St Mary's Court

On this page

• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Staff were kind and caring; however, people’s dignity and privacy were not always promoted. People’s individual preferences for support were not always considered and care plans lacked detail about what was important to people. Staff were not always available to meet people’s immediate needs; however, this was improving. Staff were knowledgeable about how to promote people’s independence and respect their choices. Workforce wellbeing was improving and the provider was implementing new staff initiatives to improve staff morale.

This service scored 65 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People and their relatives raised concerns about the turnover of staff and impact of people being supported by unfamiliar staff; however, we received generally positive feedback about the caring attitude of staff. Comments included, "Staff have been very kind to [person]", "The majority are excellent" and "[Person] values their key worker who takes time to come into their room and chat. Staff also try hard to coax [person] to join in activities, and to go to the dining room to eat with others." We received mixed feedback about how well people's choices and dignity were respected. Comments included, "Staff have put [person] in bed in a t-shirt, which [person] sees as demeaning, they like a nightie", "[Person's] clothes go missing sometimes, I come in and they're wearing someone else's clothing" and "I would like to see [person] recognised and treated as the lady she always was, for example she could have a handbag with her and more attention to her clothing and hair, I think that applies to other residents too

Staff we spoke with were able to describe how they promoted people's privacy and dignity. Comments included, "We respect privacy by knocking before entering their rooms and using curtains or screens during personal care activities" and "I knock before entering resident’s rooms, use appropriate language, respect clothing preferences and provide privacy during personal care by shutting the doors." The provider told us they discussed how to promote choice and respect people's privacy and dignity with staff regularly during their meetings and used the feedback gathered from people and relatives to address any concerns promptly, sharing lessons learnt and areas for improvement. The provider told us they regularly welcomed other professionals into the service and were developing more consistent, positive communication between the staff team and visiting professionals to support people's needs.

We received generally positive feedback from health and social care professionals about the kind and caring attitude of staff; however, some professionals told us the loss of more experienced staff and the number of changes in staffing had impacted on people’s consistency of care.

We observed staff supporting people with kindness and compassion. However, we found people's dignity and privacy were not always respected. For example, we observed people who were not fully clothed, waiting for personal care support with their doors open. This meant anybody walking past was able to see them. We also found personal, named items left in communal bathrooms where anybody could see them. We gave this feedback to the provider, who responded promptly confirming they would raise these concerns with staff and reinforce the importance of promoting dignity and respect in people's personal care support.

We received mixed feedback from people and relatives about how well staff respected people's individual preferences for support. Comments included, "Staff need to realise that [person] needs to be the one to make choices. [Person] didn't used to rise until about 10, but the night staff get them up really early which [person] isn't used to" and "They can’t always meet [person's] wish to be up before 9AM, it’s much later if [person] is on the end of the list for their floor." Despite these concerns, we received generally positive feedback about how staff responded to people's needs. Comments included, "They come to [person] quickly to support them, staff are there when needed" and "I’ve seen instances of nice care, for example most staff talk gently into [person's] ear, and they give excellent support and explanation in using the hoist. [Person] was moved from the dementia to nursing unit and appreciates that some dementia unit staff continue to visit them."

Staff were able to describe the importance of respecting people as individuals. One member of staff said, "It means tailoring my approach to meet the individual needs, preferences, and goals of each person under my care. Listening attentively to their concerns and respecting their choices." The provider told us they were aware people's care documentation required greater personalisation and they were in the process of making improvements to ensure more detailed information was included. The manager said this would provide staff with more guidance and enable them to tailor people's care to their individual preferences more effectively.

During our assessment, we observed staff providing appropriate personalised support to ensure people's needs were met. Staff were respectful of people's preferences.

The provider had considered people's personal histories, cultural needs and protected characteristics as part of their assessment and care planning. However, this information was not sufficiently detailed. Staff did not always have enough information about people's preferences and interests. The provider's processes for monitoring whether people's care was being delivered in line with their individual preferences were not robust. People and those important to them had not always been given the opportunity to regularly feedback.

We received mixed feedback from relatives about how well staff promoted people's independence and encouraged them to engage in activities which may help to maintain their wellbeing. Comments included, "[Person] could do with more motivation and needs to be encouraged", "Before being placed at St Mary’s, [person] had begun sitting up in bed, and getting out of bed to sit, but the home hasn’t seemed interested. From the start they decided [person] must be in bed all the time" and "[Person] doesn’t like communal activities and I haven’t seen any one-to-one activity provision. So there is a lot of staring into space for [person]."

Staff we spoke with were able to give examples of how they promoted people's independence and choice. Comments included, "Promoting independence entails things like involving them or engaging them in indoors or outdoor activities and providing equipment to assist them with their mobility such as walking frames" and "I encourage them to perform daily activities and make decisions about their care activities and routines." At the time of the assessment, the management team were implementing more robust systems to ensure people and relatives were involved in decisions about their care including seeking more regular feedback and completing more in-depth reviews. They told us this would provide clearer guidance for staff to support people's decision making and promote their independence.

During our assessment, we observed staff providing appropriate support which enabled people to maintain their independence where possible.

The provider's processes for ensuring people maintained independence, choice and control were not robust. People's care plans were not always accurate and lacked detail about their individual support needs and preferences and how to promote their independence and choice.

People and relatives told us staff had not always been available to provide support with immediate needs such as personal care, catheter care and support with eating and drinking. However, they told us this was now starting to improve. One relative said, "I’ve had concerns about the call buzzer not being left in reach. When [person] has used the call bell, sometimes they have been wet, because it wasn’t answered quickly enough. Sometimes a member of staff will switch off a buzzer and walk away." Another relative told us, "Things have definitely improved. There's been a massive change here, in the last couple of weeks. They've encouraged [person] to drink, l didn't think they were drinking enough. Drinks were untouched, now they have a proper chart for them."

Staff understood the importance of responding to people's immediate needs to minimise the risk of distress and told us recent improvements in staffing numbers and consistency were enabling them to spend more time with people to ensure their needs were met promptly. One member of staff told us, "There had been a massive exodus of permanent staff due to a number of different reasons but the company has been able to curb that by outsourcing the services of agencies to help with short staffing and I feel we do have sufficient time to support our residents." Another member of staff said, "I don't feel rushed during my shift and I always do my work according to needs of the residents." The management team told us they reviewed call bell response times to monitor how promptly people's needs were addressed and raised any concerns with staff during their daily meetings.

During our assessment, we observed some people waiting for staff to support them with personal care. We also saw people waiting for support with meals and left with meals which were uneaten or finished. However, generally we found people's immediate needs were responded to and calls bells were not left unanswered for prolonged periods.

We received mixed feedback about workforce wellbeing; however, staff told us they were now beginning to feel more supported following an unsettled period within the service where there had been a number of management and staffing changes. One member of staff said, "Staff morale had been on a decline toward the end of 2023, but our management has been trying their level best to encourage and assure everyone and put everything in place especially through extensive recruitment of more permanent staff to encourage good coherent teamwork and spirit." The management team confirmed they were aware of previous issues and staff concerns and were working hard to make improvements by ensuring regular, open communication and implementing more frequent group activities, supervisions, and feedback opportunities to promote wellbeing.

The provider had processes in place to gather feedback from staff and used this to identify concerns with morale or culture. The management team were operating an 'open door' policy and were accessible to staff when needed. The provider had introduced structured wellbeing activities, open to all staff and these were having a positive impact on morale. Staff supervisions had not been taking place regularly and the new manager was in the process of implementing a system to ensure these were now taking place on schedule to provide more 1:1 support to staff.