St Claire's Care Home

On this page

• Overview
• Assessing needs
• Delivering evidence-based care and treatment
• How staff, teams and services work together
• Supporting people to live healthier lives
• Monitoring and improving outcomes
• Consent to care and treatment

Effective – this means we looked for evidence that people’s care, treatment and support achieved good outcomes and promoted a good quality of life, based on best available evidence.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

The service was in breach of legal regulation in relation to consent to care and treatment.

This service scored 58 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always make sure people’s care and treatment were effective because they did not always check and discuss people’s health, care, wellbeing and communication needs with them. People had their needs assessed before moving to the service. The assessment included making sure that support was planned for people’s diversity needs, such as their religion, gender, marital status, culture and their abilities. These assessments were used to develop the person’s care plans and make the decisions about the staffing hours and skills needed to support the person. However, some people’s assessments had not been used to fully prepare a care plan to detail how staff should meet the person’s needs. A person had lived at the service for 12 days and they did not have all their care plans in place for staff to follow. For example, their likes and dislikes had not been recorded and nor had their life history. These sections would have helped staff build a rapport with the person and help get to know them. There was no medicines care plan to detail what medicines the person was taking and why.

Some people were able to recall being involved in their assessments and care planning process and some people told us they had not been involved.

The provider did not always plan and deliver people’s care and treatment with them, including what was important and mattered to them.

The provider had systems and processes in place to meet people’s nutrition and hydration needs. However, records were inconsistent and showed that some people were potentially not having enough fluids to keep well. There did not appear to be any robust monitoring of people’s fluid intake or output.

Care plans and risk assessments described what modified diet people were prescribed and the care plans followed The International Dysphagia Diet Standardisation Initiative (IDDSI) framework, however there was conflicting information in the care plan. For example, a person’s care plan described a pureed diet and elsewhere it recorded the person requiring a minced and moist diet. Minced and moist food contains tiny, soft 4mm lumps that can be mashed with the tongue and requires minimal chewing. Pureed food is completely smooth and lump-free, and requires no chewing at all. There was no IDDSI guidance for kitchen staff. Kitchen staff and staff responsible for supporting people to eat did not know about IDDSI and what the terms meant and had not received training in this. Kitchen staff were not always made aware of changes within the service, such as new people who had moved into the service, which meant they were not always aware of food preferences, allergies and intolerances prior to making food. When people moved to the service, the provider did not complete documentation for the kitchen to detail this essential information. This put people at risk of harm.

We received mixed feedback from people about the food. We observed (and staff confirmed) there was a lack of fresh food being cooked and prepared as all of the food was ready made food that had been bought in . People said, “Food is sometimes okay, sometimes it’s not. I don’t always know what I am having until it gets here”, “Food is fair I had chicken pie today”, “Food is good” and “Food here is normally excellent, [staff name] is such a good cook.” We observed that when people did not like their meal, they were given alternatives and staff encouraged people to eat more. Staff told us there were snacks and fruit available, however fruit was only on offer if it was sent up from the kitchen on the trollies.

The provider worked well across teams and services to support people. They made sure people only needed to tell their story once by sharing their assessment of needs when people moved between different services. The provider had a clear process in place to escalate health concerns. Staff worked with health professionals to ensure people got the care and support they needed.

A health care professional told us, ‘As far as I can see on the notes, the care team appeared to contact us or out of hours services when needed for patient support. The residents have all attended scheduled hospital appointments during their time with St Claire’s. When the care team have contacted the surgery to discuss a pt [patient], we generally speak to the managers [deputy manager and head of care] and have found they give a good history and answer as we would expect carers who know their residents. They appear to have notified the surgery team about ailments such as suspected infections and kept us informed if patients have not been compliant with medications or are struggling with their mental health.’

The provider supported people to manage their health and wellbeing, so people could maximise their independence, choice and control. Staff supported people to live healthier lives, or where possible, reduce their future needs for care and support.

People’s records showed staff had escalated concerns to their GP in a timely manner. Community nurses attended the service daily to provide nursing care to people. Weights were regularly monitored and action around weight loss was taken, such as referrals to dieticians. There were good links with other health professionals such as SaLT (Speech and Language Therapy), physiotherapy and the GP. People told us staff worked with GP’s and health professionals to meet their health needs.

People said, “[Staff member] spoke to the doctor and he gave me some antibiotics, but I haven’t seen him. I do see a chiropodist, but not a dentist as I don’t like them” and “I can see the doctor when I need to. The district nurse comes around and gives me a Vitamin B12 injection.”

The provider had not routinely monitored people’s care and treatment to continuously improve it. Staff had monitored people’s care and treatment. They ensured that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves.

Staff worked together as a team to support people and to ensure people received their care and support in the way they chose. People told us staff knew them well. Comments included, “I think they know me well, I have been here for quite a while” and “They know me very well.”

The provider told us in their information return which was submitted on 2 June 2026 how they liaised with health and social care professionals. We observed that the provider had worked with dementia specialist services and memory clinics to ensure people living with dementia received appropriate support. We observed that the community nurses were involved with the nursing care of people such as administering insulin injections for people living with diabetes and catheter care for those with catheters in place.

The provider did not tell people about their rights around consent or respect these when delivering care and treatment.

We checked whether the service was working within the principles of the Mental Capacity Act (MCA). The service did not always work within the principles of the MCA. A person said, “They put the cot sides up on my bed I feel like I'm in a playpen and it's horrible.” Their care records evidenced a bed rails assessment had been done but did not show that the person had been involved and consented. The consent form seen recorded the person felt safer having bed rails on their bed. The assessment showed it has been decided in the person’s best interests they will have bed rails as they were at risk of falls. There was no evidence that the person lacked capacity to make the decision to have bed rails and no evidence to show that relatives or other relevant parties had been involved in the decision. The provider had not considered the least restrictive option.

Care was not always person centred, however we did observe people were offered choices throughout the day. We received mixed feedback from people about how well they felt listened to and how well their views and opinions were important to staff. A person said, “I don't have any choices, I did moan about being put to bed at 18:00 as this is much too early. I now go to bed at 19:00.” Another person told us, “I can choose when I get up and go to bed. I do what I want. I can do things for myself.”

A person had a DoLS authorisation which had conditions in place which came into force on the 10 June 2026, the staff had worked to meet one of the conditions by creating risk assessments relating to the person’s wish to go out into the community. The second condition had not yet been met, which meant the person had not been supported to go into the community at the time we assessed the service. Staff told us in order for this to happen they would need to allocate 2 staff members to support the person and keep them safe.