St Thomas' Priory

On this page

• Overview
• Shared direction and culture
• Capable, compassionate and inclusive leaders
• Freedom to speak up
• Workforce equality, diversity and inclusion
• Governance, management and sustainability
• Partnerships and communities
• Learning, improvement and innovation

Well-led – this means we looked for evidence that service leadership, management and governance assured high-quality, person-centred care; supported learning and innovation; and promoted an open, fair culture.

At our last assessment we rated this key question inadequate. At this assessment the rating has changed to requires improvement. This meant the management and leadership was inconsistent. Leaders and the culture they created did not always support the delivery of high-quality, person-centred care.

The service had previously been in breach of the legal regulation relating to good governance. Although several improvements had been made to the auditing process, governance systems still required further strengthening to ensure people’s care was consistently and safely monitored. The provider therefore remained in breach of this legal regulation.

This service scored 61 (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 had a clear and shared vision, strategy and culture based on transparency, equity, equality and human rights, diversity and inclusion, engagement, and an understanding of the needs of people and their communities. Staff told us how they promoted people’s rights in daily practice, including dignity, privacy and respecting people’s choices and decisions. People and relatives gave examples of how staff upheld these values. One relative said, “I honestly cannot speak highly enough of the team and everything they do for [my family member]. The care, kindness and support they provide mean a great deal to both [my family member] and our family.”

The registered manager had undertaken significant work to strengthen and embed a positive culture across the home. This included delivering training, holding workshops, re‑developing the staff charter and facilitating forums to promote an inclusive and person‑centred approach. The impact of this cultural work was clearly visible across both days of our site visits.

Leaders demonstrated the values and culture of the organisation; however, they did not always have the structure, oversight or accountability needed to monitor key aspects of care consistently. Leaders were visible on the floors, but some health‑related tasks were not regularly checked or reviewed, which meant issues were not always identified or addressed in a timely way. The registered manager told us they had met with leaders based on each floor of the home to discuss this feedback and were developing a more structured and accountable approach to monitoring. We will review the impact of this at the next inspection.

Staff told us the registered manager was approachable, supportive and accessible. One staff member said, “The [registered manager] is very supportive. I can approach anyone on the management team.” When things went wrong, the registered manager was open, offered apologies where appropriate, and understood their responsibilities under the duty of candour.

The provider fostered a positive culture where staff felt able to speak up and were confident their concerns would be listened to and acted upon. Staff told us they were aware of the whistleblowing policy, which had been covered during their induction. One staff member said, “We all know how to speak up. If I saw anything unsafe, I would pass it on to the [registered] manager straight away, they would act on it. The registered manager is approachable; they are often around and I can go to them if I have any concerns.” The whistleblowing policy was readily accessible to staff, and information posters were displayed to remind staff how to raise concerns if needed.

The provider valued diversity within the workforce and promoted an inclusive and fair culture by working to improve equality and equity for staff. Staff told us they were treated fairly at work and felt the training helped them understand the diverse health conditions and experiences of the people they supported. One staff member spoke passionately about the dementia training they had recently attended, saying, “I was one of the first people to do the virtual dementia training. It was an eye opener; it gave me a lot more understanding. The training helped me put myself in people’s shoes. It made me cry; I had never thought about dementia like that. The training helps to enhance the care provided to people.”

The provider also completed health questionnaires with staff during recruitment to identify any health or emotional support needs, helping ensure staff received appropriate adjustments and support to carry out their roles effectively.

The provider did not always have clear responsibilities, roles or systems of accountability, and governance processes were not consistently effective. Leaders did not always act on the best information about risk, performance and outcomes, and oversight arrangements did not reliably identify issues that required attention.

There had been marked improvements in several areas, including audits of staff practice and environmental checks. However, the auditing process had not identified several discrepancies found during this inspection. Some concerns, such as gaps in oral care and equipment monitoring, had also been identified at the previous inspection and had not been fully resolved. Additional improvements were required in monitoring repositioning and blood glucose checks, and some risk assessments lacked sufficient detail to provide clear guidance for staff. Oversight of the experience of people who remained in their rooms also required strengthening to ensure they received regular social support and engagement.

The provider was receptive to feedback during the inspection and implemented new systems to address the issues identified. We will review the impact of these changes at the next inspection. Staff told us they had seen positive developments since the last inspection, including improvements in training, adequate staffing levels and feeling better supported by the management team.

The provider understood their duty to collaborate and work in partnership with others, but they did not always share information promptly or consistently. We received positive feedback from several health and social care professionals about the improvements made to the service, including the culture, environment and responsiveness of staff. One professional told us, “It’s not just the décor that’s improved,” and another said, “I’d have my relative move here 100%.” Three professionals described the provider as responsive and said communication was effective.

However, 3 other professionals told us they sometimes had to chase the provider for information. One professional shared email evidence showing they had contacted the provider via email without response on numerous occasions. However, they were using an outdated email inbox, which the provider told us was not monitored; we fed this back to both the provider and the professional. Two further visiting professionals told us they did not always receive a response to their telephone calls. This inconsistency risked delays in sharing important information and coordinating people’s care.

While the feedback was mixed, the provider needed to ensure all communication routes, including telephone and email, were monitored effectively so that professionals received timely responses and partnership working was consistent. The provider was receptive to this feedback during the inspection and began taking steps to address communication gaps.

The provider focused on continuous learning, improvement and innovation, and had introduced several new systems to strengthen oversight and enhance people’s experiences. However, while these developments were positive, further work was needed to ensure they were implemented consistently and resulted in sustained improvements. New monitoring systems had been introduced to improve the accuracy of records and the oversight of key health tasks, but these required time to embed. Plans were also in place to further develop the environment and to expand opportunities for people who spent time in their rooms, ensuring they received meaningful social interaction and engagement. The provider was receptive to feedback and demonstrated a commitment to learning and improvement, but more time and consistent application were needed for these initiatives to demonstrate measurable impact.