About the service
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.