We carried out a review of the data available to us about The Lighthouse Selsey on 6 July 2023. We have not found evidence that we need to carry out an inspection or reassess our rating at this stage.
This could change at any time if we receive new information. We will continue to monitor data about this service.
If you have concerns about The Lighthouse Selsey, you can give feedback on this service.
The Lighthouse Selsey is a residential care home providing personal care and accommodation for up to 9 people with learning disabilities and/or autistic people. Some people have additional mental health needs or dementia. At the time of the inspection 7 people were living at the service. The service is also registered to provide personal care to people who live in the local area in their own homes; at the time of the inspection there were no people in receipt of personal care in their own homes.
We expect health and social care providers to guarantee people with a learning disability and autistic people respect equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.
People’s experience of using this service and what we found
Right Support: The service provides a calm home which supports people to enjoy their life with reduced anxiety or emotional upset. The home uses an active support approach aimed at increasing people’s participation in daily life, increasing people’s skills and being a valued member of their household. People told us they do household tasks and were very proud to show the rota of daily tasks they had put together themselves.
People could communicate with staff and understand information given to them as staff supported them consistently and understood their individual communication needs. The Lighthouse Selsey was in the process of developing extra learning for the staff, with people being involved in teaching their staff Makaton, a type of sign language.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice.
Staff supported people with their medicines in a way that promoted their independence and achieved the best possible health outcomes. Staff supported people to play an active role in maintaining their own health and wellbeing.
Staff, people and their relatives cooperated to assess risks people might face. Where appropriate, staff encouraged and enabled people to take positive risks. Supporting people to take up local voluntary employment and to use local amenities without staff support where it was safe to do so.
Right Care: People received kind and compassionate care. Staff protected and respected people's privacy and dignity. Staff understood and responded to people’s individual needs.
People's care, and support plans reflected their range of needs and promoted their individuality, wellbeing and enjoyment of life. People could take part in activities of their choosing at the service or in the wider local area and pursue their own interests. Staff received training and support to provide care effectively. People told us they liked living at the lighthouse. One person said, “Living here makes me happy, I like my friends best and the staff.”
Staff worked in partnership with healthcare professionals to maintain people’s health and wellbeing.
People told us they felt safe with staff. Relatives had no concerns about the safety of people. There were policies and procedures regarding the safeguarding of adults and staff knew what action to take if they thought anyone was at risk of potential harm.
Right Culture:
Staff placed people's wishes, needs and rights at the heart of everything they did. The stable management and staff team supported people to receive consistent care from staff who knew them well. We observed people receiving compassionate and empowering care which was tailored to their needs throughout the inspection. One person told us, “The staff are nice and friendly, they help with all sorts if I ask.”
Staff evaluated the quality of support provided to people, involving the person, their families and other professionals as appropriate. All the relatives we had contact with were complimentary and positive about the service and the care and support their loved ones received.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was good (published 15 January 2020).
Why we inspected
This inspection was prompted by a review of the information we held about this service.
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 undertook this focused inspection to review the key questions of safe, effective and well-led only.
For those key questions not inspected, we used the ratings awarded at the last inspection to calculate the overall rating.
The overall rating for the service remains good based on the findings of this inspection.
You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for the Lighthouse Selsey on our website at www.cqc.org.uk.
Follow up
We will continue to monitor information we receive about the service, which will help inform when we next inspect.
The Lighthouse Selsey is a residential care home providing personal care and accommodation for up to nine people with learning disabilities and/or autism spectrum disorder. At the time of the inspection eight people were living at the service. The service is also registered to provide personal care to people who live in the community in their own homes; at the time of the inspection there were no people in receipt of personal care in their own homes.
The Lighthouse Selsey was built and registered with the Care Quality Commission as a residential home before Registering the Right Support guidance was produced. The principles of this guidance reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. The Lighthouse Selsey is located close to Chichester town centre which provided people with opportunities to access the local community and people using the service received planned and coordinated support. The home is larger than current best practice guidance. However, the size of the service did not have a negative impact upon people because the building was in keeping with other residential properties in the area. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were discouraged from wearing anything that suggested they were care staff when coming and going with people. This supported people’s integration into the local community
People’s experience of using this service and what we found
People lived in a home where there were adequate numbers of staff to meet their needs and to assist them with activities and accessing the community. Risk assessments were carried out to make sure people received their care safely and had opportunities to take part in activities which interested them and promoted their independence.
