House of Light

House of light is a care home registered to provide accommodation and personal care for up to six people who have learning disabilities. At the time of our inspection six people were using the service.

People’s experience of using this service and what we found

Right Support

People and relatives shared positive feedback about the care provided and the leadership of the service, one person told us “The staff are very nice and they listen. I’m safe.”People had a choice about their living environment and were able and encouraged to personalise their rooms. During the inspection, we observed staff communicating with people in ways that met their needs. Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcomes.

Right care

Staff understood and responded to people’s individual needs. Care planning documentation demonstrated service user involvement and were person centred. Activities were individualised to the person. People using the service told us they felt listen to and involved in the service. Staff had a good understanding of their responsibilities to make sure people were safe. People we spoke with told us they felt safe. The service ensured people could take part in person centred activities for example, sky diving and dancing.

Right culture

Staff promoted an open culture and was encouraged by management to express how they feel and work transparently. The registered manager was receptive to feedback and we saw evidence of ongoing improvement for the benefit of people who use the service. Staff supported people in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Why we inspected

We undertook this inspection to assess that the service is applying the principles of Right support right care right culture.

The inspection was prompted in part due to concerns found during an infection prevention and control assurance inspection. A decision was made for us to inspect and examine those risks.

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.

Enforcement and Recommendations

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 and will take further action if needed.

We have identified breaches in relation to safe care and treatment, infection control and good governance at this inspection.

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 changed from good to requires improvement. This is based on the findings at this inspection.

You can read the report from our last comprehensive inspection, by selecting the 'all reports' link for House of light on our website at www.cqc.org.uk.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.

House of Light is registered to provide accommodation and personal care for up to six people who have learning disabilities. The care service has been developed and designed in line with the values that underpin the Registering the Right Support 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.

This inspection took place on 11 and 16 July 2018. The inspection was unannounced on the first day. This meant the staff and provider did not know we would be visiting. The second day was announced.

The service had a registered manager who was present during this inspection. 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 our last inspection in October 2015 we rated the service as good. At this inspection we found the service has remained good overall and improved to outstanding in the responsive domain.

People living in the home, relatives and staff from community services told us staff had an exceptional understanding of people’s preferences related to every aspect of their life and that care was delivered in an outstanding, person-centred way. We found staff were committed to ensuring people led fulfilled lives.

People were encouraged to engage in activities that gave them enjoyment and enhanced their quality of life. People were asked about their past and we found an example of staff supporting a person to go on holiday to a country which was part of their heritage.

Staff had strong relationships with people and knew them very well as staff had worked in the home for many years. Keyworker's roles were put in place and staff were matched with people’s personalities. Relatives and healthcare professionals also expressed their views and felt the care was outstanding.

People were respected and their diverse needs met. There was a focus from staff to keep people as independent as possible and to encourage people to make choices about their care. People were involved in training, staff recruitment, running of the home, leading their reviews of care and chairing house meetings which empowered people living in the home and ensuring people were listened to.

They service used technology innovatively to engage with people in meaningful ways using videos on applications to reduce people’s anxieties which had been effective.

People accessed a wide variety of community services which were embedded into their daily lives. Some people chose to work and others attended day centres where they took part in activities. People choose their own activities and holidays which supported them to feel independent and to live full lives.

People were mainly independent with their diets although staff ensured everyone received sufficient food and fluids. Annual learning disability health checks were completed and other health appointments had been recorded which meant people’s wellbeing was being closely monitored.

The provider had not received any formal complaints but informal issues raised by people living in the home had been managed effectively and used personalised methods, asking people to speak with the directors of the home to ensure they felt their concerns were taken seriously and listened to.

People living in the home were kept safe and staff had a good understanding of how to protect people from possible harm or abuse. Risk assessments were carried out and regularly reviewed so people could live their lives in the least restrictive way possible and remain independent.

Accidents and incidents were managed and actions taken had been effective. Health and safety checks were carried out to ensure the premises remained safe for people living there.

The provider followed the Mental Capacity Act 2005 (MCA) guidance with capacity assessments available if required. Staff also understood MCA guidance and people could provide consent in a variety of ways including through pictorial communication cards and sign language. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive was possible; the policies and systems in the service supported this practice.

There were enough staff deployed to meet people's needs and staff recruitment procedures were robust. Staff told us they felt supported with regular supervisions and annual appraisals taking place to develop their skills and knowledge. Training was made mandatory by the provider and staff had all completed their training.

The service manager carried out extremely effective quality assurance checks and audits to identify when improvements were needed. Actions were implemented from these checks to ensure the home was continually improving.

People, their relatives, staff and healthcare professionals were asked for their views in annual surveys and we found the feedback received was all exceptionally positive. Staff told us the management were supportive, open and honest. The registered manager had been in their role for many years and knew people living in the home well.

People were asked for their views about their care and support and they were acted upon. One person said, 'We talk about bullying and know how to complain if we're not happy.' People who used the service were aware they could talk to senior managers from Catholic Care if they had any concerns. People were supported in promoting their independence and community involvement.

Medicines were safely administered. People who used the service received appropriate support with their medication. Care records identified how people's individual care needs should be met.

The provider supported staff to deliver care to an appropriate standard. Staff we spoke with told us everyone worked well together and they felt well supported. One member of staff said, 'We get really good support. It's great working with a team who you can trust and genuinely care.'

We observed staff supporting and interacting with people who used the service, and saw good standards of care being provided. Staff provided appropriate care to people and it was clear they knew the people they were supporting very well.

People who used the service had discussed safeguarding and 'feeling safe' during their resident meetings. One person said, 'We have talked about what to do if people are rude and we report it.'

The registered manager told us effective recruitment processes were in place and all staff who worked at the service had criminal record checks.

Staff said good systems were in place to make sure people were listened to, and they were confident the registered manager and area manager would deal with any concerns or comments promptly and take appropriate action where necessary. Staff told us people received very good care and support, and their needs were appropriately met.