Parkwood House

Updated 1 November 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on 7 and 12 September and was unannounced.

The inspection team included a social care inspector, a specialist nurse advisor, and an 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, their area of expertise being that of people living with dementia in residential and community based services for older people.

Prior to the inspection, we reviewed information we held on the service. This included compliments received about the service, previous inspection reports, notifications and the Provider Information Return (PIR). The PIR is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. Notifications are incidences registered people are required to tell us about by law.

During the inspection we spoke with 10 people using the service, six visitors, eight staff, the registered manager and registered provider. Some people using the service were unable to provide detailed feedback about their experience of life there. During the inspection, we used different methods to give us an insight into people’s experiences. These methods included both formal and informal observation throughout the inspection. We used the Short Observational Framework for Inspection (SOFI). SOFI is a specific way of observing care to help us understand the experience of people who could not comment directly on their experiences. Our observations enabled us to see how staff interacted with people and see how care was provided.

We looked in detail at three people’s records and a random selection of medicine administration records. We looked at three staff files and a selection of quality monitoring information, including feedback questionnaires, audits, and action plans. We received feedback from two visiting health care professionals.

Updated 1 November 2018

Parkwood House is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Parkwood House is registered for a maximum of 45 people. Many people using the service live with dementia or have a physical disability. The home provides accommodation over three floors. It occupies a cul-de-sac position directly opposite a level access park with café. There were 36 people using the service at the time of this inspection.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

This inspection took place on 7 and 12 September and was unannounced.

At the last inspection in February 2016 the service was rated Good. At this inspection, we found the service had improved to Outstanding.

Why the service is rated Outstanding.

People had contacted the Care Quality Commission with compliments about the service prior to our inspection and every comment during the inspection also praised the service, with comments including, “They are most caring towards their clients and nothing is too much trouble and they are always ready to listen to relatives and friends. Hopefully when my time comes this is the place I would choose”.

People were at the heart of everything the service did. Staff had an excellent understanding of people's needs and provided person centred care to a very high standard. The passion to provide people with love and a life of value, regardless of their disability, was led by the provider, registered manager, and was the overarching ethos of the service. The provider said the registered manager showed great leadership and the registered manager said, “I couldn’t ask for more provider support.”

People said they felt safe. Recruitment, medicine management and infection control standards promoted people’s safety. The premises were kept in a safe state and there were plans for continuing improvement, of the toilets and shower rooms, as two examples. Risk management was robust whilst not placing undue restriction on people. Any restriction was with people’s consent or following meetings to establish what was in their best interest.

The service was very well staffed, which meant people had constant attention paid to their needs and wishes. Nursing and care staff were supported by equally enthusiastic ancillary staff, such as activities, catering, housekeeping and administration. Staff were skilled and knowledgeable, with exceptional knowledge in how to protect people’s legal rights and how to safeguard people from abuse, as two examples. Training ensured staff understood the dementia care model used at the service, which enhanced people’s emotional wellbeing. This provided feelings of value to people using the service and gave pride to staff that they were providing such good care. One staff member said, “The wellbeing of residents is the top of our list.”

Nursing and personal care was of a very high standard and in line with detailed, comprehensive care plans. An electronic care planning and recording system ensured information was available to all management and staff at different levels according to their role. Failsafe, ‘red flag’ signals highlighted any important task not performed within a set timescale, repositioning being one example.

The service had achieved awards for the care provided. The service was working towards, and now seeking the Dementia Care Matters Quality of Life ‘Quality Mark’. Meaningful activities were a constant theme and included musical events, quizzes, outings, arts and crafts, board games, films and ball games. Very popular were visits by different animals, and connections with a local primary school. The children from this school visited the service and some people visited their school. This had included helping the children with a World War 2 project. The registered manager said, “All this has had a positive emotional impact on our residents and the team, building and forging loving relationships throughout the generations”.

People received kindness, compassion, respect and were treated with dignity. Staff understood and met people’s emotional needs. When a person died the mood between residents and staff was sombre and so music played was used to reflect the sadness, being respectful of people’s feelings at that time. The service was inclusive of people’s families, arranging regular meals for visiting family and always offering a room to family should a person be receiving end of life care. One person’s end of life care plan included the recognised needs of their spouse, who devoted much time to visiting them.

Every aspect of the service was monitored and audited to ensure the best possible service delivery. This included surveying opinion of the food, activities, and potential staff. A director of nursing for the provider organisation ensured best practice was used and took responsibility to “Audit the audits”. Feedback questionnaires to people using the service, family and friends, staff and professional contacts were meaningful and showed a genuine desire to promote improvement. For example, staff were asked if they received appropriate praise for their work. Staff said they were “Very happy” working at Parkwood House. Staff rarely left except to progress in their career, which the service fully supported.

The service fully met their legal responsibilities and kept themselves appraised of changes in legislation and good practice.