St Mary's Residential 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 remained good. This meant people’s outcomes were consistently good, and people’s feedback confirmed this.

This service scored 63 (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.

We found that people’s needs were not always assessed appropriately before they moved into the service. For example, the last person who was admitted to the service had an unpopulated pre assessment,we found no evidence that the person or relative had been consulted for the assessment.However,the service had sought a GP summary and received information from the local authority which ensure staff understood the person’s needs.

Relatives told us they had not seen people’s care plans for a long time or not at all. A relative said, “I remember it from when [person] was admitted but I have not seen it since.”

Care plans we saw showed people’s needs were assessed by the service, they were reviewed and we saw referrals had been made to appropriate healthcare professionals for further support for people, including dietitians and SALT.

The leadership team had been working with the care team developing care plans and advised that they would ensure the pre assessment process would be followed going forward with the new manager.

The provider planned and delivered people’s care and treatment with them, including what was important and mattered to them. They did this in line with legislation and current evidence-based good practice and standards. The provider used recognised risk assessments tools to help assess people’s needs and make changes where necessary. These included Waterlow for assessing people’s risk of developing pressure ulcers and malnutrition Universal Screening Tool to assess people’s risk of malnutrition.

Staff told us that if they saw changes with people’s needs they spoke to the Senior Care Assistant. One staff member told us, “I am responsible for the shift lead. Any concerns about the residents, I make sure I get advice, that could be 111 or GP.”

The provider worked well across teams and services to support people.Records showed people were supported to access external health professionals, including when people needed to attend hospital. During our inspection we observed people being visited by the district nurse and staff calling the GP for advice on people’s needs. Relatives told us they were happy that the service followed the instruction of the GP.

The provider did not always support people to manage their health and wellbeing, so people could not always maximise their independence, choice and control. Staff did not always support people to live healthier lives, or where possible, reduce their future needs for care and support.

Menus we saw did not offer fresh fruit and vegetables, for example on the first day of our inspection, people’s lunch choices were sausages or burgers, with mashed potatoes or chips with baked beans and cake for pudding.

We received mixed responses from relatives regarding the services meal options. A relative told us,“It seems fine.” Another relative told us, “Lunch is a cooked meal, but it is school dinner basic.”

We saw people have access and received plenty of drinks during our inspection and they had accessible snacks.

When we informed the nominated individual,they told us that fruit was always available as a snack and fresh vegetables would be available for people.

The provider did not always routinely monitor people’s care and treatment to continuously improve it. They did not always ensure that outcomes were positive and consistent, or that they met both clinical expectations and the expectations of people themselves. For example, we found a person who had been recently assessed as requiring two hourly turns due to risk of skin damage, did not have a turn chart in place to record the turns.This put the person at risk. We found no harm had come to the person.

When we informed the leadership team, they were proactive in ensuring a turn chart was implemented and regular oversight was made.

The provider told people about their rights around consent and respected these when delivering person-centred care and treatment. Where a person did not have capacity to make their own decision, or had fluctuating capacity, the provider had completed mental capacity assessments. This meant the service had acted in line with the Mental Capacity Act (MCA) code of practice.Staff had received training in MCA and understood what consent means. We observed staff seeking consent before supporting people’s needs.