used the service and 13 relatives about their experience of the care provided. We spoke with 9 staff including the manager, area manager, director of clinical governance, the cook, domestic and care workers. We also spent time in communal areas observing how staff supported people.

We reviewed a range of records. These included care records, records relating to medicines, staff recruitment, training, and supervision, building maintenance, cleaning and equipment checks, accidents and incidents and safeguarding logs. We also looked at a variety of records relating to the management of the service, including audits and policies and procedures.

Updated 18 May 2023

About the service

Parkhill Nursing Home is a residential care home providing care and support for up to 38 people in one adapted building. The home is an extended Victorian property with bedrooms on three floors. At the time of our inspection there were 28 people using the service.

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

There was not always sufficient, trained staff deployed to meet people’s needs. People did not receive the support they needed in a timely manner. Improvements had been made to the building, furnishings, and decoration but some improvements to the décor and infection prevention practices needed improving. Various risks related to health and safety and accidents and incidents were not always well managed and people were at risk of harm. Recruitment processes were not always safe, and we found concerns in this area. There was a system in place for staff when they commenced their role. However, not all staff had the relevant training such as safeguarding and MCA and DoLS. Care records were person centred but did not always contain the relevant information to guide staff on how to safely care for people and some records were not accurate. We made a recommendation about this .

People were not always treated with dignity and respect. Not all staff knew people well which led to undue distress. Although we witnessed some choices being offered, this was limited, and we witnessed task focused interactions rather than person focused care. Feedback from people that use the service, and their relatives was mixed and whilst some people described the staff as caring, others did not.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice

End of life discussions were taking place when appropriate and documented. People’s communication needs were identified, and information was made available to people in accessible formats .

Activities were not always taking place and there was no schedule to guide staff. We made a recommendation about this. There was a system in place for responding to complaints but there was no log of previous concerns and limited evidence of lessons learnt.

Audits were in place. However, they did not always identify risk and there was little evidence of learning lessons when things go wrong. Where risk was identified, this was not actioned in a timely manner. There was evidence of people and their relative’s taking part in meetings to discuss on-going improvements at the service. Staff, people, and their relatives spoke highly of the manager.

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

Rating at last inspection

The last rating for this service was good (published 26 January 2018)

Why we inspected

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

You can see what action we have asked the provider to take at the end of this full report.

Enforcement and Recommendations

We have identified breaches in relation to risk management, staffing, staff recruitment, dignity and respect and good governance. We have also made recommendations in relation to care plans and activities.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.