People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. We received positive feedback from professionals the service worked well with other organisations. People were supported to maintain their health and wellbeing. People enjoyed the meals provided and were offered foods to encourage a varied diet.
People were encouraged to engage in activities and some people accessed day services, occupational volunteer roles and clubs to promote their social networks. People's communication needs were fully considered, and people has access to information that was accessible and meaningful to them. People's care plans were person-centred and captured their likes, dislikes and preferences.
We observed people and staff had developed positive relationships, and staff treated people with compassion, kindness and respect. People's independence was promoted where possible, and people and their relatives were encouraged to be involved in their care. One person said, “This is my home, I don’t see it as a care home. It's my home and the people living here are my family.”
The registered manager monitored the quality of the service and used feedback from people and staff to identify improvements and act on them. The service worked in partnership with other agencies to ensure quality of care across all levels. People, relatives and staff were encouraged to provide feedback about the service. There was a culture of openness and transparency. Staff were positive about the management and leadership of the service. The service had quality assurance systems in place, which were used to good effect and to continuously improve on the quality of the care provided.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence. The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
For more details, please see the full report which is on the CQC website at www.cqc.org.uk
Rating at last inspection
The last rating for this service was Good (published 28 February 2017).
Why we inspected
This was a planned inspection based on the previous rating.
Follow up
We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.
The Lighthouse Selsey provides care and accommodation for up to nine people and there were six people living at the home when we inspected whose ages ranged from 20 to 62 years. People had needs associated with learning disability and mental health. The service promoted people to be independent and to access community facilities. The service is also registered to provide personal care to people who live in the community in their own homes; at the time of the inspection there were no people in receipt of personal care in their own homes.
All bedrooms were single. Six bedrooms had an en suite toilet and one had an en suite shower and toilet. Communal toilets and bathroom s were also provided on each floor. There was a communal lounge and dining area which people used.
The Lighthouse Selsey was last inspected in November 2014 and was rated “Good” overall. At this inspection we found that the service remained “Good” overall. At the last inspection there was a concern raised with the provider about the safety of the premises which has now been resolved.
The service did not have a registered manager at the time of the inspection but there was a manager in post who had applied for registration with the Commission. 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.
Staff were trained in adult safeguarding procedures and had a good awareness of what to do if they considered people were at risk of harm or if they needed to report any suspected abuse. People said they felt safe at the home.
Care records showed any risks to people were assessed and there was guidance of how those risks should be managed to prevent any risk of harm.
There were sufficient numbers of staff to meet people’s needs. Staff recruitment procedures were adequate and ensured only suitable staff were employed.
Medicines were safely managed. People were supported and monitored to handle their own medicines where this was assessed as safe.
Staff were trained and supervised so they provided effective care to people.
The CQC monitors the operation of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Staff were trained in the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). People’s capacity to consent to their care and treatment was assessed and applications made to the local authority where people’s liberty needed to be restricted for their own safety.
People were involved in choosing and preparing meals with the support of staff.
People’s health care needs were assessed, monitored and recorded. Referrals for assessment and treatment were made when needed and people received regular checks such as dental and eyesight checks.
People said they were treated well by the staff and were fully involved in planning their care and lifestyle. The service promoted people to develop independence and to access community facilities.
Care plans were individualised and showed people received person centred care. Person centred care ensures the person is at the centre of arrangements for their support taking account of their individual wishes, needs, circumstances and health choices. People attended a range of activities based on what they wanted. The service promoted to people to access employment and support groups.
People said they had opportunities to express their views or concerns. There was a record to show complaints were looked into and any actions taken as a result of the complaint.
The culture of the service was person centred. Staff demonstrated values of treating people as individuals and promoting people having a fulfilled lifestyle. People’s views about the quality of the service were sought. Staff views were also sought and staff were able to contribute to decision making in the home.
A number of audits and checks were used to check on the effectiveness, safety and quality of the service.
The inspection was unannounced and took place on 11 and 20 November 2014.
The Lighthouse Selsey is a nine bed residential care home that provides support to adults with learning disabilities and autism. People have different communication needs; however, everyone was able to verbalise their thoughts and feelings. The main ethos of the home is to support people to gain further independence and social skills. A domiciliary care agency is also operated from the same address as the care home, but has separate office facilities to avoid encroaching on the lives of people who live in the care home. At the time of this inspection, there were six people living at the home and one person who was receiving personal care from the domiciliary care agency.
