We carried out a review of the data available to us about Parkbourn on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Parkbourn, you can give feedback on this service.
Parkbourn is a residential care home. This service supports people with autism. The service can support up to eight people; there were eight people living at the service at the time of the inspection.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
The service was a large home, bigger than most domestic style properties. It was registered for the support of up to eight people. This is larger than current best practice guidance. However, the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.
People’s experience of using this service and what we found
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.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent. We saw many examples where staff had supported people to become more independent, make choices and increase their physical and emotional wellbeing. With staff support and by increasing their understanding, personalised daily routines were established, reflecting people's preferences and healthy eating was promoted.
The Secretary of State has asked the Care Quality Commission (CQC) to conduct a thematic review and to make recommendations about the use of restrictive interventions in settings that provide care for people with or who might have mental health problems, learning disabilities and/or autism. Thematic reviews look in-depth at specific issues concerning quality of care across the health and social care sectors. They expand our understanding of both good and poor practice and of the potential drivers of improvement. As part of thematic review, we carried out a survey with the registered manager at this inspection. This considered whether the service used any restrictive intervention practices (restraint, seclusion and segregation) when supporting people.
The service used positive behaviour support principles to support people in the least restrictive way. No restrictive intervention practices were used.
Parkbourn is located in an area that enabled people using the service to participate in their own local community. People were active each day to and enjoyed activities at a day service; some attended local community facilities. Social activities also took place at home, with regular trips to local places of interest, restaurants and pubs.
The service was highly effective at promoting people's independence. This included personal care and daily activities such as laundry, cleaning their home, shopping, preparing meals and drinks.
Staff had developed effective communication with people. This meant that they were able to make their own decisions about their support; staff ensured they were supported to make choices on a day to day basis.
Risks that people faced had been assessed and those identified were safely managed. Medicines were managed safely. Staff showed a good understanding of their roles and responsibilities of keeping people safe from harm.
People were supported to access healthcare when needed. Staff worked with healthcare staff to enable coordinated appointments which gave the people the best outcomes and maintained their dignity. For example, planning ahead, no waiting time and home visits where possible.
People were offered choice and control and where able consented to their care and support. Staff supported people to be as independent as possible with activities of daily living, such as personal care, shopping, cooking and laundry.
People were encouraged and supported to eat and drink well. People were given a choice of suitable meals and snacks. Staff supported people to make meals of their choice throughout the week.
People received care from a consistent staff team, who had worked at the service for a number of years. Enough staff were employed each day to meet people's needs, keep them safe and give them the opportunity to take part in their chosen activity.
Staff received a range of training appropriate to their role and people's needs, and were supported by the registered manager and senior support workers through regular supervision.
Effective systems were in place to check the quality and safety of the service. The environment was clean and safe and in a good state of repair and decoration.
The leadership of the service promoted a positive culture that was person-centred and inclusive. The registered manager and the staff team showed a desire to improve on the service provided and in turn the quality of life experiences for the people at Parkbourn.
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 21 June 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
Parkbourn is a small service registered to provide accommodation for people who require personal care. The service accommodates eight adults with learning disabilities. The service is provided by Autism Initiatives, a charity that provides various types of support for people who have autism. Parkbourn is located in a residential area of Maghull, Merseyside. The property comprises four domestic properties that have been converted into one building.
At the last inspection in April 2015, the service was rated ‘Good’. We found during this inspection that the service remained ‘Good.’
There was a registered manager in post. The registered manager had systems and processes in place to ensure that staff who worked at the service were recruited safely. Staff were able to describe the course of action they would take if they felt anyone was at risk of harm or abuse. This included ‘whistleblowing’ to external organisations. Rotas showed there was an adequate number of staff employed by the service to support people safely. Risks were well assessed and information was updated as and when required. People were supported to manage their medication by staff who were trained to do so.
Training was well coordinated. All newly appointed staff were enrolled on the Care Certificate as well as the providers own internal induction process. Supervisions and appraisals were completed in line with the provider’s policy.
The service was working in accordance with the MCA and associated principles. We saw that when people could consent to decisions regarding their care and support this had been well documented, and where people lacked capacity, the appropriate best interest processes had been followed and DoLS had been appropriately applied for.
We were unable to speak to and observe the people who lived at the home on both days of our inspection as they went out during the week. Some of the people who lived at the home would not have been able to verbally communicate their views due to their cognitive abilities, so we spoke to people’s families, and a health and social care professional involved with the home.
Support plans contained information about people’s likes, dislikes, preferences and personalities. Staff we spoke with demonstrated that they knew the people they supported well, and enjoyed the relationships they had built with people. We saw staff were extremely caring in their approach by reading about staff support and speaking to the staff on duty and people’s families.
Complaints were well managed and documented in accordance with the provider’s complaints policy. The complaints policy contained contact details for the local authorities and commissioning groups.
Quality assurance systems were effective and measured service provision. Regular audits were taking place for different aspects of service delivery. Regular action plans were drawn up when areas of improvement were identified. Staff meetings took place.
Further information is in the detailed findings below.
Parkbourn is a service registered to provide accommodation for people who require personal care. The service accommodates eight adults with learning disabilities. The service is provided by Autism Initiatives, a charity that provides various types of support for people who have autism. Parkbourn is located in a residential area of Maghull, Merseyside. The property comprises four domestic properties that have been converted into one building.
This was an announced inspection which took place on 23 & 24 March 2015.
