St Martins Residential Home

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

Safe – this means we looked for evidence that people were protected from abuse and avoidable harm. At our last assessment we rated this key question Good. At this assessment the rating has changed to Requires Improvement.

This meant some aspects of the service were not always safe and there was limited assurance about safety. There was an increased risk that people could be harmed.

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

This service scored 59 (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 proactive and positive culture of safety, based on openness and honesty. Staff listened to concerns about safety and investigated and reported safety events. However, lessons were not always learnt to continually identify and embed good practice.

Staff knew how to record accidents and incidents. These were dealt with as an opportunity to put things right, learn and improve. A member of staff told us they would document information relating to the above and escalate this to senior staff and/or the management team, to ensure any follow up action required was undertaken and lessons learned.

People and relatives spoken with told us they felt able and comfortable to raise concerns. A person using the service told us, “I would speak to the manager, they would listen.” Relatives’ comments included, “I have no qualms talking to the staff or manager” and “I can go the manager at any time. I am confident I would be listened to and any issues addressed.” However, where complaints were recorded citing staff practice shortfalls, monitoring of their performance had not been completed.

The provider worked with people and healthcare partners to establish and maintain safe systems of care, in which safety was managed or monitored. They made sure there was continuity of care, including when people moved between different services.

People’s needs were assessed prior to their admission to the service and this information was used to inform their care plan and associated risk assessments. The registered manager told us about the service’s assessment and admission process. They confirmed that people’s care and support was planned where possible with the person, those acting on their behalf and other key partners to ensure continuity of care.

The service collaborated with people and healthcare partners to understand what being safe meant to them and the best way to achieve that. They concentrated on improving people’s lives while protecting their right to live in safety, free from bullying, harassment, abuse, discrimination, avoidable harm, and neglect.

People and their relatives considered themselves and their family member to be safe. People using the service told us, “I do feel safe, at the moment I am alright. I have got no concerns” and “I am safe.” Relatives told us, “[Name of person using the service] is safe, never seen or heard anything untoward” and “I have no concerns about [Name of person using the service] and have total peace of mind when I leave here [St Martins Residential Care Home].”

Staff were able to tell us about the different types of abuse and what to do to make sure people were protected from harm. Staff told us they would escalate any concerns to the provider, registered manager, Local Authority or Care Quality Commission. The registered manager was aware of their responsibility to notify us and the Local Authority of any allegations or incidents of abuse. Staff had completed appropriate safeguarding training.

The provider did not ensure all risks to people’s safety and wellbeing were identified or provided enough detail as to how these should be mitigated. Staff did not always provide care to meet people’s needs that was safe.

Not all risks to people’s safety and wellbeing were identified or provided enough detail as to how recognised risks should be mitigated. This referred specifically where people could become anxious, distressed and exhibited behaviours that could place themselves and others at risk of harm. Where people were judged to be at risk of dehydration and required their fluid intake to be monitored and recorded, records demonstrated their fluid targets were not always maintained and there was a lack of evidence to show what was being done to monitor and address this. A person’s care plan referred to them requiring their body to be repositioned at regular intervals to reduce the risk of pressure ulcers developing. However, records showed these were not routinely completed. This meant we could not be assured the person was being repositioned in line with their care needs to reduce the risk of their skin integrity declining. Potential risks associated with 1 person’s catheter care were not identified and recorded. A catheter is a medical device used to empty the bladder and collect urine in a drainage bag. Additionally, we could not be assured the person’s catheter bag was regularly emptied as the records were not routinely completed.

The provider controlled potential risks in the care environment. They made sure equipment, facilities and technology supported the delivery of safe care.

People and relatives did not express any concern in relation to the safety of the environment.People had access to an outside space that was secure and safe. Routine environmental and equipment checks were completed to ensure the premises were safe. For example, safety checks were completed relating to the service’s electrical and gas installation system, portable appliances throughout the service and fire safety equipment checks. Specialist or adaptive equipment was made available for people’s use to ensure their needs were met.

The provider did not always make sure there were enough qualified, skilled and experienced staff. They did not always make sure staff received effective support, supervision and development.

People’s and relatives’ comments relating to staffing were generally positive. People’s comments included, “I’ve got a buzzer, they [staff] don’t dilly dally and I have not had to wait recently. I did a while back when they were short staffed” and “I can buzz, and they [staff] come fairly quickly. If I have to wait for them, they explain what has happened to delay them, I am not just left”. Relatives confirmed what people told us stating, “I am not aware of them [staff] being short staffed at all” and “I think there is enough staff.” There were enough staff deployed in line with staffing levels stated by the registered manager. Observations throughout both days of our assessment demonstrated call alarms to summon staff assistance were responded to in a timely manner.

Although staff had received appropriate mandatory training, observations of staff’s practice did not provide assurance staff were skilled and competent to effectively apply their learning in their everyday practice. There were people at the service who were living with dementia, but not all staff demonstrated and delivered effective person-centred dementia care and support. Not all staff were skilled and supportive whilst supporting people at mealtimes.

Not all staff had received regular formal supervision, and this included the registered manager. For example, the registered manager had not received formal supervision since July 2024. A member of staff who had been employed in July 2024, had only received 1 supervision at the time of our assessment. Following our assessment the registered manager provided an additional supervision record for this member of staff. Where staff supervisions were happening in line with the registered person’s expectations and issues were raised by a staff member, there was a lack of information recorded as to how this was to be monitored in the longer term and the action to be taken.

The provider had an effective recruitment and selection procedure in place. However, no information was recorded to demonstrate the progress and satisfactory completion of an employee’s performance and probation review during their initial employment period.

Newly employed staff received an induction and were given the opportunity to ‘shadow’ more experienced staff to ensure they understood the routines of the service and their roles and responsibilities.

The provider assessed and managed the risk of infection. They detected and controlled the risk of it spreading and shared concerns with appropriate agencies promptly.

The service was clean, hygienic and odour free.

Staff were clear about their roles and responsibilities to ensure people were protected by the prevention and control of infection arrangements at St Martins Residential Care Home. Staff had access to policies and procedures on infection control and had sufficient Personal Protective Equipment [PPE]. Staff were observed using Personal Protective Equipment [PPE] appropriately and when required.

Audits relating to the service’s infection, prevention and control arrangements were being conducted and demonstrated there was a good level of compliance. Staff had received appropriate infection, prevention and control training.

The provider made sure that medicines management was safe and met people’s needs. A person using the service told us, “I have loads of medication, that is all okay. When I’m in pain, I can ask for some tablets.” Another person told us, “I have my medication in the morning and in the evening, none is missed.”

Staff were observed to administer people’s medicines appropriately and in line with current guidance. The medication rounds were evenly spaced out throughout the day to ensure people did not receive their medicines too close together or too late. Observation of staff practice showed staff undertook this task with dignity and respect for the people being supported.

Medicine records were maintained to a good standard, and Medication Administration Records [MAR] demonstrated people received their medicines as they should and in line with the prescriber’s instructions. The service ensured people's behaviour when anxious and distressed was not controlled by excessive and inappropriate use of medicines. Minor improvements were required to ensure PRN [as needed] protocols were in place for all prescribed medicines administered in this manner. We found staff were not consistently recording the correct codes when completing the MAR and a stock discrepancy was highlighted for 1 person.

Staff confirmed they had received appropriate medicines training and had their competency assessed at regular intervals to ensure their practice remained safe when supporting people with their medicines.