St Martha's

We carried out this inspection from 10 February to 6 March 2026. This was the first rated inspection for this service. St Martha’s is a residential care home providing accommodation for up to 41 people with complex and enduring mental health needs. Accommodation is provided over 2 nursing units, Tulip and Daisy. At the time of the inspection there were 30 people living in the service.

The provider had a good learning culture and people could raise concerns. Managers investigated incidents thoroughly. People were protected from harm and kept safe. Staff understood and managed risks. Managers made sure staff received training and regular support to maintain good-quality care. People received their medicines as prescribed. There were sufficient staff to meet people’s needs, and the provider was taking action to strengthen recruitment records.

People were treated with kindness and compassion. Staff protected their privacy and dignity. They treated them as individuals and supported their preferences. People had choice in their care and were encouraged to maintain relationships with family and friends. Staff responded to people in a timely way. The provider supported staff wellbeing.

People knew how to give feedback and were confident the provider took it seriously and acted on their views. People received fair and equal care and treatment and engaged in planning their care.

Leaders and staff had a shared vision and culture based on listening, learning and trust. Leaders were visible, knowledgeable, and supportive, helping staff develop in their roles. Staff felt supported to give feedback and were treated equally, free from bullying or harassment. Staff understood their roles and responsibilities. Audits were effective in monitoring safety and risk in the service.

St Martha’s is a hospital for older people with mental health problems and is run by Oldercare (Haslemere) Limited. St Martha’s also operates a nursing unit for older people. The service can admit patients with a functional or organic mental health disorder. Organic mental illness is usually caused by disease affecting the brain such as dementia. Functional mental illness is predominantly a psychological cause. It may include conditions such as depression, schizophrenia, mood disorders or anxiety. The service accepts patients with an organic illness aged 45 and above, and 55 and above if they have a functional illness. The service supports patients detained under the Mental Health Act (MHA) 1983, and patients subject to the Deprivation of Liberty Safeguards (DoLS).

St Martha’s is registered to provided accommodation for persons who require nursing or personal care, treatment of disease, disorder or injury, assessment or medical treatment for persons detained under the Mental Health Act 1983 and diagnostic and screening procedures.

We undertook this assessment in December 2024 in response to identified risk and timescale since previous inspections. We inspected Rose ward, the female-only ward, Shamrock, the male-only ward and Iris, the mixed-sex ward.

During this assessment we piloted an approach to identifying and improving service culture using extended observations on Rose and Shamrock wards.

We last assessed this service in January 2020 and rated the service good. We rated effective, caring, responsive and well-led as good and safe as requires improvement.

At the last assessment we found one breach of a legal requirement relating to safeguarding service users from abuse and improper treatment (Regulation 13). Improvements were found at this assessment and the service was no longer in breach in this area.

At this assessment the service was in breach of the legal requirement in relation to safe care and treatment. Wards were not always a safe environment to provide care to this patient group due to several unmitigated ligature risks. A ligature risk is anything that can be used to attach a cord, rope or other material for the purpose of hanging or strangulation that could pose a risk to patient safety.

We have asked the provider for an action plan in response to the concerns found at this assessment.

St Martha’s is a residential care home providing accommodation for people who require nursing or personal care for up to 41 people. Accommodation is provided over 2 nursing units, Tulip and Daisy and a “swing” unit, Iris. The service supports people with mental ill-health and people living with dementia. At the time of the inspection the service was providing support to 35 people.

The service is located on the upper floors of a building also housing wards for people requiring support with mental ill-health. The units contained ensuite bedrooms and communal dining and living rooms, with kitchens that were locked. Daisy Unit specialises in providing care to people who live with dementia. The “swing” unit, Iris, had a number of rooms laid out as studio flats which could be occupied by those requiring accommodation for nursing or personal care, or who are supported to live more independently from the ward setting. Primarily the service supports people who are moving from the ward setting as part of their recovery but also supports those moving from their own home or other services in the community, who need additional support.

This was the first inspection of this aspect of the service since the service commenced. On this inspection we reviewed a limited number of quality statements, which meant the nursing home aspect of the service has not yet been rated.

We found the service was assessing and managing risks to people and ensuring they were safe. People living at the service had a variety of support needs, and staff were skilled in providing pro-active, person-centred care. People’s transition into the service, and support from other professionals involved in their care was well managed. There was a clear pathway for people to move to the service, and to seek further care and support within the ward environment, if needed.

Although some environmental adaptations were made at Daisy Unit, the environment was not fully adapted to meet the needs of those with dementia, or to promote independence. Not all people’s rooms were adapted to their preferences and some appeared clinical,. Some communal areas of the environment in the Tulip unit were over-stimulating with loud sounds, such as banging doors, alarms, TV and radios as well as strong aromatherapy smells, and areas which were extremely warm. This can cause increased agitation, particularly for those who are unable to express discomfort.

People were supported to make decisions about their care and support. We observed staff were responsive to people and gave them choices. Staff were patient with people and supported them to meet their needs.

Medicines were stored, administered and managed safely, and there were clear plans in place for the use of medicines to support people’s anxiety and agitation. There was guidance around use of covert medicines. Although records did not reflect that decisions were made for each medicine individually, the manager agreed to take action with the GP to resolve this.

There were robust governance processes and oversight of care being provided, including audits and supervision of staff. Staff fed back positively about the manager of the service and felt able to speak up.