A registered manager was in post. 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.
During our inspection we used a number of different methods to help us understand the experiences of people who lived at Parkbourn. This was because the people who lived at Parkbourn communicated in different ways and we were not always able to directly ask them their views about their experiences. We spent time with four people who were living at the home, conducted general observations, talked with staff and relatives and reviewed a number of records. Our observations showed people appeared relaxed and at ease with the staff.
Staff had received safeguarding adults training and had a good awareness and understanding of abuse and the procedures to follow should they wish to report an alleged incident. Relatives we spoke with told us the staff made sure their family member was kept safe.
Risks to people health and safety had been assessed and plans were in place to ensure people’s safety and to maximise their independence. Staff told us how they managed risks and how they supported people with individual choices. This included areas such as, accessing the community and supporting people with behaviours that may challenge.
We observed staff supporting people in a way they liked and met their needs. Staff interactions with people was warm and respectful and demonstrated a good knowledge and understanding of people’s individual needs, choices and preferences.
Staff had a good knowledge of people’s needs and people’s care files held ‘person centred’ plans. These are care plans which record detailed information about the individual. Care documents recorded strategies to support behaviours that cause concern through positive intervention support planning to enhance people’s quality of life. Care documents were updated regularly to ensure the information was accurate so that people received the support needed.
Some care documents were signed by people, however we saw there was a lack of recorded evidence to support people’s and or/their relative’s inclusion in the planning and delivery of their care. Relatives told us they were involved in their family member’s care and staff were ‘good at keeping in touch'.
People received the support they needed to optimise their health. This included appointments with external health care professionals such as GP, dentist, optician and hospitals; these were documented in the care files we looked at. A relative said, “I am always told if (family member) needs to see a doctor.”
There we sufficient numbers of staff were available to support people with their personal needs and social activities. Staff communicated well with the people they supported and visual aids and signs were available. Relatives’ comments about the staff included, “The staff are very good”, “Staff put in so much time and effort” and “Can’t praise the staff enough.”
Recruitment checks had been carried out to confirm staff were suitable to work with vulnerable people.
Medicines were administered safely to people. Staff received medicine training and had their medicine practice checked to ensure they had the skills and knowledge to safely administer medicines.
Measures were in place to regularly check the safety of the environment. We saw regular health and safety checks of the environment had been undertaken and this included checks for fire prevention equipment.
People who lived at Parkbourn needed support when making decisions around their daily life and care needs. The manager discussed us how people who lived at the home, relatives and external health professionals were involved in decisions to support people’s care welfare. This followed good practice in line with the Mental Capacity Act (2005) Code of Practice.
People at Parkbourn had access to a three week menu (in word and picture format) which was displayed. People’s nutritional needs were monitored by the staff.
With regards to food stores there was little choice available in the fridges, for example snack foods. The manager agreed to review the arrangements around when foods were purchased to ensure stocks were kept constant.
Staff received specific training and support to meet the care needs of the people who lived at Parkboun. This included Autism Initiatives Five Point ‘Star’ framework to help understand and support people with autism, training around behaviours that might challenge and communication strategies.
We spoke with the manager regarding the environment. Areas such as, bathrooms and some communal rooms and hall ways were bare and there was some broken plaster work that required repair. The manager was aware of the need to have the plaster work repaired and they informed us new furniture was going to be purchased for one of the lounges.
People had access to an activities programme within the home and through Autism Initiatives day services.
Staff had access to a whistle blowing policy thus ensuring an open culture existed.
A process was in place for managing complaints and an easy read version of the complaints procedure was displayed in the home for people to see. The manager informed us no complaints had been received. Relatives told us they would know how to raise a complaint or concern.
Quality assurance systems were in place to monitor performance and drive forward improvements. This included a number of internal and external audits (checks) on how the service was operating and also seeking feedback from people and their relatives. Where improvements had been needed these had been shared with the staff and actioned.
Our discussions with the manager and staff showed that the culture of the home was based around treating people as individuals and promoting an awareness and understanding of autism.
During the inspection we looked at care, maintenance, food preparation and training records. Responses and comments we had about the home were all positive. We briefly spoke to one resident about the home. When asked about the food the person said, 'It's very good.'
The manager and staff member we spoke with had an awareness of residents care needs. We discussed with staff the individual needs of residents. Comments included, 'We are a small home and I have been here a long time and know all the people well.'
There were a range of audits and systems in place to monitor the quality of the service being provided.
We asked staff about their work, and how they found working with the people living in the home. One staff member told us "I've worked here for some time now and I enjoy the work I do." We asked this person what it was that made their work enjoyable. They told us "I love seeing the positive changes I can help to make for the people I work with. The approach of the organisation is good; we practice power with people, not power over people."
One person living at the home spent some time sitting with us during our inspection. They told us how they enjoyed shopping for clothes, and spoke about the films they had seen recently, and trips they had made to the theatre.
We were able to speak to a relative of a person living at Parkbourn. This relative described how their family member considered Parkbourn as their home. "Our (family member) is very happy; she is always smiling and enjoys the company of the staff. The staff are so supportive of her and us, and have helped us keep in daily contact with her." This relative went on to say that they felt confident in the level of support and care their family member received at the home.
Our observation of staff interaction with people living in the home, was that it was warm, friendly and supportive.
However during our visit we met with all of the people living there. We spent time observing the support they receive from staff with their everyday lives and how they choose to spend their time at home. We have taken this information into account in writing this report.