St Martins Residential 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 the legal regulation in relation to consent.

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 made sure people’s care and treatment was effective by assessing and reviewing their health, care, wellbeing and communication needs with them.

Relatives confirmed initial discussions were held with the registered manager and with a representative from the Local Authority. Staff completed an assessment of their family member’s care and support needs. Visits to St Martins Residential Care Home were conducted to enable the prospective person and/or their relative to view the premises, to meet staff and others living at the service.

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

Staff were able to demonstrate a good understanding and knowledge of how people using the service should be supported. However, staff’s practice did not always evidence this. The dining experience was not as positive as it should be for people using the service. Staff did not showcase food choices through ‘show plates’ by allowing people to choose their meals at the point of service. Staff did not routinely explain to service users what the meal provided was, despite many people living with dementia. Some members of staff were observed to be distracted while supporting individuals to eat. For example, by initiating support and then carrying out another task without explaining to the service user being supported, what was happening. A person using the service had their plated meal placed in front of them and did not receive timely assistance from staff, making their food go cold. Staff were seemingly unaware of this and failed to intervene until we became involved. These actions were not person-centred and were undignified as they can negatively impact a person’s dining experience.

People told us they had enough to eat and drink and generally enjoyed the meals provided.Comments included, “The food is okay, there is enough fruit and vegetables”, “The food is pretty good and there is enough variety” and “The food is fine, although it is very repetitive.” People stated they were offered drinks throughout the day but would occasionally like a glass of wine or a beer with their meal.

The provider worked well across teams and services to support people.

Information reviewed demonstrated the service worked with others, for example, the local authority, healthcare professionals and services to support people’s ongoing care provision.

Staff told us they had the information they needed to support people. The registered manager and staff confirmed daily handovers took place to discuss changes in people’s care and support needs.

The provider supported people to manage their health and wellbeing. Staff supported people to live healthier lives and where possible, reduce their future needs for care and support.

People had access to healthcare services when they needed it and confirmed their healthcare needs were met. A person who used the service told us, “I can request to see a GP, I see a chiropodist every 3 months and go to a private optician.” Relatives confirmed staff were responsive to their family member’s healthcare needs and were kept up to date about their family members needs and the outcome of health-related appointments. A relative told us when their family member was unwell, appropriate emergency healthcare support was contacted at the earliest opportunity, and they were kept informed of the consequence.

The provider did not always routinely monitor people’s care and treatment effectively to continuously improve it.

An electronic software system was being used for care planning. Staff used handheld devices to access people’s care records and record the day-to-day support people received. Although there were arrangements in place to monitor people’s weight, food and fluid intake, records relating to the latter were not always consistent with targets set within their individual care plan. The fluid intake for some people were below recommended quantities, either because people had not received sufficient fluids or because the monitoring system was not accurately reflecting what had been given by staff. Where people required their body to be repositioned because they were at risk of developing pressure ulcers, records required improvement.

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

The Mental Capacity Act 2005 [MCA] provides a legal framework for making particular decisions on behalf of people who may lack the mental capacity to do so for themselves. The MCA requires that, as far as possible, people make their own decisions and are helped to do so when needed. When they lack mental capacity to take particular decisions, any made on their behalf must be in their best interests and as least restrictive as possible. People can only be deprived of their liberty to receive care and treatment when this is in their best interests and legally authorised under the MCA. In care homes, and some hospitals, this is usually through MCA application procedures called the Deprivation of Liberty Safeguards [DoLS].

We found the service was not working within the principles of the MCA. Staff did not demonstrate sufficient knowledge and understanding of the key requirements of the MCA and how this affected people using the service. CCTV was installed and introduced at St Martins Residential Care Home in June 2024, to monitor all communal areas. We found consent had not been formally sought and recorded for people using the service or staff employed. Stair gates were fitted at the top and bottom of the main staircase. No assessment of capacity was completed or considered for less restrictive options or to demonstrate the equipment in place was in peoples’ best interests, including if the restriction installed was necessary and proportionate.

Legal authorisations were in place to deprive a person of their liberty but had not always been applied for in a timely manner.