St James's Lodge

St James’s Lodge is a nursing home providing care for adults under and over 65 years living with dementia, sensory impairments, physical disabilities and learning disabilities. At the time of our assessment, St James’s Lodge was not providing support to people with a learning disability. The service is registered to provide accommodation to a maximum of 38 people. At the time of our assessment 26 people were living at the service.

Following our assessment in October 2025, we served 3 warning notices against the provider and registered manager for breaches in regulations relating to dignity and respect, safe care and treatment and good governance. We also identified a breach in relation to the regulation relating to Consent to care and treatment and requested an action plan from the provider.

At this assessment, the provider had met the conditions of the warning notice relating to the dignity and respect regulation, however, the provider remained in breach of the regulations relating to consent to care and treatment, safe care and treatment and good governance.

People’s care plans were not always sufficiently detailed to ensure staff had all the information they required to safely meet their needs, and some contained contradictory information. This meant people were at risk of not receiving the care they required to keep them safe. People did not consistently receive safe care and treatment, risks were not always identified, assessed or managed in a timely or effective way.Medicines were not managed safely, which placed people at risk.

People’s rights under The Mental Capacity Act 2005 were not fully upheld. The absence of effective monitoring and provider level oversight meant mental capacity assessments or best interest decisions were not in place where the provider was undertaking restrictive practices.

Staff did not feel fully supported in their roles and spoke of the service leadership being a significant factor in this. A number of staff had left employment at the service, with exit interviews indicating leadership approach, attitude and style being a factor for their resignation. Staff surveys indicated further concerns around leadership; however, the provider had not acted on this information.

Leadership and governance were not effective. Although there was a registered manager in post, there was limited provider oversight. This had not ensured the service management had performed their roles effectively to meet the requirements of the regulations. Provider level systems to monitor quality and drive improvement were not robust. Although regular provider visits took place, these were not formally recorded, and there were no clear action plans produced by the provider to monitor progress or drive improvement.

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