Archived: Lighthouse Homecare

Updated 20 September 2016

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 was 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 inspection took place on 18 and 19 May 2016. To ensure we met the provider and staff at the service’s main office, we gave short notice of our inspection. The inspection was undertaken by one inspector and a specialist advisor. The specialist advisor had professional experience of mental health and substance misuse services. We checked the information we held about the service and the provider. We reviewed notifications that had been sent by the provider as required by the Care Quality Commission (CQC).

The registered manager had not received a Provider Information Return (PIR) at the time of our visit. The PIR is a form that asks the provider to give some key information about the service, what the service does well and what improvements they plan to make. We gathered this information during the inspection. Before our inspection we looked at records that were sent to us by the manager or the local authority to inform us of significant changes and events. We reviewed our previous inspection reports.

During our inspection we spoke with five people. We also spoke with the provider, the deputy manager (who had been in post for one month) and three members of staff. We looked at eight care plans. We looked at three staff recruitment files and records relating to the management of the service, including quality audits.

Updated 20 September 2016

This inspection took place on 18 and 19 May 2016. To ensure we met the provider and staff at the service’s main office, we gave short notice of our inspection.

This location is registered to provide personal care to people in their own homes. The service provided personal care support to ten people in a supported living service. The premises consisted of individual rooms which people could lock and shared communal areas.

We are currently reviewing details of the service provision at the premises to ensure that the provider is registered for the correct regulated activity.

People who used the service were younger and older adults with either physical or mental health needs or learning disabilities and people with alcohol and substance misuse needs.

The service did not have a registered manager. 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 did not have a registered manager in place to ensure the effective operational management of the service. The provider had not ensured effective oversight of the service in the absence of a registered manager.

Staff had not received the relevant training or understood what processes they needed to follow to keep people safe from possible harm. Staff had not received training to meet people’s individual care and treatment needs. Staff had not received training in the principles of the MCA (2005). Staff had not received regular supervision to address their training and development needs to ensure people received effective care.

Fire safety measures were not sufficiently robust to ensure people would be safely evacuated in the event of a fire. Health and safety assessments had not been completed to ensure the environment was safe for people.

There was an insufficient staffing level to meet people’s assessed needs. The provider had not completed safe recruitment checks to ensure staff were suitable to care for people.

People had not consistently had access to appropriate health professionals to effectively meet their health needs. People’s care and treatment was not routinely reviewed with the involvement of relevant health care professionals to ensure their health, safety and welfare.

Staff had not reviewed people’s care plans and risk assessments regularly with their involvement. Staff followed care plans and provided care which did not reflect people’s most current needs and preferences.

The provider had not encouraged people or explored different ways of giving people information about how to make a complaint. A complaints process was not in place to ensure service improvements were made.

The provider had not considered accessible ways to inform people about services available to them, to include advocacy. We have made a recommendation about this.

People’s care plans were not personalised in all cases to enable staff to meet people’s individual preferences. We have made a recommendation about this.

The provider had not notified us of significant events at the service. The provider had not demonstrated they understood their regulatory obligations to share important information with us to keep people safe.

The provider had not routinely consulted people or staff to obtain their feedback to influence how the service was developed.

A robust quality assurance system was not in place to effectively identify all service shortfalls and to ensure service improvements were made.

The service supported people to have meals that were in sufficient quantity, well balanced and met people’s needs and choices.

People told us staff treated them with kindness, compassion and respect. People’s privacy and dignity was respected by staff. Staff promoted people’s independence and encouraged them to be as independent as possible. People were supported to take part in activities based on their needs and wishes.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we told the provider to take at the back of the full version of the report.

The overall rating for this provider is ‘Inadequate’, and the service is therefore in special measures.

Services in special measures will be kept under review and, if we have not taken immediate action to propose to cancel the provider’s registration of the service, will be inspected again within six months.

The expectation is that providers found to have been providing inadequate care should have made significant improvements within this timeframe.

If not enough improvement is made within this timeframe so that there is still a rating of inadequate for any key question or overall, we will take action in line with our enforcement procedures to begin the process of preventing the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration within six months if they do not improve. This service will continue to be kept under review and, if needed, could be escalated to urgent enforcement action. Where necessary, another inspection will be conducted within a further six months, and if there is not enough improvement so there is still a rating of inadequate for any key question or overall, we will take action to prevent the provider from operating this service. This will lead to cancelling their registration or to varying the terms of their registration.

For adult social care services the maximum time for being in special measures will usually be no more than 12 months. If the service has demonstrated improvements when we inspect it and it is no longer rated as inadequate for any of the five key questions it will no longer be in special measures.