CQC report explained · a residential care home
What the CQC found at Parkgate Manor
Rated Requires improvement: inspectors found the home was not performing as well as it should and told it what to change.
What inspectors found, December 2022
Rated Requires Improvement; inspectors found important progress since Inadequate, but the home still had breaches in person-centred care, dignity and governance.
This was an unannounced follow-up inspection on 29 September, 6 October and 7 October 2022. Inspectors spoke with people, relatives, staff and health professionals. They observed care and checked care plans, medicines, staffing, training, incidents and management records.
The home had improved from Inadequate and was no longer in Special Measures. Inspectors found enough improvement in medicines, safeguarding, staffing, training and risk management. There were enough staff, people were kept safe from infection, and activities and outings had increased.
However, care plans contained inaccuracies and did not always show people's current needs. Some routines did not give people enough choice or protect dignity. Systems for checking care plans, health records, staff supervision and people's views were not reliable. All five areas were rated Requires Improvement.
Staffing and training
Inspectors found enough staff to meet people's needs safely. Staff had received a wide range of training, including specialist training for epilepsy, swallowing difficulties, dementia and positive behaviour support.
“There were enough staff to meet people's needs safely.” from the report
Medicines
Medicines were ordered, stored, given and recorded using safe procedures. Staff had training and competency checks, and medicines audits were carried out regularly.
“There were safe procedures to ensure medicines were correctly ordered, stored, given and recorded appropriately.” from the report
Warm relationships
Staff knew people well and used a warm approach. Inspectors saw staff respecting privacy and dignity during personal care and other support.
“People were supported by staff who knew them very well. Staff used a warm and caring approach and they regularly checked with people to make sure they were ok.” from the report
Activities and outings
The home had appointed two activity coordinators and increased activities, entertainment, trips and opportunities to go out. Inspectors saw people taking part and enjoying activities.
“We observed a variety of activities throughout our inspection.” from the report
Infection control
Inspectors were assured that the home used protective equipment safely, supported visitors safely and had arrangements to prevent and manage infection outbreaks.
“We were assured that the provider was responding effectively to risks and signs of infection.” from the report
Inaccurate care plans
seriousCare plans contained numerous inaccuracies and unclear information about people's needs. This could make it harder for new or agency staff to support people correctly.
“We found numerous inaccuracies in the information provided in care plans, areas that were either unclear or needs that had not been explored.” from the report
Health referrals and records
needs fixingThe home did not have a reliable system to check whether specialist referrals had been completed. Some health monitoring records were also incomplete.
“There was no system to ensure that referrals made for professional advice and support were always followed up.” from the report
Choice and dignity
seriousSome routines limited people's everyday choices, such as being served drinks with milk already added. Keyworker time and opportunities to hear people's views were not consistently used as intended.
“Some staff practices although well intentioned were institutional and did not enable people to make informed choices.” from the report
Limited feedback
needs fixingPeople's meetings and relative surveys were not completed consistently. The home also needed to develop a more person-centred way of gathering people's views.
“Systems to obtain people's views were not effective either through keyworker meetings or surveys and further work was needed to adopt a more person-centred approach to enable people's individual views to be sought.” from the report
- 01How have you checked and corrected the inaccurate or conflicting information in each person's care plan?
- 02How do you now track health referrals, such as epilepsy or memory clinic referrals, through to the appointment and outcome?
- 03How will people make everyday choices, including choices about drinks, activities and going out?
- 04How often will each person have meaningful keyworker time, and how will their views be recorded?
- 05What checks now confirm that care plans, health records and staff supervision are completed and reviewed?
This was an unannounced follow-up inspection that assessed all five key questions and included infection prevention and control checks. This explanation was written from the published report of 8 December 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, March 2022
Rated Inadequate and placed in special measures; inspectors found serious risks to safety, dignity, medicines, staffing and leadership.
This was an unannounced inspection on 19 and 20 January 2022. Two inspectors spoke with people living at the home, relatives, staff and health and social care professionals. They observed care and reviewed care, medicine, staff and management records.
Inspectors found widespread and serious problems. Risks were not always assessed or managed safely. Medicines were sometimes given incorrectly. There were not always enough skilled staff. Inspectors also found unauthorised physical, isolation and medicine-based interventions, poor infection control in some areas, and delays in responding to safeguarding concerns.
People were not consistently treated with dignity or involved in decisions. Care plans did not always reflect people's needs, choices or interests, and there was little meaningful activity. Staff training and support were not adequate. The home had weak checks on quality and safety, and the registered manager left during the inspection.
The overall rating was Inadequate. Safe, effective, responsive and well-led were rated Inadequate. Caring was rated Requires Improvement. The service was placed in special measures, meaning CQC would keep it under review and normally re-inspect within six months.
