St Mary's Care Home

Date of Assessment: 4 February to 10 March 2026.

The service is a nursing home providing support to adults of all ages living with learning and physical disabilities. It also supports older people and people living with a dementia.

This assessment was carried out because of the rating and breach of legal regulation found at our previous visit. These breaches related to the good governance and management of the service and person-centred care. At this latest assessment we found a breach of legal regulation in relation to consent and a continuing breach of regulation in relation to good governance.

We assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted.

The environment did not yet reflect best practice for smaller, homely settings and the current size and layout remained inconsistent with ‘Right support, right care, right culture’ guidance. Action was being taken to address this, but it had not been embedded when we visited. Premises safety was not always assured and we found shortfalls in mental capacity and best interests decisions, including a serious incident where a person left the home unsupervised overnight. Governance systems had not consistently identified or addressed all concerns. Training on supporting people with a learning disability and autistic people was not yet at the required level for all staff, but action was taken to address this during the assessment.

People, relatives and staff were overwhelmingly positive about the day‑to‑day support, describing kind and caring staff, strong relationships and a culture where the registered manager and deputy were visible and approachable. People were supported to attend college, do voluntary work and take part in a wide range of activities, including work to develop independent living skills. External professionals reported notable improvements for some individuals and local authority reviewers and learning disability teams described a vibrant, friendly atmosphere.

Date of Assessment: 12 February to 12 May 2025. St Mary’s Care Home is registered to provide nursing and residential care. However, the service has never provided nursing care. The provider originally registered the service to provide support for people who were living with dementia, mental health needs or physical disabilities. They later added support of people with a learning disability or autism. At the time of this inspection, 53 people were living at the service with 35 people described as having a learning disability or autism.

We assessed the service against ‘Right support, right care, right culture’ guidance to make judgements about whether the provider guaranteed people with a learning disability and autistic people respect, equality, dignity, choices, independence and good access to local communities that most people take for granted.

When the provider changed to a specialist service for people with learning disability or autism, this had not been reflected in the design of the service, staff practice and the environment. Neither the registered manager nor staff understood the principles of right care, right support and right culture or any best practice guidance of working with people who had a learning disability or autism. The provider governance arrangements had not identified action was needed to ensure the service changed and effectively supported this specialism.

Staff were empathetic and kind, they were attentive and consistently engaged people in conversation. For most people the service met their needs. However, people with needs related to their learning disability or autism did not always get their needs met and would sit unoccupied for long-periods of time.

Initially there were insufficient staff to provide individualised support for people but during the inspection the provider employed more staff and changed the shift patterns. Despite these improvements, we continued to find staff were not meeting the needs of people whose presenting need was their learning disability or autism.

Since starting the inspection, the provider has made positive changes to the environment to make this more appealing for the younger adults and installed a domestic kitchens and. However, the service still did not provide individualised support, which enabled people to lead meaningful goal-orientated lives.

At our last inspection in 2022 when the service predominantly supported older people, we rated the service as good. At this inspection we found the provider was in breach of legal regulations relating to providing person-centred care, the registered manager's skills to provide a specialist service and governance arrangements.