CQC report explained · a residential care home
What the CQC found at St Mary's Home
Rated Good: inspectors found the home performing well and meeting their expectations.
- Safe?
- Good
- Risk assessments and staff guidance had been updated. Inspectors found suitable staffing, safe recruitment, safe medicines management and appropriate safeguarding arrangements.
- Effective?
- Good
- This question was not inspected during this visit, so no new rating or detailed findings were given in this report.
- Caring?
- Good
- This question was not inspected during this visit. The summary nevertheless said people received kind and compassionate care from staff who knew them well.
- Responsive?
- Good
- This question was not inspected during this visit, so no new rating or detailed findings were given in this report.
- Well-led?
- Good
- Management audits, safety checks and record keeping had improved. Important incidents were being reported to the CQC and feedback was used to plan improvements.
What inspectors found, April 2023
St Mary's Home is rated Good; inspectors found safer risk management, kind care and improved oversight.
This was an unannounced follow-up inspection on 16 and 23 February 2023. One inspector spoke with seven people and three staff, received written feedback from four healthcare professionals, and checked care, medicines, recruitment and management records.
The home was rated Good for Safe and Well-led. Inspectors found that risk assessments and care guidance had been updated, staff knew how to manage identified risks, medicines records were complete, and staffing and recruitment were suitable.
People were described as receiving kind and respectful care. The home supported people's choices and activities, and worked with healthcare professionals. Management systems had improved, including record keeping and reporting important incidents to the CQC.
The previous rating was Requires Improvement, published on 25 July 2022. The provider had been in breach of Regulation 17 at that inspection, but inspectors found enough improvement had been made and the home was no longer in breach.
Improved risk management
Risk assessments were updated and staff had clearer instructions for managing people's individual risks, including risks when eating.
“At this inspection, we found that people were now being protected against the risk of harm from identified risks.” from the report
Safe staffing and recruitment
Inspectors found enough staff to meet people's needs. Recruitment checks included employment history, references and DBS checks.
“People continued to receive care and support from suitable numbers of staff to keep them safe.” from the report
Kind and respectful care
Staff used language people understood, knew people well and supported their choices, interests and activities.
“People received kind and compassionate care from staff who used positive, respectful language which people understood and responded well to.” from the report
Better management oversight
The home introduced extra quality and safety checks. Records and reporting to the CQC had improved since the previous inspection.
“The service carried out regular audits to drive improvements. Additional quality and safety checks had been introduced following our last inspection.” from the report
Good partnership working
The home worked with learning disability teams, local authorities and healthcare teams to support people's needs and continuity of care.
“The provider worked alongside other agencies to meet people's presenting needs.” from the report
Inspectors raised no specific concerns in this report.
- 01How are risk assessments reviewed now, especially for people who need careful monitoring when eating?
- 02What extra checks are now used to make sure important incidents are reported to the CQC on time?
- 03How do you check that medicines records remain complete and show medicines were given at the right times?
- 04How will you support my relative's individual wishes, choices and social or leisure interests?
- 05What were the ratings and findings for Effective, Caring and Responsive at the previous inspection?
This was a focused follow-up inspection of Safe and Well-led; the other key-question ratings were carried forward from the previous inspection. This explanation was written from the published report of 13 April 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, July 2022
St Mary's Home rated Requires Improvement; inspectors found kind, responsive care but weaknesses in risk records, staff training and management oversight.
Inspectors made an unannounced visit on 13 June 2022. They spoke with 11 people and six staff, observed interactions, and checked care, medicines, staff and management records.
People were generally treated kindly and respectfully. Staff supported people's choices, communication, activities, healthcare and dietary needs. Medicines were managed safely, and staffing levels were suitable.
However, some risk assessments did not give staff clear instructions. Staff had not received training in autism or learning disabilities. Management checks did not always find record-keeping problems, and important incidents were not always reported to the CQC.
The overall rating changed from Good to Requires Improvement. Effective, Caring and Responsive were rated Good. Safe and Well-led were rated Requires Improvement.
Kind and respectful care
Inspectors saw staff using patient, positive and respectful approaches. People were supported to express themselves and make choices.
“People received kind and compassionate care from staff who used positive, respectful language which people understood and responded well to.” from the report
Safe medicines processes
Medicines records were completed correctly and showed that people received medicines when needed. The provider had acted on advice from a medicines consultancy.
“People's MAR were correctly completed and clearly showed that people received their medicines at the times that they needed them.” from the report
Suitable staffing
Inspectors found enough staff to meet people's needs. Recruitment checks included employment history, references and DBS checks.
“People received care and support from suitable numbers of staff to keep them safe.” from the report
Choice and activities
People were supported with their preferred activities, community work, holidays and social interests. People could choose alternative meals if they wished.
“People were supported to undertake activities that met their preferences.” from the report
Access to healthcare
People were supported to see healthcare professionals, and guidance from those professionals was included in care delivery.
“People had access to healthcare services to monitor and maintain their health and wellbeing.” from the report
Risk guidance was not always clear
seriousSome care records did not explain clearly enough how staff should respond to behaviours that could cause anxiety or distress. Staff were not always able to describe the correct response.
“People were not always protected against the risk of harm from identified risks.” from the report
Training gap
needs fixingStaff had not received training in autism or learning disabilities, despite supporting people with these needs. The manager arranged training after the inspection.
“At the time of the inspection, we identified and staff confirmed they had not received training in autism or learning disabilities.” from the report
Weak management checks
seriousAudits did not always identify inaccurate or outdated records. Some incidents involving police attendance and physical altercations were reported to the local authority but not to the CQC.
“The registered manager did not always send statutory notifications to the CQC in line with legislation.” from the report
- 01What changes have you made to risk assessments so staff have clear instructions for responding to anxiety or distress?
- 02Have all staff now completed autism and learning disability training, including agency staff?
- 03How do you check that care records are kept accurate and updated promptly?
- 04How do you make sure incidents that must be reported are notified to the CQC?
- 05What progress has been made in response to the Regulation 17 action plan?
This was an unannounced inspection covering all five CQC question areas, including infection prevention and control; inspectors reviewed three care records, three medicines records and three staff files. This explanation was written from the published report of 22 July 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 Mary's Home
4 rated inspections over 7 years: the service has held its Good rating throughout.
- April 2023Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- July 2022Requires improvementdown from GoodSafe: Requires improvementWell-led: Requires improvement
- February 2018Goodstayed GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- December 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- February 2014
Report published without a new overall rating.
- February 2013
Report published without a new overall rating.
- January 2012
Report published without a new overall rating.
- January 2011
Registered with the Care Quality Commission on 28 January 2011.
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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At least 100 live-in carers within about an hour of Wandsworth
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Most charge £980 to £1,260 a week. 77 can care for a couple. 11 years' experience on average.
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