St Johns House

Updated 17 March 2026

Date of Assessment: 20 to 30 April 2026.

St Johns House is a residential home which supports up to 35 people. At the time of inspection, there were 33 people living there. We found the experience people received at the service was not consistent. While we found most people were very happy with their care citing the pleasant environment, kind staffing and variety of activities, this experience was not shared by everyone. We found 1 person had been subject to an alleged serious safeguarding incident and minimal action had been taken by leaders to safeguard the person, and others, from the risk of continued risk of harm. We also found the incident had not been shared with the Local Authority or notified to CQC without delay. The person involved in this incident had not received any update on what action, if any, the service was taking. One person was subject to unsafe and undignified care when being supported to eat their meal and there was a lack of assurance at the time on how this would be effectively managed to ensure people were safe from continued risk. Following these incidents being shared with the provider, subsequent assurances and actions were put in place after the inspection. However, the local systems were not robust or effectively established to ensure all areas of improvement were identified prior to our inspection visit.

We found people had not always felt heard with a lack of clarity on what actions were being taken in response to all feedback shared, especially in relation to staffing and call bell response times. We found individual experiences where some people felt isolated and unable to join in group activities due to a long term disability and they told us adjustments had not been made. Again, the provider shared assurances and actions following the inspection, but governance systems were not consistent in ensuring everyone felt heard and their feedback acted upon.

We have identified a breach of regulation in relation to governance systems being insufficient to ensure people’s safety, feedback was acted upon and quality assurance systems were established and robust to act on poor care.

Updated 17 March 2026

People’s experiences of living at St Johns House were mixed. Many people told us they felt comfortable living at the service and described it as a friendly and homely place. People spoke positively about relationships with staff and told us they were generally treated with kindness and respect. One person said, “I am very happy here.” Relatives also shared positive views, with 1 telling us, “Generally it is fine and it is safer than living independently.”

People told us staff usually knew them well and understood their preferences and routines. Care was mostly personalised, and people were supported to make everyday choices about their care, activities and meals. Mealtimes were observed to be calm, and people were offered choices and alternatives when required. Activities were available, and many people enjoyed group activities and visiting entertainers. However, not everyone was able to access activities in a way that met their needs. One person told us they felt isolated, particularly where adjustments had not been made to support one‑to‑one or in‑room activities.

Most people said they felt safe and supported by staff, but this was not consistent for everyone. One person shared a serious safeguarding concern that had not been acted on appropriately at the time nor had they received any update on what was going to happen.

People and relatives raised ongoing concerns about call bell response times. Some people told us they waited a long time for support, particularly when needing assistance with personal care. One person said, “Staff are too busy” and another person said, “They need more staff at peak times. There are less staff at weekends and a few weeks ago carers needed to work in the kitchen.” These delays left some people feeling frustrated and unheard.

Overall, while many people experienced kind, compassionate care and positive relationships with staff, inconsistencies in responsiveness, dignity and how concerns were addressed meant not everyone had the same quality of experience at the service.