St James's Lodge

On this page

• 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 Requires Improvement. At this assessment the rating has remained Requires Improvement.

This meant people did not always feel well-supported, cared for or treated with 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 always treated people with kindness, empathy and compassion and respected their privacy and dignity. Staff treated colleagues from other organisations with kindness and respect.

Following our last assessment the provider had taken steps to remove institutionalised practices within the service, such as ‘assigned’ shower and bath days and the shared use of prescribed net underwear. People told us they could now receive a bath or shower when they wished.

Comments we received from people and their relatives about the staff employed at the service was very positive. One person told us, “There is no problem with the staff. I’ve never felt that I am being a burden. They are very kind and very caring.” A relative said, “The staff seem very attentive.”

We observed positive and caring interactions between staff and people. People’s privacy was respected, and we saw staff knocking on people’s doors before entering.Staff spoke kindly to people, and staff demonstrated an understanding of how to treat people with compassion.

The provider did not always treat people as individuals or make sure people’s care, support and treatment met people’s needs and preferences. They did not always take account of people’s strengths, abilities, aspirations, culture and unique backgrounds and protected characteristics.

Care and support, particularly at busy periods such as personal care in the mornings, was task-focused rather than person-centred. Both staff and people were consistent in their feedback about this. One person said, “They are too busy to chat. They are always hurrying.” Another person commented, “There is never any time to chat. They are in and out. You don’t get much of a chance to talk. You can have a good laugh with them if they do come in.”

Whilst staff were limited in the time and interaction they could have with people, it was clear they knew people well and aimed to achieve the best possible outcomes they could. One staff member commented, “It’s not that staff don't want to do it [provide high quality care], but we're under pressure to get everyone’s personal care done in an unrealistic timeframe.”

The provider did not always promote people’s independence, so people did not always know their rights and have choice and control over their own care, treatment and wellbeing.

People were not always supported to maintain their independence, choice and control. Staffing levels, deployment and the lack of leadership during key periods of the day had an impact on people’s choices. One staff member said, “Staff shortages inevitably put additional pressure on those remaining and can impact the quality of care residents receive.”

Activities were limited, and there was no structured support for people who were nursed or cared for in bed, and we observed some people spent a lot of time alone. One person told us, “I am bored. I watch TV, read and do crosswords. I do get asked if I want to go outside. They occasionally do activities like bingo.” Another person said,” I get bored. I read books. There is bingo and chair golf but I’m happy to stay in my room. Not many people go to the lounge, they stay in their rooms. The staff will take you outside if you ask.”

There were no planned group activities to support people to build relationships and reduce social isolation. The provider was currently recruiting an activities member of staff and the registered manager confirmed there was no structured activity schedule. This meant opportunities for people to engage in meaningful activity and maintain independence were limited.

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 or act to minimise any discomfort, concern or distress.

Due to the current staffing levels and lack of oversight of the provider and registered manager, people’s needs could not always be met in a timely way. Staff we spoke with all spoke of their frustration in not being able to meet people’s needs timely due to insufficient staff. The call bells within the service were frequent and people we spoke with commented on this.

When we asked staff if improvements had been made since our last assessment, one commented, “No, things have not improved. The main issues are understaffing, management, and residents not being able to do what they want to do most of the time as well.” Another staff member told us, “There are bells ringing and I cannot split myself into 3 so they do wait a while sometimes.”

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

Staff told us they were currently very dissatisfied and unhappy in their roles. Most staff we spoke with attributed this to the current management and leadership within the service. Staff felt staffing levels were impacting the quality care delivery they could provide to people. Staff told us they did not feel consistently supported or valued.We received feedback how staff could not always have their breaks as needed. A high number of staff told us the registered manager was not approachable, with a number of staff commenting on how they felt poorly spoken to by the registered manager which impacted on their morale and well-being.

Staff also felt the current management approach had contributed to a very high staff turnover. We reviewed a sample of exit interviews completed by staff who had recently left, who stated the current management and staffing levels were significant factors for them leaving.

This meant systems were not in place to fully support staff, which could impact on the care provided to people.