CQC report explained · a residential care home
What the CQC found at St Martins
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, July 2023
Overall Requires Improvement; inspectors found serious safety and management problems, with the well-led rating Inadequate.
This was an unannounced focused inspection on 7 and 8 June 2023. Inspectors also visited again on 3 July to check the provider's action plan. They spoke with people, a relative, staff and a professional, and reviewed care, medicine, recruitment and management records.
Inspectors found risks from poor cleanliness, infection control, unsafe water temperatures, damaged equipment and trip hazards. Risk checks were not followed up reliably. Staffing arrangements and checks of staff skills were also not always enough to make sure people received safe and timely care.
There were some positive findings. Medicines were managed safely, people were supported with food and drink, staff recruitment checks were completed, and people were protected from abuse. Staff also supported people with healthcare and mental capacity decisions.
The overall rating fell from Good at the previous inspection to Requires Improvement. Safe and Effective were rated Requires Improvement, while Well-led was rated Inadequate. The inspection found breaches of regulations about safe care and treatment and governance.
Medicines
Inspectors found that medicines were given safely, stored correctly and recorded accurately. Reviews and risk assessments were completed.
“People received their medicines safely and in line with their wishes.” from the report
Food and drink
People were offered choices and staff knew their dietary needs, likes and dislikes. A relative said their loved one had gained weight.
“People were supported to eat and drink enough to maintain a balanced diet.” from the report
Protection from abuse
People told inspectors they felt safe. Staff knew about abuse risks and how to report concerns.
“People were protected from the risk of abuse and neglect.” from the report
Support and care planning
Care assessments were detailed and regularly reviewed. Staff had guidance about people's risks, changing needs and when to seek professional help.
“Comprehensive assessments were completed and regularly reviewed.” from the report
Infection control and cleanliness
seriousPoor cleaning and unsafe disposal of protective equipment placed people at risk of infection. Inspectors found dirt, debris and staining in bedrooms and shared areas.
“People were at risk of infection due to poor infection control practices.” from the report
Building and equipment safety
seriousSome safety problems were known but had not been fixed. These included water above 60 degrees, a broken tap, sharp tile edging and flooring that could cause trips.
“People were at risk from health and safety concerns which had not been identified or acted upon in a timely manner.” from the report
Staffing and competence
seriousThere was not always enough competent staff to support people safely and promptly. Checks of staff skills after training had not been completed.
“There was not always enough competent staff on duty to ensure people were supported safely.” from the report
Weak management checks
seriousAudits and governance systems did not identify or address important risks. Policies were out of date and staff responsibilities were unclear.
“Governance in the service was not reliable and effective.” from the report
Environment and dementia support
needs fixingThe home did not fully support independence for people living with dementia. It lacked dementia-friendly signs and had damaged furnishings and decoration.
“People living at the home, some of whom had dementia were not fully supported to remain as independent as possible.” from the report
- 01What has been done to keep water temperatures safe, and how are water safety checks now recorded and followed up?
- 02How often are bedrooms, communal areas and equipment cleaned, and who checks that cleaning is completed properly?
- 03What staffing levels are planned for each shift, including when the registered manager is away?
- 04How are staff now assessed as competent in moving and handling people safely?
- 05What action has been taken to update policies, improve audits and make sure reported building and safety problems are fixed promptly?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected in this report, and the previous ratings were used for the overall rating. This explanation was written from the published report of 14 July 2023 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, February 2022
Inspected but not rated; inspectors found good COVID-19 precautions but some cleaning and social distancing shortfalls.
This was an unannounced targeted inspection on 20 January 2022. It focused on infection prevention and control during a COVID-19 outbreak, and on whether staffing pressures affected care.
The home had safe visiting arrangements, enough personal protective equipment, COVID-19 testing and COVID-related staff training. People were tested before admission, and visiting was supported during the outbreak, including for people receiving end-of-life care.
Inspectors were only somewhat assured about social distancing, the cleanliness of some areas and the completion of cleaning records. Some areas were cluttered and dusty, and some equipment needed deep cleaning. The home addressed these shortfalls immediately after the inspection.
The service was inspected but not rated. This means the report does not provide an overall quality rating or a rated judgement for safe care.
Safe visiting
The home used a booking system and supported visitors to follow infection control measures. Visiting was also accommodated for people receiving end-of-life care during the outbreak.
“The provider had a booking system for visitors in place to ensure the visits were facilitated safely and in line with the government's guidelines.” from the report
PPE and testing
The home had supplies of PPE, and inspectors saw staff using it correctly. People and staff could access COVID-19 testing.
“The provider ensured sufficient supplies of personal protective equipment (PPE) were made available to staff and visitors. We observed staff wearing correct PPE.” from the report
Safe admissions
People were tested for COVID-19 before the home agreed to admit them.
“People were admitted to the service safely. The provider ensured people had been tested for COVID-19 before the service agreed to admit them.” from the report
Social distancing
needs fixingPeople in the lounge were sitting very close together. Inspectors encouraged the home to find more creative ways to support social distancing, especially for people living with dementia.
“People who were present in the lounge were sat very close to each other. The provider told us implementing social distancing and isolation was a significant challenge due to caring for people who live with dementia.” from the report
Cleaning and records
needs fixingSome areas were cluttered and dusty, some equipment was dirty and the cleaning schedule was not always completed. The home addressed these shortfalls immediately after the inspection.
“Some areas of the home were cluttered and dusty. Some equipment was dirty and required deep cleaning. The cleaning schedule was not consistently completed.” from the report
- 01What changes have been made to keep people safely apart in shared areas, particularly for people living with dementia?
- 02How do you now check that all areas and equipment are clean and that cleaning schedules are completed?
- 03What evidence can you show that the cleaning and social distancing issues found at this inspection were fully resolved?
- 04How will visiting work during a future COVID-19 outbreak, including visits for people receiving end-of-life care?
- 05How do you manage COVID-19 testing and PPE for staff, visitors and people admitted to the home?
This was an unannounced targeted inspection of infection prevention and control and COVID-19-related staffing pressures; it was not a full inspection and the service was not rated. This explanation was written from the published report of 23 February 2022 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
Every inspection of St Martins
3 rated inspections over 4 years: the service has held its Requires improvement rating throughout.
- July 2023Requires improvementcurrent ratingSafe: Requires improvementEffective: Requires improvementCaring: GoodResponsive: GoodWell-led: Inadequate
- February 2022Inspected but not ratedSafe: Inspected but not rated
- April 2020Goodup from Requires improvementSafe: GoodEffective: GoodWell-led: Good
- March 2019Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- September 2017
Registered with the Care Quality Commission on 4 September 2017.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
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