Lighthouse Lodge

Updated 25 January 2022

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection was planned to check whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008.

We received information of concern about [infection prevention and control measures/visiting arrangements/staffing at this service. This was a targeted inspection looking at the infection prevention and control measures the provider has in place. We also asked the provider about any staffing pressures the service was experiencing and whether this was having an impact on the service.

This inspection took place on 18 January 2022 and was announced. We gave the service four hours’ notice of the inspection.

Updated 25 January 2022

About the service

Lighthouse Lodge is a care home that provides accommodation for up to 80 people who need help with their personal care. At the time of the inspection 44 people lived in the home. Some of the people living in the home, lived with dementia.

People's experience of using this service

Medication management was unsafe. Some people’s medicines were not given safely in accordance with the manufacturer’s instructions. Staff lacked clear guidance on how to administer people’s ‘as and when’ required medicines. Records in relation to the administration of thickening medication (prescribed to prevent people from choking) were not properly maintained and some of the medicines within the home could not be accounted for.

Some of the risks to people’s health and well-being were not monitored properly. Information on some people’s emotional well-being was not accurately recorded to enable staff to offer appropriate support. People’s bowel health was not accurately recorded to enable staff to assess and monitor for further complications. This placed people at risk of inappropriate and unsafe care.

The systems in place to monitor the quality and safety of the service were not always used effectively to identify and mitigate risks. This meant the service was not always well-led.

Staff recruitment was managed well and the number of staff on duty was sufficient to meet people’s needs. Staff spoken with were knowledgeable about the day to day support people needed. They knew their personalities and preferences and spoke with genuine warmth about the people they cared for. Feedback from people and their relatives was positive.

The home was safe, clean and well maintained. Infection control arrangements were in place to prevent and mitigate the risk of COVID-19. Appropriate protective and personal equipment (PPE) was in place and care staff used this appropriately. Catering staff were reminded during the inspection, that the use of a facemask, was required at all times when in the kitchen.

The manager knew the service well. During our inspection, they were open and transparent. The culture of the service was positive and the atmosphere relaxed and homely. It was clear the manager was passionate about the service and committed to continuous improvement. However, the lack of reliable and effective quality assurance meant that service delivery risks had not been picked up and addressed to ensure people always received good care.

Rating at last inspection and update:

The last rating for this service was requires improvement (published 24 October 2020). The service remains rated requires improvement.

Why we inspected:

The inspection was prompted in part due to concerns received about medicines, people’s care and the management of the home. As a result, we undertook a focused inspection to review the key questions of safe and well-led only.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

We reviewed the information we held about the service. No areas of concern were identified in the other key questions. We therefore did not inspect them. Ratings from previous comprehensive inspections for those key questions were used in calculating the overall rating at this inspection.

The overall rating for the service has not changed and remains requires improvement. This is based on the findings at this inspection.

We have found evidence that the provider needs to make improvements. Please see the Safe and Well Led sections of this full report. You can see what action we have asked the provider to take at the end of this full report.

Enforcement

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 enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

We have identified breaches in relation to Regulation 12 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in respect of medication and risk management and Regulation 17 of The Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in respect of good governance.

Please see the action we have told the provider to take at the end of this report.

Follow up:

We will continue to monitor information we receive about the service until we return to visit as per our reinspection programme. If we receive any concerning information we may inspect sooner.