St Mary's Care Home

Updated 6 December 2022

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by two inspectors and an Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

St Mary’s is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement dependent on their registration with us. St Mary’s is a care home with nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was not a registered manager in post.

Notice of inspection

This inspection was unannounced.

What we did before inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority, professionals who work with the service and Healthwatch. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We spoke with 7 people who used the service and 9 relatives. We observed the support people received. We spoke with 11 including the manager, area manager, deputy manager, nurses, senior staff, care staff, catering staff and the nominated individual. The nominated individual is responsible for supervising the management of the service on behalf of the provider.

We reviewed a range of records. This included 7 people’s care records and multiple medicine records. We looked at 3 staff files in relation to recruitment. We also viewed a variety of records relating to the management of the service, including audits, policies and procedures.

Updated 6 December 2022

About the service

St Mary’s is a care home providing personal and nursing care for up to 54 people. The service provides support to older people, some of whom may have physical and nursing needs. At the time of our inspection there were 44 people using the service. The care home is an adapted building across two floors.

People’s experience of using this service and what we found

The provider’s governance system had not always been followed and actions were not always reviewed to make sure risks to people's health and safety had been fully resolved. There had been a number of changes to management which made it difficult to progress improvements. People had little opportunity for activities or social engagements.

People and relatives were positive about the caring nature of regular staff and had good relationships with them. There was a friendly culture in the home.

The provider tried to make sure there were enough staff to support people but there had been a lot of staff changes and the provider had to use temporary or agency staff too. Staff said there was not much time to spend with people but tried to make sure they were safe.

The premises had not been redecorated in some time and several areas were worn, dark or cluttered. The state of some bathrooms made them difficult to keep clean and some were odorous.

People said the meals were good and they were offered drinks and snacks at other times.

People were encouraged to retain their independence where possible, and their individual lifestyle preferences were respected.

People were supported to have maximum choice and control of their lives and staff assisted them in the least restrictive way possible and in their best interests; the policies and systems in the service upheld this practice.

People, relatives and staff said the new manager was open and approachable. Overall, relatives said people were well-cared for at the home. Relatives said there was a lot of issues to resolve at the home but they were hopeful the new management arrangements would address them.

Following our visits to the service, we asked the provider to send us an improvement plan detailing what actions they would take in relation to the issues identified during our inspection.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection and update

The last rating for this service was requires improvement (published 21 January 2020). The provider completed an action plan after the last inspection to show what they would do and by when to improve.

At this inspection we found the provider remained in breach of regulations.

Why we inspected

This inspection was prompted in part due to concerns received about the management of the service. A decision was made for us to inspect and examine those risks.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

You can see what action we have asked the provider to take at the end of this full report.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for St Mary’s on our website at www.cqc.org.uk.

Enforcement and Recommendations

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service and will take further action if needed.

We have identified breaches in relation to person-centred activities and the governance of the service. We have made recommendations about the timeliness of staff support at mealtimes and refurbishment planning.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.