During our inspection the manager was present. The manager had been in post for a month prior to our inspection. We were informed that the manager would not be registering with the Care Quality Commission and that a new person who had been recruited to manage the home would be submitting an application. 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 had good systems in place to keep people safe. People told us they felt safe. Staff were aware of their responsibilities in relation to safeguarding. The manager was clear about when to report concerns and the processes to be followed in order to keep people safe.
People were able to make choices, to take control of their lives and be supported to increase their independent living skills. Risk assessments and support plans were in place that considered potential risks to people. Strategies to minimise these risks were recorded and acted upon. People were safely supported to manage their medicines independently or with support if needed. People were supported to access healthcare services and to maintain good health.
There were enough staff on duty to support people and meet their needs. Appropriate recruitment checks were completed to ensure staff were safe to support people. Staff were sufficiently skilled and experienced to effectively care and support people to have a good quality of life. People told us that they were happy with the support they received from staff. Staff received training, supervision and appraisal that supported them to undertake their roles and to meet the needs of people.
The Lighthouse Selsey met the requirements of the Deprivation of Liberty Safeguards (DoLS) and people confirmed that they had consented to the care they received. Staff were kind and caring and people were treated with respect. Staff were attentive to people and we saw high levels of engagement with them. Staff knew what people could do for themselves and areas where support was needed.
People were supported to express their views and to be actively involved in making decisions about their care and support. Everyone had a key worker who they met with on a monthly basis to discuss the previous month’s events and also to plan the next months. Staff knew in detail each person’s individual needs, traits and personalities. People were supported to access and maintain links with their local community. The importance of community links and social inclusion was reinforced in peoples support plans. Support plans were in place that provided detailed information for staff on how to deliver people’s care. The files were well- organised, containing current and useful information about people.
The Lighthouse Selsey was well-led by a manager who encouraged people to work collaboratively to provide an holistic approach. Care was personalised and empowering, enabling people to take control of their lives and make decisions and choices. The manager was committed to providing a good service that benefited everyone.
Regular meetings were held with people, staff and relatives and friends of people which encouraged open and transparent communications between them and management. In addition, quarterly newsletters and annual questionnaires were used to find out people’s views, and where necessary make changes to the service and drive improvements. People were routinely listened to and their comments acted upon. Monthly meetings took place where people could raise issues and a pictorial complaints procedure was in place that supported people to understand formal complaint processes.
Quality assurance audits were completed for both the care home and the domiciliary care agency which helped ensure quality standards were maintained and legislation complied with. Accidents and incidents were acted upon and reviewed to prevent or minimise re-occurrence.
People that we spoke with expressed the view that staff were appropriately trained to meet their needs. Observations that we made during our inspection supported people's views. Staff were seen responding appropriately to meet people's needs. Also, when talking to the manager she appeared knowledgeable of people's conditions.
Everyone told us that they had a key worker who supported them and helped them make decisions about their care. For example, one person said, 'X is my key worker; she is a nice lady and always comes to my reviews. I chose her; she talks nicely to me and is very helpful'.
People told us they felt safe living at the service. Our evidence does not support this. For example, appropriate action had not been taken to reduce risks to peoples health needs, staff had not been trained to meet people's needs safely and effective monitoring of the service had not taken place.
We also spoke with the acting manager, the nominated individual and the two care assistants who were on duty. They agreed with the areas of non compliance that we identified. For example, the manager said, 'I have only been here two weeks and my priority has been reviewing the care plans. There is no quality assurance in place, no audits completed and staff have not had any training as far as I can see for a long time'.
People said they were consulted about their care, although people were not aware if they had a care plan or if they had agreed to it. All of the people we spoke with knew they had a keyworker (this is a named members of staff who gives one to one support) and knew who this person was.
Family members told us that their relatives were supported by the staff to receive the care they needed. They said that people were given as much choice as possible and that they were encourages to live as independently as possible.
Families told us they knew what action they should take if they had any cause for concern and they said that they felt that the home would respond appropriately to any concerns that may be raised.
Staff said that they would always respect people's wishes and when asked what they would do if they felt there may be a conflict between a person's wishes and their care needs they told us that they would speak with the manager.