St Thomas' Priory

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 requires improvement. At this assessment the rating has remained requires improvement. This meant the effectiveness of people’s care, treatment and support did not always achieve good outcomes or was inconsistent.

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 ensure people’s care and treatment was effective because documentation sometimes contained conflicting information, and risk assessments did not always include enough detail to guide staff. Some assessments were comprehensive, but others lacked sufficient information, including diabetes risk assessments. Each person had a care plan in place, but some contained inconsistencies, which created a risk of unclear direction for staff. The provider responded to our feedback by updating the relevant risk assessments and care plans during the inspection.

Relatives did not always feel involved in reviews of people’s care, and people told us they had not seen their care plans. One relative said, “I’ve not seen a physical care plan. One came from the hospital for [my relative], and I don’t think it has been reviewed since then.” One person said, “I have not been involved in any care plan.” The provider told us there were regular opportunities for people and their relatives to be involved in care planning and reviews. They said they would reinforce this with people and relatives to ensure everyone was aware of these opportunities.

Staff told us people’s needs and any changes in care were discussed during handovers. Handover records clearly showed how updates were shared, helping staff remain aware of current risks and support needs. However, inconsistent documentation and limited involvement of people and relatives demonstrated further improvement was needed to ensure care planning was always accurate and inclusive.

The provider did not always plan or deliver care in line with current legislation, evidence‑based practice, or what mattered most to each person. Risk assessments and care plans were not always clear or detailed enough. Some health tasks, such as weight monitoring, were completed well, but others, including oral care, were not monitored consistently. For people who declined oral care over a sustained period, there were no recorded actions to show how staff responded or escalated concerns. The provider responded to our feedback by explaining oral care would be monitored in the daily senior catch up meetings.

People’s nutritional health was monitored effectively. People told us they enjoyed the meals provided and felt their health needs were supported. One person said, “The food is excellent here. There is a choice of 2 main meals. We have sandwiches and gateaux for tea.” One relative told us, “[Person’s name] weight had gone down, but it is gradually increasing. The staff are monitoring it.”

We observed people enjoying their meals and choosing where they preferred to eat, which supported their comfort and autonomy. Despite these positive elements, inconsistent monitoring of specific health needs and unclear care plans showed further improvement was required to ensure care always aligned with evidence‑based practice.

The provider worked effectively with other teams and services to support people’s care. Feedback from visiting professionals was mostly positive. One professional told us, “I find it absolutely amazing. Any recommendations I make are followed.” Another professional said, “Staff are good at picking up if a person is changing in their behaviour. We discuss any changes when I come, and referrals are made quite quickly. I think the staff know who needs what on the whole.” However, some professionals reported the provider was slow to provide timely information. The provider acted on this feedback and introduced new systems to strengthen communication.

Relatives told us they received regular updates. One relative said, “I have regular phone calls and regular updates. I would say communication is great.”

Staff told us they worked closely with relevant professionals, including doctors and podiatrists, and described how they followed clinical recommendations. We reviewed referrals and evidence of escalation to external professionals, which showed staff sought appropriate support when concerns arose.

The provider did not always support people to manage their health and wellbeing effectively. Where people required monitoring of specific health needs, such as blood sugar levels or oral care, this was not completed consistently. Gaps in monitoring increased the risk of changes in health not being identified promptly.

Relatives told us they had seen improvements in people’s health and wellbeing, and some described positive changes since the last inspection. One relative explained how their family member, who had previously been reluctant to eat, had begun eating again, praising staff for their patient and supportive approach.

People told us staff helped them maintain healthy routines and remain active. One person said, “I do physio in the morning and more exercises in the afternoon. I am always hoisted into the wheelchair.” Despite these positive experiences, inconsistent monitoring of key health areas showed further improvement was needed to ensure people always received timely and coordinated support.

The provider did not always monitor people’s care and treatment effectively to support continuous improvement. Gaps in key care records meant the provider could not be confident people consistently received care in line with their assessed needs.

For people living with diabetes who required regular blood glucose monitoring, there were multiple gaps in records. Staff told us checks were completed weekly; however, the frequency and documentation did not reflect this. When we asked about the gaps, staff said people sometimes declined to have this checked, but this was not recorded. As a result, it was unclear whether monitoring had been missed or whether people had chosen not to participate. Although recorded readings were stable, the provider needed to improve documentation to clearly evidence the reasons for any missed checks.

We also found prolonged gaps in repositioning records for people who required regular support to reduce the risk of pressure damage. The registered manager told us staff sometimes missed entries or were delayed in updating records. People’s skin was intact at the time of inspection, but inconsistent documentation meant the provider did not have reliable assurance that repositioning was completed as required.

Staff told us they monitored people’s health needs safely, and they demonstrated good knowledge of each person’s risks and support needs.

The provider informed people of their rights around consent and respected these when delivering person‑centred care and treatment.

People told us staff respected their choices and decisions. One person said, “I can choose when I get up and go to bed.” Another person preferred to stay in their room and said, “They [staff] try to get me to go to the lounge, but I prefer it here.” Staff respected this choice.

Staff understood the principles of the Mental Capacity Act (MCA). The MCA 2005 provides a legal framework for making specific decisions on behalf of people who may lack mental capacity. We observed staff speaking with people and asking whether they needed assistance with tasks. One staff member said, “It’s about supporting people to make their own choices and respecting their decisions, even if you disagree, but at the same time supporting them safely.”

Assessments of people’s mental capacity and best‑interest meetings had taken place to ensure decisions were appropriate and least restrictive. These included decisions about personal care and the use of bedrails.