St Marks Court

People received safe, effective and person-centred care. Staff understood people’s individual needs and risks, and care plans were generally detailed and personalised. Staff respected people’s choices and preferences. Staff worked effectively with health and social care professionals and referred people for specialist support when their needs changed.

People and relatives were mostly positive about the care provided. Staff treated people with kindness, dignity and respect. Staff supported people to maintain relationships, follow their interests and access their communities. Staff adapted their approach to people’s communication needs and supported people to make choices about their daily lives.

The service had improved since our previous assessment. Leadership was more stable and visible, and the environment was cleaner and better presented. Leaders reviewed staffing arrangements against people’s assessed needs and staff rotas, and actively managed short-notice gaps. We found staffing hours exceeded the provider’s calculated requirements.

We found no evidence that staffing levels regularly prevented people from receiving the care and support they needed. However, leaders needed to continue monitoring how staff were deployed, the mix of staff skills and continuity of care where several people required support at the same time.

Leaders had established local, regional and provider-level systems to monitor the quality and safety of care. These systems identified many of the issues found during our assessment and set out actions for improvement. However, the provider did not always demonstrate that improvements were effective and sustained. Medicines management required improvement. Some records about people’s care, their ability to make decisions and the support they would need in an emergency were inaccurate, inconsistent or incomplete. Activity provision and recording also became less consistent during a vacancy, although people continued to have opportunities for meaningful engagement.

Overall, the service had made clear improvements and people generally received personalised and compassionate care. The main areas for further improvement related to medicines management, record accuracy and ensuring actions identified through governance systems were implemented effectively and improvements sustained.