We carried out a review of the data available to us about Hill Lodge on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about Hill Lodge, you can give feedback on this service.
We found the following examples of good practice.
On arrival we were asked to sanitise our hands, sign in, have our temperature taken and asked if we had symptoms of, or been in contact with anyone who had symptoms of, COVID-19. We were also asked to show our vaccination record and evidence of a lateral flow device test taken that day. Face masks were available at the door should they be needed, and visitors were only admitted to the service after following these procedures.
The provider had supported people to understand the importance of handwashing using visual aids. For example, using soap, water and pepper to demonstrate how effective handwashing is in removing germs. They also ensured people had regular opportunities and prompts to wash their hands.
The provider had strengthened their links with their local community and local healthcare professionals. They told us how supportive these links had been to the home. For example, neighbours had checked if people needed anything during the pandemic and offered to pick anything they needed up from the local shops. Local police officers would stop by to say hello to people and for one person they visited to sing happy birthday to them from outside during the pandemic. Their visits have since developed into people being offered talks by the police on topics such as hate crime.
Hill Lodge is registered to accommodate up to 18 people with a learning disability or physical disability. People were accommodated in five adapted buildings. At the time of this inspection there were 16 people living at the home. The care service has been developed and designed in line with the values that underpin the Registering the Right Support CQC policy and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
We carried out an unannounced comprehensive inspection of this service on 27 February 2018. After that inspection we received information about incidents which raised concerns in relation to people’s continuing safety at the service. As a result we undertook a focused inspection to look into those concerns. This report only covers our findings in relation to the key areas of safe and well-led. You can read the report from our last comprehensive inspection, by selecting the “all reports” link for Hill Lodge on our website at www.cqc.org.uk.
At our last inspection we rated the service good. At this inspection we found the evidence continued to support the rating of good. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection.
Why the service is rated good
The service continued to meet all the fundamental standards relevant to people’s care and support being safe and well led. Processes were in place to protect people from risks, including risks to their safety and wellbeing, in a way that enabled them to take part in activities according to their preferences. People were supported by sufficient numbers of suitable staff to maintain their safety. There were appropriate processes and procedures in place to make sure medicines were handled safely and to make sure people were protected from risks associated with the spread of infection.
There was a positive, empowering culture in the home. The provider engaged with people, their representatives, and staff to deliver a management system whose purpose was to drive forward and improve the quality of the service. Where appropriate the provider worked in partnership with other agencies and organisations.
Further information is in the detailed findings below.
Hill Lodge is a ‘care home’. People in care homes receive accommodation and personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.
Hill Lodge accommodates 18 people with a learning disability and / or physical disability in five adapted buildings. There were 16 people living at the home when we inspected. The care service has been developed and designed in line with the values that underpin the Registering the Right Support CQC policy and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.
There was a registered manager in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
At the last inspection, in 2016 the service was rated Good. At this inspection we found the service remained Good.
In 2017 there was a change in registered manager and several safeguarding concerns were made. This inspection was carried out after the safeguardings had been closed and an action plan was in place to improve the service.
People were safeguarded from avoidable harm. Staff adhered to safeguarding adults procedures and reported any concerns to their manager and the local authority.
People told us they felt safe. Risks were assessed to minimise them and staff were aware of people's individual risks. People received their medicines safely and they had their nutritional and health needs met. Emergency systems had been put in place to keep people, visitors and staff safe.
Staffing levels ensured that people's care and support needs were safely met and safe recruitment processes were in place. Medicines were managed safely.
Systems were in place to ensure the premises were kept clean and hygienic so that people were protected by the prevention and control of infection. There were arrangements in place for the service to make sure that action was taken and lessons learned when things went wrong, to improve safety across the service
People’s needs and choices were assessed and their care provided in line with up to date guidance and best practice. They received care from staff that had received training and support to carry out their roles. People were assisted to prepare their own meals and make healthy choices to maintain their health and well-being. Staff supported people to attend appointments with healthcare professionals. The service worked with other organisations to ensure that people received coordinated and person-centred care and support.
People’s diverse needs were met by the adaptation, design and decoration of premises and they were involved in decisions about their environment. Staff demonstrated their understanding of the Mental Capacity Act, 2005 (MCA) and they gained people's consent before providing personal care.
Staff were caring and compassionate and people were relaxed in staff company. People were treated with dignity and respect and staff ensured their privacy was maintained. People were encouraged to make decisions about how their care was provided and staff had a good understanding of people's needs and preferences.
People were listened to, their views were acknowledged and acted upon and care and support was delivered in the way that people chose and preferred. Care plans were person centred and reflected how people’s needs were to be met. Records showed that people and their relatives were involved in the assessment process and the on-going reviews of their care. They were supported to take part in activities which they wanted to do, within the service and the local community. There was a complaints procedure in place to enable people to raise complaints about the service.
The service had an open culture which encouraged communication and learning. People, relatives and staff were encouraged to provide feedback about the service and it was used to ensure continuous improvement. Staff were motivated to perform their roles and worked to empower people to be as independent as possible.
The registered manager adhered to the requirements of their Care Quality Commission registration, including submitting notifications about key events that occurred. A programme of audits and checks were in place to monitor the quality of the service and improvements were made where required. The service had changed, according to staff for the better and now these changes needed to be embedded into every day practice.
Further information is in the detailed findings below.
Hill Lodge provides long term accommodation to 18 adults who have a learning disability, autism and/or a physical disability. At the time of our visit there were 16 people living at Hill Lodge. Hill Lodge is divided up into four buildings, the main house and three bungalows. They are all run as one location and have the same manager. All the buildings have single bedrooms with ensuite facilities, a dining area and lounge and garden.
A registered manager was in place. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are “registered persons”. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.
The registered manager was experienced in the care of people with a learning disability.
Although people could not communicate fully verbally we observed they felt safe and were relaxed. Relatives and visitors we spoke with told us that they felt people were safe.
Medicines were safely managed and administered by staff.
Servicing and maintenance checks were carried out by staff which protected people who used the service from injuries caused by equipment. Where there had been accidents these had been recorded and where necessary investigated.
Staff were trained to safeguard people and knew what to do if they witnessed abuse. They were also working within the principles of the Mental Capacity Act 2005 which meant that they were making sure people had support in place if they needed to be assisted with decision making.
People’s health and wellbeing was maintained because staff accessed advice and support from healthcare professionals.
The staff were caring and supportive of people. The majority treated them with respect.
People took part in a variety of activities supported by staff.
There was an effective quality assurance system in place which meant that the service was continually improving.