St Mary's Nursing Home

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question good. At this assessment the rating has remained good. This meant people’s needs were met through good organisation and delivery.

This service scored 68 (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 were at the centre of their care and treatment choices and they decided, in partnership with people, how to respond to any relevant changes in people’s needs.

People’s care plans were person‑centred and contained information about their preferences, likes and dislikes and their care and clinical needs. People were supported to make everyday decisions about their care, such as what they wore, where they spent their time and how they wished to spend their day. One person told us, “I think it’s very personal care.” Another said, “If I ask for anything I get it, it’s very individual.”

Staff understood the importance of delivering care which reflected each person’s individual routines, preferences, needs and goals. They told us care plans and risk assessments provided the information they needed to offer personalised care. This included knowing people’s preferred daily routines.

We saw positive interactions between people and staff in the home. People were greeted by their preferred name and staff spoke confidently about people as individuals. Staff understood people’s needs and preferences. This included understanding what helped to reassure and calm people if they became distressed. One member of staff told us, “They are a human being and they need respect. Just because they have dementia, it doesn’t mean they don’t have feelings. They have choices, right to the very end. It's all about respect.” Another staff member said, “I try to make them feel so special. I greet them nicely, politely and talk, ask questions, give choice. It makes them more relaxed.” They described how music soothed 1 person and how playing their preferred tunes before providing personal care, made the person relaxed and less anxious.

The provider understood the diverse health and care needs of people and their local communities, so care was joined-up, flexible and supported choice and continuity.

The provider had a good understanding of people’s needs and worked in partnership with other health and social care professionals to support continuity of care. Staff collaborated with professionals such as speech and language therapists, social workers and dietitians when people required additional support. This helped ensure care was well coordinated. Where people received input from external professionals, their recommendations were recorded in care plans and used by staff to guide day‑to‑day practice.

Relatives who wished to remain involved in their family member’s care were supported and encouraged to do so. This helped ensure care remained consistent and aligned with people’s preferences. We saw an example where staff applied for additional funding to help meet a person’s assessed needs.

Many people were admitted to the home from hospital. The service worked closely with hospital teams to support timely and safe discharges, helping to reduce delays and ensure people experienced joined‑up care when moving between services.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

Some of the information displayed within the home was not fully up to date. For example, an information guide in the entrance included the name and photograph of a previous manager, which could cause confusion for people and visitors. Much of the written information displayed around the service was not accessible for people with visual impairments, including information on how to make a complaint. There was limited use of alternative formats, such as large print, pictorial or easy‑read information displayed.

Staff had developed a welcome pack to provide people with information on arrival. However, some of the content did not accurately reflect services available at St Mary’s Nursing Home. For example, it advised a hairdresser visited weekly, but staff confirmed only a barber currently visited, and regular opportunities for women to get their hair styled were not available.

However, some positive practice was identified. For example, people whose first language was not English had access to pictures and translated materials to support staff in offering choices. Additionally, some people used whiteboards to support communication and sensory care needs.

People’s care plans included information about their communication needs and preferences. Care plans clearly described how information should be shared with people to make it accessible to them. However, this information was not always used consistently in practice to ensure people received information in a way which met their needs. As a result, some people may not always receive information in the format or at the time which best supported their understanding, limiting their ability to make fully informed choices about their care.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not always involve people in decisions about their care or tell them what had changed as a result.

Systems for regularly gathering people’s views needed further development and consistency. At the time of the inspection, there was no evidence of regular residents’ meetings, which meant people had fewer opportunities to share ideas, raise concerns or influence changes in the home. Minutes from previous meetings were also not readily available, limiting people’s ability to see how their feedback was being used to inform service provision.

A suggestion box was introduced on the second day of our inspection to provide further opportunities for people to share their feedback about the service.

Processes for managing complaints were working more effectively. People told us they felt comfortable raising any concerns with staff if they were unhappy with any aspect of their care. One person said, “[Staff] treat me like 1 of them. If needed I’d go to 1 of the carers, they are all nice people. I’d have no problems raising anything.” A relative told us they had raised a concern with the registered manager and said it had been investigated and addressed promptly. We also saw relatives had sent in compliment cards, highlighting the quality of care provided to their family members.

The provider made sure people could access the care, support and treatment they needed when they needed it and people told us they were treated fairly by staff.

Staff understood the additional support people with protected characteristics might need to access healthcare. Professionals such as GPs, chiropodists and opticians visited the home when required, and people were referred to dietitians or speech and language therapy services when needed. When people had hospital appointments, appropriate transport was arranged to ensure they could attend without difficulty. Some people also used accessible taxis to visit family members, helping to maintain relationships and support their wellbeing.

The home was accessible for people using wheelchairs and specialist nursing chairs. A range of mobility equipment, such as hoists, stand aids and rotundas, was available to support safe movement.

People’s care plans recorded their protected characteristics and the specific support or equipment they needed to ensure equitable access to all areas of the home. People were encouraged to use communal areas, and we saw specialised seating in place to help people who might otherwise remain in bed, to sit out and take part in daily life. One person told us they enjoyed spending time on different floors of the home and used the lift independently to move around.

The environment was light and welcoming, and ongoing improvements helped enhance people’s comfort and accessibility throughout the home.

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Many people living at St Mary’s Nursing Home had complex needs. We saw some people received 1:1 support when required, and staff demonstrated a good understanding of how to reduce distress and respond to people’s needs. In most cases, support was provided promptly.

Staff were aware people required differing levels and types of support depending on their health conditions and medical needs. Care plans described how staff should respond to each person’s individual needs, so people were still given every opportunity to achieve positive experiences and outcomes. For example, 1 person’s plan explained although they had a physical disability and limited communication, they enjoyed sitting in communal areas, so they felt part of life at the home. Another person preferred spending time alone in their room but valued staff stopping by for conversation, and this was reflected in their care plan.

A monthly church service was available to support people’s religious and spiritual needs.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

The provider supported admissions for people who wished to spend the end of their life at St Mary’s rather than remain in hospital. Relatives told us the quality of care their family members received at the end of their life had been very good. One relative said, “When your [family member] is dying, you want the best for them, with no distress. [Staff] were very kind to [family member] and treated them as a china doll. They kept us informed all the time about changes. There was always someone to talk to when we had concerns. Staff read to them. We could not have asked for a nicer ending.” The relative also said, “They are a really, really caring community and showed such kindness. We were so pleased with the care we sent a bouquet of flowers to the manger and a second one to the staff.”

People’s care plans included their wishes and preferences for end‑of‑life care, supported where needed by input from specialists such as hospital Parkinson’s teams. People were encouraged to make choices about where they wished to be cared for at the end of their life and whether they wanted to be admitted to hospital for further treatment in a life‑threatening situation.

ReSPECT forms, [Recommended Summary Plan for Emergency Care and Treatment], were completed to record how people wanted staff to respond in a medical emergency. Staff could access this information on their electronic care devices, ensuring it was immediately available when needed.

When people were approaching the end of their life, relatives were invited to stay at the home if this was their preference. The provider planned further improvements to facilities to better support families at this time. The nominated individual explained that when a person died, they left the home through the front door, with staff lining up to pay their respects. This demonstrated compassion and respect.