Archived: Lighthouse Care Solutions Limited

Updated 11 August 2018

This inspection took place on 17 July 2018 and was announced. We provided 48 hours' notice of the inspection because the location provides a domiciliary care service and we needed to be sure staff would be available for us to talk to, and that records would be accessible. The inspection was undertaken by one inspector.

We did not ask the provider to complete a Provider Information Return (PIR) as part of this inspection process. This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We checked the information we held about the service and the provider and saw that one concern had been raised with us in relation to medicines practice and a missed call, we used this information as part of our inspection planning.

People who used the service were not able to speak with us on the telephone however, we received feedback from three relatives about the service provided and contacted two staff members by email to request feedback. During the inspection we spoke with the care co-ordinator and the registered manager.

We looked at the care records for three people who used the service to see if they were reflective of their current needs. We reviewed two staff recruitment files and training records. We also looked at further records relating to the management of the service, including quality audits and feedback from people and their relatives in order to assess the provider’s quality monitoring systems.

Updated 11 August 2018

This inspection took place on 17 July 2018 and was announced.

Lighthouse Care Solutions is a domiciliary care agency. It provides personal care to people living in their own houses and flats in the community and specialist housing. It provides a service to adults with learning and physical disabilities and older people, including people living with dementia who live in their own homes. At the time of our inspection there were four people using the service.

The service had a registered manager who was also the provider. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 the previous inspection of this service in January 2018 we had identified that improvements were needed across the areas of safe and well-led to help ensure that people received safe care and support. The provider sent us an action plan in March 2018 setting out the improvements they planned to make. At this inspection we found that some improvements had been made however, these were insufficient to evidence that the provider fully understood what was required of them under the Health and Social care Act (Regulated Activities) Regulations 2014. This is the second consecutive time the service has been rated Requires Improvement.

In January 2018 we had identified that staff had not been provided with sufficient information and guidance to support them to manage risks to people’s safety and welfare effectively. At this inspection we found that further work was still needed in this area. At the previous inspection we noted that the provider’s recruitment process required improvement to help ensure the right people were safely recruited. At this inspection there had not been any new staff recruited in the interim period so it was not possible for us to confirm improved practice in this regard. Learning from incidents was not effectively used to improve the quality of service people received. People’s relatives felt that people received safe care. There were enough staff employed to meet people’s needs safely.

At the previous inspection the provider did not have a system of robust record keeping in place. At this inspection we found that whilst some improvements had been made these were insufficient to evidence that the provider fully understood what was required of them under the Health and Social care Act (Regulated Activities) Regulations 2014. The registered manager had recently secured support from an independent consultant to help them improve the quality of the service provided together with their knowledge and understanding.

People and their relatives knew the registered manager by name and felt that they were always approachable with any problems. The registered manager demonstrated a good knowledge of the staff they employed and people who used the service. Satisfaction surveys had been distributed to people who used the service and their relatives.

People’s relatives felt that the care and support provided was appropriate to meet people's needs. Staff received basic core training to support them to be able to care for people safely and since the previous inspection in January 2018 a system of staff supervision had been introduced. Staff were available to support people to access healthcare appointments if needed and they liaised with health and social care professionals involved in people's care if their health or support needs changed. People's consent to care was sought by staff.

People and their relatives told us they were happy with the staff that provided the care. Staff took the time to do things outside of their remit to help improve people’s experiences and to recognise and act on details that were important to people. People’s relatives felt that their views and those of the people who used the service were listened to and respected at all times and that people were treated with dignity and respect. People’s personal and private information was stored in a manner that respected and promoted dignity and confidentiality.

People’s relatives had been involved in developing people's care plans where appropriate and felt that their opinion was respected and taken into account along with the wishes of the person themselves. The management team had made significant improvements with care plans, staff now had access to detailed information about how people wished their care to be provided. Relatives of people who used the service confirmed that staff were responsive to the needs and wishes of people and were confident to raise any concerns with the registered manager if needed.