St Mary's Court

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

We identified 1 breach of the legal regulations. People’s care was not person-centred and did not always reflect their individual preferences. People and those important to them did not always feel listened to. People’s communication needs were not fully considered when providing information. People’s end of life care wishes were not always documented in sufficient detail. People were supported to access relevant health services and the provider made referrals to healthcare professionals in line with people’s individual support needs.

This service scored 57 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

People did not always receive person-centred care. People's care plans did not reflect how their individual needs and preferences were being considered. For example, people's preferences for the gender of their care staff had not been recorded and there was a lack of information in the 'about me' and 'personal history ' sections of the care plan. People's involvement in reviewing their own care was not always documented. We found some information relating to people's preferences was missing or too generalised to give a clear picture of the person as an individual. For example, under the care plan for ‘meaningful activities’, we found ‘Information not provided’ for one person and ‘They can’t engage in activities’ recorded for another. This did not provide staff with detailed guidance about what the person could do or how to engage with them in a meaningful way.

Staff were able to tell us about people's different health needs and how their care needed to be personalised to support these. However, we found staff were not always able to provide as much information about what people enjoyed doing, what was important to them and how they promoted meaningful, personalised interests and hobbies. We found people had not always been consulted about decisions relating to their care or their home environment. The management team told us they were starting to address these issues by involving people and their relatives more fully in reviewing and updating care plan information to ensure it better reflected what was important to each person.

During our assessment, we observed staff responding appropriately to people's requests and providing support which reflected their wishes.

People received care from a range of relevant health professionals to support their individual needs. People's care plans contained information about who was involved in their care and how and when they should be consulted.

Staff told us they knew how to escalate any changes in people's needs in order to ensure referrals were made to the relevant health professionals promptly. The provider told us communication between services was now improving following an unsettled period of change within the management team. The manager confirmed they were working to make improvements to the communication and information sharing between different services to ensure joined-up, consistent care for people.

Health and social care professionals told us they were working with the service to provide support and ensure people's care was more coordinated with appropriate services accessed promptly when required. Comments included, "There have been numerous staff changes at the home and we are doing our best to support them through these changes" and "They are in regular contact via email and we are doing all we can to support them."

The provider had a process in place for making referrals to and working alongside other services to support people's needs. Relevant information was documented in people's care plans. However, this was not always fully updated to ensure it was an accurate reflection of people's assessed needs. This meant there was a risk people may not always receive consistent support.

We received mixed feedback from people and relatives about how well staff understood people's different communication methods. People's communication needs were noted in their care plans; however, this information lacked detail. People did not always have access to information in different formats. For example, we found a lack of pictorial and easy read information in the service. Menus, activity guides and care plan documentation had not been adapted to suit people's individual communication needs.

Leaders told us they were implementing improvements such as pictorial menus and more detailed communication care plans. Experienced staff we spoke with demonstrated a knowledge of people's communication needs and how to provide information effectively. However, where a number of established staff had left, this had impacted on the staff team's knowledge and understanding of people's communication needs. The provider told us they were now ensuring regular agency workers were deployed and newer staff were supported by more experienced staff.

The provider considered people's communication needs as part of their initial assessment and monitored these through their monthly review process. However, we found this process was not robust as information lacked detail and personalisation. The provider told us they were continuing to review and update people's communication plans at the time of the assessment.

People and their relatives told us they did not always feel listened to or involved, with concerns needing to be raised more than once and requests not always acknowledged or acted upon. However, they told us this was now starting to improve and they had confidence the new manager would listen and respond appropriately. One relative said, "All the things we did complain about have now been sorted for us. We were thinking of moving [person] because it got so bad, but I feel since Christmas thing have been improving."

The provider told us they were aware people, relatives and staff had not felt fully involved in the recent changes in the service and this had led to concerns being raised and a loss of confidence in the openness of the management team. The manager told us they were working to make improvements by ensuring they were present and available to speak with and by implementing more regular meetings and opportunities for honest and open feedback and discussion.

The provider had processes in place for involving people and relatives and responding to concerns; however, the feedback we received indicated these were not working effectively as people and relatives did not always feel listened to. The provider was in the process of making improvements at the time of the assessment and had identified areas where action hadn't been taken and had been open with those involved and made changes.

People were supported to access appropriate care and support services which suited their individual needs. When and how people received support was adjusted where possible to meet their individual preferences.

Staff and leaders understood people’s right to equity in accessing care and support. Staff understood how to make adjustments dependent on people’s individual care needs and the service made referrals to other services in order to meet people's needs.

Health and social care professionals told us they were involved with the service and provided input into people's care and support, giving feedback and recommendations to staff to support their understanding of people's individual needs.

The provider had policies in place to ensure compliance with human rights requirements. This included consideration of the needs of people with different protected characteristics and how to make reasonable adjustments to ensure equity.

People were able to access services appropriate to their support needs. However, we found people’s individual needs were not always fully considered to ensure equity in their experience of care. For example, where people were living with dementia or where people within the service were considerably younger than others, we were not assured the provider had assessed the living environment or their access to meaningful activities to ensure people experienced equally good outcomes.

Staff understood people’s human rights and their right to equality and the provider promoted access to appropriate healthcare to ensure people's physical and mental wellbeing was supported. However, we found the service did not always support people to fully engage with community activities and services which met their individual needs and preferences.

The provider had systems in place to identify changes in people's needs and liaised with other healthcare professionals such as the GP, community nursing and dementia support team to ensure people had appropriate support in place when required.

The provider had received positive feedback from a number of relatives about the sensitive, kind, and caring support given to people receiving end of life care. However, we found people's care plans did not provide meaningful, personalised guidance for staff about what was important to people approaching end of life. This meant there was a risk people may not everything in place to meet their wishes.

Staff told us they had received training in the provision of end of life care and understood the importance of promoting people's dignity and respecting their wishes. The provider acknowledged people's care documentation did not always reflect people's wishes in sufficient detail. The management team told us they were addressing this as part of the larger care plan review taking place at the time of the assessment

The provider considered people's future plans and end of life care wishes as part of their initial assessment and monitored these through their monthly review process. However, we found this process was not robust as information lacked detail and personalisation.