St James's Lodge

On this page

• Overview
• Person-centred Care
• Care provision, Integration and continuity
• Providing Information
• Listening to and involving people
• Equity in access
• Equity in experiences and outcomes
• Planning for the future

Responsive – this means we looked for evidence that the provider met people’s needs.

At our last assessment we rated this key question Requires Improvement. At this assessment the rating has remained Requires Improvement.

This meant people’s needs were not always met.

This service scored 61 (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 make sure people were at the centre of their care and treatment choices and they did not always work in partnership with people, to decide how to respond to any relevant changes in people’s needs.

Risk assessments had been reviewed. However, care plans had not always been updated in line with risk assessments, or information was not recorded in the correct place or was at times conflicting between documents. This meant they did not always fully identify the care people needed. An action plan for improving care plans had been put in place by the compliance manager, however no action had been taken by the registered manager to update and improve the care plans.

There were some shortfalls in how the provider understood the diverse health and care needs of people and their local communities, so care was not always joined-up, flexible or supportive of choice and continuity.

Care was not always well coordinated or delivered consistently. There were examples of integration with external professionals, such as regular GP visits. Healthcare professionals we spoke with did not raise any concerns around their working relationship with the service or outcomes for people. However, some care records contained contradictory or incomplete information, particularly around repositioning, diet modification, pressure ulcer risk management and mobility, which could present risk and affect continuity of care.

The provider did not always supply appropriate, accurate and up-to-date information in formats that were tailored to individual needs.

No significant concerns were raised by people or their relatives in relation to communication, however people fed back to us they were unaware they had a care plan or records relating to their care or treatment. Whilst they did not communicate to us this had any impact on them; we advised the provider of the information we had received from people for action to be taken as needed.

The complaints procedure and accessible information standard information was clearly displayed on the wall the service foyer. Since 2016, all organisations that provide publicly funded adult social care are legally required to follow the Accessible Information Standard. The Accessible Information Standard tells organisations what they have to do to help ensure people with a disability or sensory loss, and in some circumstances, their careers, get information in a way they can understand it. It also says people should get the support they need in relation to communication.

The provider did not always make it easy for people to share feedback and ideas, or raise complaints about their care, treatment and support. Staff did not always involve people in decisions about their care or tell them what had changed as a result.

A meeting for people and their relatives had been completed since our last assessment. However, it is not evident the registered manager was present at this meeting to ensure they were visible and understand the needs and preferences of people they supported. The meeting minutes show that 1 person highlighted, ‘Half of the staff don’t listen and in particular she mentioned that it was the senior management.’ This does not evident a proactive approach to listening to and acting on feedback. The meeting minutes highlight people had made suggestions and presented ideas, such as new activities, but this had not been acted upon.

The provider made sure that people could access the care, support and treatment they needed when they needed it.

We saw records of involvement from healthcare professionals such as GP’s within people’s care records. The feedback we received from people, relatives and healthcare professionals provided assurance people were supported to access specialist healthcare and support in a timely way. One person we spoke with said, “I only have to mention that I’m feeling unwell and they contact the doctor’s surgery.” Another person said, “The staff picked up when I was unwell and got the doctor in for me.”

Staff and leaders actively listened to information about people who are most likely to experience inequality in experience or outcomes and tailored their care, support and treatment in response to this.

Care staff had completed diversity and equality training and training in relation to professional boundaries. Additional training was provided in relation to person-centred care which had been completed by some staff. This training supported staff to be aware of the importance of ensuring people were not subject to inequality or discrimination. Staff, people and their relatives did not identify any concerns to us about discrimination or inequity in care and treatment outcomes.

People were supported to plan for important life changes, so they could have enough time to make informed decisions about their future, including at the end of their life.

At the time of our assessment there was nobody receiving end of life care. Staff supported people to remain at the service at the end of their lives if this was their choice. The service could work closely with healthcare professionals and had a strong relationship with the local hospice so that where required, they appropriately planned for and met people’s needs at the end of their lives.