We carried out a review of the data available to us about No. 1 Hermosa 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 No. 1 Hermosa Lodge, you can give feedback on this service.
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.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
No. 1 Hermosa Lodge is a supported living service providing personal care to people with learning disabilities who live in their own homes in the Dawlish and Teignbridge areas. A supported living scheme is one where people live in their own home and receive care and support in order to promote their independence. At the time of our inspection the service provided support to 26 people living in their own homes. However, only five people required support to meet their personal care needs at the time of this inspection. Therefore, we only looked at the care and support received by those people.
No 1. Hermosa Lodge provides other services which help people to live independently, such as assistance with shopping and enabling people to undertake activities in the community.
Services for people with learning disabilities and/or autism are supported. The service has been designed and developed taking into account best practice guidance and the principles and values underpinning Registering the Right Support. The focus in this section is on the environmental factors relating to the service. People are supported to live in shared houses or in their own flats or houses in the community.
People’s experience of using this service and what we found
We carried out this targeted inspection due to concerns we had received in recent months. This inspection covered only the areas relating to the concerns we received. These related to quality assurance, safeguarding and whistle blowing, staff levels, skills and knowledge, medicines, care planning, complaints and concerns, and communication with families. We decided to inspect and examine those risks.
We found the provider had already made a number of improvements. They had plans in place to make further improvements to address all the concerns raised. Please see the Safe, Effective and Well-led sections of this full report for further details.
The provider had taken actions to improve people’s safety and protect them from abuse. These had included changes to the management structure of the service, with new appointments such as a deputy manager and area manager. They had also improved their quality monitoring systems to ensure improvements were being made in all areas of the service. People and staff had seen positive changes and improvements and we heard how these had resulted in a safer and better service.
Risk assessments and support plans were in the process of being reviewed thoroughly and updated.
The management team and staff had improved the communication with relatives. They contacted relatives on a weekly basis to keep them updated and involved in the service. A relative told us, “I am still involved daily and have fantastic communication with my daughter and the key workers. A social worker told us, “The contact I have had with staff has been positive and professional and they are supportive of the person concerned.”
People told us they were happy, liked where they lived, and liked the staff. They said they felt safe and knew who to speak with if they felt worried or concerned.
There were sufficient staff employed to meet people’s needs safely. Staff were flexible and able to provide support when people wanted, for example to accompany them on an outing or activity. Staff were well trained and well-supported. Staff were positive about their jobs and told us about recent improvements. Comments included, “Everything that’s happening now is very positive”,
“People are absolutely safe. They have a brilliant life. Eat well, bath and shower every day. Brilliant flats. Can’t fault the team”, “I feel valued” and “The managers have always been welcoming and accommodating and are never too busy to respond to people or staff.”
Improvements had been made to the way medicines were recorded and monitored. The provider had realised the recording system had been too complicated leading to recording errors. They were in the process of improving the recording systems. They had implemented further training for staff in this topic and carried out monitoring and competency checks.
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.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
This service was previously included in the registration of Eldra Court, which is also run by Phoenix Learning and Care Limited. In 2019 the provider applied to register No.1 Hermosa Lodge separately. Registration was approved in 2019 and the service would normally have a comprehensive inspection within the first year following registration. However, due to Covid-19 restrictions we have not yet carried out the first comprehensive inspection, and the service has not yet been rated. We plan to carry out a comprehensive inspection of the service when visiting restrictions are lifted. This inspection did not cover all key areas and targeted only the areas relating to the concerns we had received. Therefore, we were unable to give the service a rating following this inspection.
Why we inspected
CQC have introduced targeted inspections to follow up on Warning Notices or to check specific concerns. They do not look at an entire key question, only the part of the key question we are specifically concerned about. Targeted inspections do not change the rating from the previous inspection. This is because they do not assess all areas of a key question.
We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what action was necessary and proportionate to keep people safe as a result of this inspection.
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any further concerning information we may inspect sooner.