Lighthouse

Updated 27 July 2018

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014. This was a comprehensive inspection.

This inspection took place on the 11 and 27June 2018. It was unannounced and carried out by one inspector.

The provider returned a Provider Information Return (PIR) when requested. This is a form that asks the provider to give key information about the service, what the service does well and improvements they plan to make. We checked if the information in the PIR was up to date as the PIR was dated 2017, and the deputy manager updated us where necessary. We also reviewed any other information that we hold about the service such as safeguarding information and notifications. Notifications are the events happening in the service that the provider is required to tell us about. We used this information to plan what areas we were going to focus on during our inspection.

Throughout the inspection, we observed staff’s interaction with people and how well people responded. We spoke with six people who use the service, two of their relatives, three health and social care professionals, the registered manager, the two deputy managers and six members of staff.

We reviewed four people’s care and support files and four staff recruitment and support records. We also looked at a sample of the service’s quality assurance systems, training records, medication system, care workers’ rotas and complaints records.

Updated 27 July 2018

Lighthouse is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Lighthouse does not provide nursing care. It is registered for up to 14 people who are living with a learning disability and have complex behavioural needs. At the time of our inspection there were 13 people using the service. The service was rated good at our last inspection in November 2015. At this inspection, we found the service had made continual improvements, therefore we rated it as overall outstanding.

There was a registered manager in post. 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 service worked extremely well in partnership with others to ensure that people received support that met their complex needs. People received good quality healthcare tailored to meet their own individual requirements.

The building was undergoing many improvements; it was safe and was adapted to meet the needs of people using the service. There was good outside space where people could enjoy the well-kept gardens. People had as much choice and control over their lives as possible. The service worked in line with other legislation such as the Mental Capacity Act 2005 (MCA) and had completed mental capacity assessments and Deprivation of Liberties (DoLS) where required to ensure people’s rights and freedoms were respected and protected.

Staff were kind, caring and compassionate. They understood people’s individual circumstances and ensured that people were supported in a way that respected their dignity, privacy and independence. People were actively involved in every aspect of their lives; they made daily decisions about their care and support. Staff supported people emotionally and promoted their sense of well-being and pride.

People received exceptional person-centred care that was extremely responsive to their complex changing needs. The care and support plans ensured that people were encouraged and supported to develop and maintain the skills to lead a full and happy life. People enjoyed many activities both inside and outside of the service. They had good community links, and annual holidays both in England and abroad. There was a good complaints process in place and people felt able to raise any concerns, which were dealt with quickly.

The deputy managers worked together under the supervision of the registered manager to ensure that people received a high-quality service. Staff shared their vision to provide people with person centred care that gave them control, choice and independence and enabled any barriers to this aim to be removed. The quality assurance system and processes were exceptionally effective. The service had recognised where improvements were needed through their many audits, and had learnt from mistakes and taken the necessary steps to make continuous improvements. The registered manager, together with their two deputy managers ensured that all interested parties were kept fully involved and worked extremely well with other professionals to ensure that people received excellent person-centred care.

People were protected from the risk of harm and abuse. Staff were well trained and demonstrated an excellent knowledge of their responsibilities to protect people. There were policies and procedures in place and staff knew how to implement them. Risks were well managed, and people were supported to undertake every-day risks safely to enhance their lives and improve their independence. Staffing levels were extremely good and they enabled people to access the local community on a regular basis. The recruitment process was thorough and offered equal opportunities for staff.

Medicines management was very good. Staff had been trained, and knew people, and their medicine needs very well. The service had very good infection control policies, procedures and practices. The registered manager and the two deputy managers shared information with staff to ensure that lessons were learnt when things went wrong.

People received a thorough assessment prior to moving into the service and this informed their care and support plans. There was a good induction process and staff were well trained, supported and supervised. Where people required support with meals they were encouraged to learn cookery skills to enhance their independence.

Further information is available in the detailed findings below.