23 September 2020
During an inspection looking at part of the service
Lighthouse Care Agency is a domiciliary care agency providing personal care to people living in their own homes. At the time of the inspection three people were receiving support with personal care.
Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.
People’s experience of using this service and what we found
The provider and registered manager of the service had not made sufficient improvements to the safety and governance of the service since the last inspection.
There was a continued lack of understanding, competency, oversight and governance systems to ensure people received a safe service. Systems that were in place were not implemented effectively and audits did not identify ongoing concerns with the service.
Records relating to people's risks and care needs were incomplete and contained misleading information. As a result, staff did not receive all the information and guidance they required to provide care that met people's needs.
Medicine administration records were not completed appropriately. Staff did record the administration of peoples’ medicines.
Safe recruitment practices were not always followed. Records relating to staff recruitment were disorganised and staff files did not contain up to date information.
People provided positive feedback about the individual staff who provided their care. People were encouraged to make decisions about how their care was provided and their privacy and dignity were protected and promoted.
We have identified breaches in relation to people’s risk assessments and care plans, medicines, staff recruitment, and the governance of the service at this inspection.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at the last inspection (and update)
The last rating for this service was inadequate (published 8 February 2020) and the provider was in breach of four regulations. Conditions were placed on the providers registration. Previously, the provider had been rated requires improvement on three consecutive occasions. The provider continued to complete an action plan after the last inspection to show what they would do and by when to improve. At this inspection not enough improvement had been made and the provider was still in breach of regulations.
Why we inspected
This inspection was carried out to follow up on action we told the provider to take at the last inspection. This report only covers our findings in relation to the Key Questions Safe and Well-led which contain those requirements.
We previously carried out a comprehensive inspection of this service on 21 and 23 October 2019. Breaches of legal requirements were found.
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 remains inadequate
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 people’s risk assessments and care plans, medicines, staff recruitment, and the governance of the service at this inspection.
Full information about CQC’s regulatory response to the more serious concerns found during inspections is added to reports after any representations and appeals have been concluded.
Follow up
We will meet with the provider to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the 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.
The overall rating for this service is ‘Inadequate’ and the service remains in ‘special measures’. This means we will keep the service under review and, if we do not propose to cancel the provider’s registration, we will re-inspect within 6 months to check for significant improvements.
If the provider has not made enough improvement within this timeframe. And there is still a rating of inadequate for any key question or overall rating, we will take action in line with our enforcement procedures. This will mean we will begin the process of preventing the provider from operating this service. This will usually lead to cancellation of their registration or to varying the conditions the 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.