This inspection took place on 27 February (unannounced) and 1 March 2018 (announced).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.