Some kind interactions
Although care was inconsistent, some staff appeared to know people well and supported them in a caring way. Relatives also said staff knew people well.
“We observed other staff who appeared to know people well and interacted with them in caring manner” from the report
Some healthcare support
Staff made some healthcare referrals and arranged independent advocacy to help people understand and decide about treatment.
“Staff had arranged for some people to have support from independent advocate services to help them understand and make decisions about suggested healthcare treatments.” from the report
Some infection controls
Inspectors were assured about several infection control arrangements, including visitors, admissions, protective equipment and testing.
“We were assured that the provider was preventing visitors from catching and spreading infections.” from the report
Personal bedrooms
People were able to decorate their own bedrooms according to their preferences. Some people who preferred a quieter setting had rooms on the top floor.
“People had decorated their individual bedrooms according to their preferences.” from the report
Unsafe care and medicines
seriousCare plans did not give staff enough information about serious risks, including choking, epilepsy and constipation. Medicines were sometimes given in the wrong amounts or stored unsafely.
“Medicines were not safely managed. People were not always given the correct amounts of laxative medicines they had been prescribed.” from the report
Abuse and restrictive practices
seriousInspectors found unauthorised physical, isolation and chemical interventions. Some incidents and safeguarding concerns had not been reported or properly acted on.
“The provider failed to ensure systems and processes protected people from abuse and improper treatment.” from the report
Not enough skilled staff
seriousThere were vacancies, sickness and problems with agency staff attending. Staff said they did not always have the skills or experience to support people safely.
“There were not always enough support staff available to safely meet people's needs according to then provider's assessed safe levels of staffing.” from the report
People's choices and dignity
seriousPeople were sometimes moved, served food or given drinks without being asked. Inspectors also saw staff using disrespectful language and not responding promptly to distress.
“We observed several instances over the course of the inspection where staff moved people in their wheelchairs without asking permission or explaining what was happening.” from the report
Little meaningful activity
needs fixingPeople often spent long periods doing nothing and were not consistently supported to pursue interests, go out or take part in suitable activities.
“People's care records showed they were not leaving the service or being offered any activities apart from meals, personal care and watching television for long periods each month.” from the report
Weak leadership and checks
seriousAudits did not identify or fix continuing problems. Staff supervision and appraisals were not working properly, records were not always accurate, and the service had a closed culture with low morale.
“There were minimal internal quality assurance systems and processes to audit or review service performance and the safety and quality of care.” from the report
- 01What immediate changes have been made to medicine storage, administration, recording and audits?
- 02How are restrictive interventions such as physical intervention, isolation or medicine being authorised, recorded and reviewed?
- 03How do you make sure there are enough permanent and agency staff with the right skills for each person's needs?
- 04How are people's care plans being rewritten with their involvement, including their communication methods, interests, independence and life goals?
- 05What action has been taken to improve safeguarding reporting, staff supervision, quality checks and the management arrangements?
This was an unannounced inspection of all five key questions, prompted partly by concerns about staffing and people not being kept safe from abuse; the report says the safe and effective ratings had fallen from Good and the other ratings had also deteriorated since the previous inspection. This explanation was written from the published report of 12 March 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk. The report was longer than we could read in one go; the later sections may not be reflected.
Every inspection of Parkgate Manor
6 rated inspections over 7 years: the service has held its Requires improvement rating throughout.
- December 2022Requires improvementcurrent ratingup from InadequateSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- March 2022Inadequatedown from Requires improvementSafe: InadequateEffective: InadequateCaring: Requires improvementResponsive: InadequateWell-led: Inadequate
- August 2021Requires improvementSafe: GoodCaring: GoodResponsive: Requires improvementWell-led: Requires improvement
- April 2021Inspected but not ratedSafe: Inspected but not rated
- July 2019Requires improvementdown from GoodSafe: GoodEffective: GoodCaring: Requires improvementResponsive: Requires improvementWell-led: Good
- September 2016Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2015Requires improvementSafe: Requires improvementEffective: Requires improvementCaring: Requires improvementResponsive: Requires improvementWell-led: Requires improvement
- October 2014
Report published without a new overall rating.
- January 2014
Report published without a new overall rating.
- June 2013
Report published without a new overall rating.
- April 2013
Report published without a new overall rating.
- May 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 11 January 2011.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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19 live-in carers within about an hour of East Sussex
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £1,000 to £1,400 a week. 13 can care for a couple. 10 years' experience on average.
“When he point blank refused to go into hospital for a life saving blood transfusion she talked him through the situation and agreed to go in the ambulance with him and stayed until he was settled.”
“Una felt safe, secure and loved in her time with Debbie which is a gift that I am eternally grateful for.”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.