Parkgate Manor

At the last assessment, the provider was in breach of legal regulations in relation to people’s health appointments and some staff practices were institutional. Improvements were found during this assessment and the provider was no longer in breach of these regulations. However, whilst improvements were made in relation to care planning, further oversight is needed to ensure records are continually reviewed and updated as needed.

The provider had also previously been in breach of the legal regulation in relation to concerns identified around some quality assurance processes, a lack of audits in relation to care plans, seeking feedback from people, relatives and staff, supervision of staff and compliance for right support, right care, right culture guidance. The provider has been continuously in breach of regulation in respect of governance since August 2021. Whilst some improvements were made, these were not sustained, and the provider remained in breach of this regulation. In addition, we found further shortfalls in relation to infection prevention and control, management of medicines, cleaning schedules and health and safety checks that indicated there was not effective oversight of these areas. The manager confirmed in writing and provided evidence of the actions taken to address the shortfalls. Progress made now needs to be sustained and embedded.

We assessed the service against ‘Right support, right care, right culture’ (RSRCRC) guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted. Whilst we found staff were caring, offered people choices, and treated people with dignity, the systems in place did not demonstrate that people’s voice was always heard and acted upon.

The model of care was not in line with current best practice guidance, RSRCRC. The service is larger than best practice guidelines. This was because the service was operating before the guidance was released. The provider was aware of this and although progress was being made to improve outcomes to meet the principles of RSRCRC, further work was needed to demonstrate more clearly how this was being achieved and would be developed further.

There had been no registered manager for 14 months. The managing director had previously been the registered manager and knew people, staff and the service well. (They are referred to throughout this report as the manager.) There had been inconsistent leadership due to a turnover of registered managers. This meant quality assurance and monitoring systems had not been sustained.

We observed that the service provided kind and compassionate care, and staff knew people and their needs well. The provider worked in partnership with external health and social care professionals to ensure good outcomes for people. Professionals spoke highly of staff at Parkgate Manor. Although staff had not received formal supervision, they spoke positively about working at the service and felt well supported.

There were good training opportunities available to staff. All staff had opportunities to attend face to face specialist training to meet the needs of people living at Parkgate Manor. Management at Parkgate Manor knew the service, people, and staff well.