CQC report explained · a nursing home
What the CQC found at St Mary's Nursing Home
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, May 2022
Rated Good; inspectors found safe, effective and well-led care, with some further work on guidance for medicines given when needed.
This was an unannounced focused inspection on 21 April 2022. Inspectors spoke with people, relatives and staff, observed care, and checked care, medicines, staffing, recruitment and management records.
The home was rated Good for Safe, Effective and Well-led. Inspectors found enough staff, suitable recruitment checks, trained staff, safe infection control and systems for reviewing accidents and incidents.
People's health, nutrition and choices were supported. The home had improved its mealtime support and oral health records since earlier inspections. Inspectors also found a caring and open culture, based on feedback from relatives and staff.
The overall rating improved from Requires Improvement to Good. This was a focused inspection, so Caring and Responsive were not assessed in this report and their previous ratings were carried forward.
Enough staff
Inspectors found enough staff to provide care and spend time talking with people. Staffing was increased at important times when needed.
“There was enough staff to care for people.” from the report
Health support
People's health was monitored and they were referred to health professionals when needed. Hospital information sheets gave important details about each person's usual health and support needs.
“People's health was monitored and where a need was identified, they were referred to other healthcare professionals.” from the report
Improved mealtimes
Inspectors found that mealtimes had improved since the previous inspection. People who needed help were given time to eat at a relaxed and unhurried pace.
“At this inspection we saw improvement had been made to mealtimes.” from the report
Good management
The provider and manager had improved care records and quality checks. Relatives and staff said managers listened to concerns and focused on people's needs.
“The provider had made sufficient improvements to determine they were no longer a breach of Regulation 17 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014: Good Governance.” from the report
Medicine guidance
minorGuidance for staff was not detailed enough for some medicines given when needed. No harm was found, and the manager took immediate steps to address this after inspectors raised it.
“There was no evidence of harm to people, however, guidance could have been more detailed to support staff to administer some "as required" medication consistently.” from the report
- 01What extra checks now confirm that guidance for medicines given when needed is complete and followed consistently?
- 02How will you maintain safe staffing levels if there are shortages or sickness, and how much agency nursing staff are currently used?
- 03How are people's food and fluid intake charts reviewed when someone is at risk of losing weight?
- 04How are relatives involved in reviewing care plans and decisions made in a person's best interests?
- 05What were the previous ratings for Caring and Responsive, which were not assessed in this inspection?
This was a focused inspection of Safe, Effective and Well-led only; Caring and Responsive were not inspected and their previous ratings were carried forward. This explanation was written from the published report of 19 May 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.
What inspectors found, June 2019
St Mary's Nursing Home was rated Requires Improvement overall; inspectors found safe, caring and responsive care, but records and some daily care arrangements were not reliable.
Inspectors made an unannounced visit on 20 May 2019. They spoke with people, relatives, staff, the registered manager and the provider. They also reviewed care, medicine, food and drink, repositioning and management records.
The home was rated Good for Safe, Caring and Responsive. People were protected from identified risks, treated with dignity, and supported with personalised care and activities. Staff were trained and people could access healthcare when needed.
The home was rated Requires Improvement for Effective and Well-led. Oral care was not always assessed, lunchtime organisation meant two people did not receive meals as intended, and important care records were incomplete. The overall rating fell from Good at the previous inspection, published in November 2016.
Risk management
Staff understood people's risks and took practical steps to reduce harm, including managing choking, falls and sore skin risks.
“People's needs had been assessed to identify any risks to their health and wellbeing, and staff knew people well and how to safely meet their care needs.” from the report
Kind and respectful care
Inspectors saw staff treat people as individuals, use respectful communication and support their dignity and independence.
“Positive and caring interactions took place between people and staff at the home, where people were respected as individuals.” from the report
Activities and social contact
The home provided one-to-one activities suited to people's interests, helping reduce social isolation.
“Activities took place to reduce risks of social isolation.” from the report
Staff training
Staff described their training as detailed and practical. New staff received an induction and worked alongside experienced staff until assessed as competent.
“Training is good, they go through things in detail and come onto the floor as well and show you practically.” from the report
Incomplete care records
seriousRecords for injections, catheter flushes, repositioning and food intake had gaps. This could make it harder for staff to know what care was needed next.
“Staff did not consistently complete important records related to people's care and support.” from the report
Mealtime organisation
needs fixingThe lunchtime arrangements were busy and poorly organised. Inspectors found that two people did not receive their meals in the intended order or as intended.
“However, staff's lack of organisation during lunchtime, across both floors, posed risks to people not having their meal as intended.” from the report
Oral care planning
needs fixingPeople's oral care needs were not always assessed or recorded in care plans. The manager said oral health care plans would be introduced.
“However, people's oral care needs were not always assessed, and care plans did not inform staff of the support people required to maintain oral health.” from the report
Quality checks
seriousManagement checks did not always find errors in care records or equipment settings. This included an airflow mattress pump that was set at the wrong level for a person's recorded weight.
“The registered manager oversight of some checks and audits they had delegated to staff was not always effective in identifying where improvements were needed.” from the report
- 01What changes have been made to ensure care records, repositioning charts and food and drink records are completed every time?
- 02How are oral care needs assessed and recorded for each person, including people who receive nutrition by other means?
- 03What was the outcome of the review of night-time staffing on the first floor?
- 04How are lunchtime meals now organised so that each person receives the correct meal and support?
- 05How can people safely access the garden, and what risk assessments support the current arrangements?
This was an unannounced planned inspection of the whole care service, covering all five rating areas, the premises and the care provided. This explanation was written from the published report of 11 June 2019 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 Nursing Home
2 rated inspections over 3 years: the service has improved, from Requires improvement to Good.
- May 2022Goodcurrent ratingup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: GoodWell-led: Good
- June 2019Requires improvementSafe: GoodEffective: Requires improvementWell-led: Requires improvement
- March 2019
Registered with the Care Quality Commission on 13 March 2019.
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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Most charge £950 to £1,260 a week. 77 can care for a couple. 11 years' experience on average.
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