St James's Lodge

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• Overview
• Kindness, compassion and dignity
• Treating people as individuals
• Independence, choice and control
• Responding to people’s immediate needs
• Workforce wellbeing and enablement

Caring- this means we looked for evidence that the provider involved people and treated them with compassion, kindness, dignity and respect.

At our last assessment we rated this key question good. At this assessment the rating has changed to requires improvement.

This meant people did not always feel well-supported, cared for or treated with dignity and respect.

The provider and registered manager were in breach of the legal regulation relating to dignity and respect.

This service scored 50 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

The provider did not always treat people with kindness, empathy and compassion, or respect their privacy and dignity.

We observed institutionalised practices which compromised dignity, such as shared use of prescribed net underwear. There was a basket of net underwear prescribed for a person used by others as a communal source of underwear.

Although individual staff were kind and caring, we observed several practises where people were not respected, and their dignity was disregarded.

Although most relatives described staff as compassionate, the shortfalls identified at this assessment impacted people’s experience of care.

This contributed to a breach of regulation in relation to dignity and respect.

The provider did not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences.

People told us they were not involved in their care planning. One person said:“I don’t get asked what I want – they just do it.” This meant people’s wishes and preferences were not fully assessed, documented or known to staff, which could affect their safety and wellbeing.

A relative told us, “Mum is fully in control of her care, she is very verbal with what support she wants, her likes and dislikes. Staff listen to this”. However, people less able to verbalise their wishes were at risk of receiving care which was not in line with their preferred routines or preferences.

The provider did not always listen to and understand people’s needs, views and wishes.

People’s independence and choices were not consistently promoted, we saw a bath rota, limiting personal choice. A person confirmed, “I cannot choose when I have a bath.”

Staff feedback indicated routines were prioritised over individual preferences, “Residents are made to get out of bed even if they have said they want to stay in bed.”

This contributed to a breach in regulation in relation to dignity and respect.

The provider did not always listen to and understand people’s needs, views and wishes. Staff did not always respond to people’s needs in the moment.

Staff told us, “We are rushing and do not have time to spend with people.” Another said, “Call bells are ringing and we cannot get there straightaway.” These delays affected people’s comfort and wellbeing.

A relative told us, “I’ve had to prompt them to get a GP in, usually chest infection related”.

We observed the early morning routine when staff were busy supporting people to get out of bed. Call bells were constantly ringing during this period. One person was shouting for help and ringing their call bell. They had to wait around 10 minutes before staff responded. However, for most of the site visit we observed emergency bells being answered promptly.

People told us if they needed anything, they would use their call bell. Comments included, “If I need their help I use the bell, they always come, sometimes it takes longer for them to arrive to help me”, and “I use my bell to get staff attention or I shout”.

The provider did not always care about and promote the well-being of their staff. They did not always support or enable staff to deliver person-centred care.

Staff did not feel consistently supported or valued. One staff member said, “It’s awful, we are understaffed, management are awful the way they treat people.” Another told us, “The atmosphere is very low, we feel we do not have enough staff to meet the needs of the residents.” Staff reported high workloads, long shifts, and inadequate staffing levels, which affected both their wellbeing and the quality of care provided.

We received mixed feedback from staff in relation to enjoying working at St James’s Lodge. Comments included, “I enjoy it here and I like to get to know the residents and staff”, and “It is nice. It can be stressful at times, but that is working in healthcare”.

The registered manager told us, they tried to support staff choice when managing staffing rotas, and they had recently had some changes with staffing to improve the morale.