29 October 2022
We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.
The inspection was carried out by one inspector.
Service and service type
This service provides care and support to people living in ‘supported living’ settings, so that they can live as independently as possible. People’s care and housing are provided under separate contractual agreements. CQC does not regulate premises used for supported living; this inspection looked at people’s personal care and support.
This service is required to have a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.
At the time of our inspection there was a registered manager in post.
Notice of inspection
We gave the service short notice of the inspection. This is because the service is small in relation to personal care provision and people are often out. We wanted to be sure people would be at home to speak with us and that the registered manager would be in the office to support the inspection.
What we did before the inspection
We reviewed information we had received about the service since it registered with us.
We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.
During the inspection
We spoke with five people who used the service and four members of staff, including the registered manager, deputy manager and two care support staff. We reviewed a range of records. This included two people's care records and two medication records. We looked at four staff files in relation to recruitment. A variety of records relating to the management of the service, including policies and procedures were reviewed.
After the inspection
After our visit we sought feedback from relatives, staff and health and social care professionals to obtain their views of the service provided to people. We received feedback from three relatives, two further staff via email and one health and social care professional. We continued to seek clarification from the provider to
validate evidence found.
29 October 2022
We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.
About the service
No 1 Hermosa Lodge provides care and support to people living in their own homes, so that they can live as independently as possible. Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided. There were currently ten people receiving a service.
People’s experience of using this service and what we found
The service was able to demonstrate how they were meeting the underpinning principles of Right Support, Right care, Right culture.
Right Support: Model of care and setting maximises people's choice, control and Independence.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
People lived safely and free from unwarranted restrictions because the service assessed, monitored and managed safety well. There were comprehensive risk assessments in place covering all aspects of the service and support provided.
People were kept safe from avoidable harm because staff knew them well and understood how to protect them from abuse. The service worked well with other agencies to do so. People's interaction with staff was relaxed and positive, which indicated they felt safe. Staff supported them to recognise when they might be vulnerable to abuse or exploitation and understand how to protect themselves.
People were supported to manage their medicines and could self-administer if they could do so safely. Infection control measures were in place.
Care files were personalised to reflect people's personal preferences, needs and goals. Their views and suggestions were taken into account to improve the service. People were supported to maintain a healthy diet. Health and social care professionals were regularly involved in people's care to ensure they received the care and treatment which was right for them.
There were safe and effective staff recruitment and selection processes in place.
Right Care: Care is person-centred and promotes people’s dignity, privacy and human rights
Staff relationships with people were caring and supportive. Staff provided care that was kind and compassionate and clearly focussed on ensuring people led the best life they could. Relatives commented, “It was absolutely magnificent how staff supported [person’s name] (during the pandemic) ... [Family member] took them out last week with their carer, and said they were a different person.”
Right Culture: The ethos, values, attitudes and behaviours of leaders and care staff ensure people using services lead confident, inclusive and empowered lives.
People's equality, diversity and human rights were respected. The service's vision and values centred around the people they supported. The organisation's statement of purpose documented a philosophy of putting the individual at the centre of everything they do, allowing them to flourish within their community; and become and remain as independent as possible. Our inspection found that the organisation's philosophy was embedded in No 1 Hermosa Lodge. For example, people were encouraged and supported to lead rich and meaningful lives, try new activities, develop new skills and have greater control over their lives.
People were supported by staff who had received relevant and good quality training in evidence-based practice. This included training in the wide range of strengths and issues people with a learning disability and or autistic people may have, mental health needs, communication tools and positive behaviour support.
The provider worked hard to instil a culture of care in which staff truly valued and promoted people's individuality, protected their rights and enabled them to develop and flourish.
Staff felt respected, supported and valued by the provider and management team, which supported a positive and improvement driven culture. They told us, “I feel I'm able to raise concerns that I have to staff and managers with confidence, as they're lovely members of the team. Managers make you feel comfortable and feel like you’re able to bring any concerns you may have up.”
A number of methods were used to assess the quality and safety of the service people received. The service made continuous improvements in response to their findings.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection and update
This service was registered with us on 10 May 2019 and this is the first rated inspection.
Why we inspected
We undertook this inspection to assess that the service is applying the principles of right support right care right culture.
We will continue to monitor information we receive about the service, which will help inform when we next inspect.