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Archived: Lighthouse Homecare Inadequate


Inspection carried out on 18 May 2016

During a routine inspection

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 t

Inspection carried out on 29 May 2014

During a routine inspection

Our inspection team was made up of one adult social care inspector. We answered our five questions; Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

We looked through the care records of six people that used the service. We spoke with three members of staff, spoke with two people that used the service and three relatives of people using the service. We also spoke with three social care professionals who had some involvement with the support of people who used the service.

Below is a summary of what we found. The summary describes what people using the service, their relatives and the staff told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

This is a summary of what we found:

Is the service safe?

People told us they felt safe. Safeguarding procedures were clear and staff understood how to safeguard people they supported. Staff knew about risk management plans and showed us examples where they had followed them. People had the opportunity to make choices and remained in control of decisions about their care and lives.

People benefited from safe care and support, due to good decision making and appropriate management of risks to their health, welfare and safety. The service had been led effectively to manage risk.

Is the service effective?

The staff rotas reflected people�s care needs in terms of staff qualifications, skills and experience. This helped to ensure that people�s needs had been met. People told us that they were happy with the care they had received and felt their needs had been met.

We learned from speaking with people who used the service and their relatives and social workers that the staff and registered manager understood people's care and support needs. One person told us that, �...going to the homecare service had been a very good move. It has paid dividends�. One carer was described as, �...right on the ball. Top hole. Very good in meetings and very well organised�.

Is the service caring?

The service had placed the needs, wishes, preferences and decisions of people using the service at the centre of their work. One of the people we spoke with told us about support which had been provided which was, � contract, beyond their hours and out of the kindness of her heart�. We were told that the service deserved a, �...pat on the back�, for helping to resolve problems quickly and efficiently.

Is the service responsive?

People's needs were assessed before they received care and support from the service. We found that people had been given the right support and had been helped in areas that were important to them. Records illustrated that people's preferences had been recorded and care and support had been provided that met their wishes. People had been supported and cared for in a way that helped them to be as independent as possible. One person we spoke with told us that the registered manager had been very approachable, and had listened to and acted on comments made about how services had been provided.

Is the service well led?

The registered manager and care staff had a clear understanding of the ethos of the service. Quality assurance processes were in place. We saw that people had been asked for their feedback on the service they received and that they had filled in satisfaction surveys. They confirmed they had been listened to and where needed improvements had been made to the quality of care provided.

Inspection carried out on 29 November 2013

During a routine inspection

Lighthouse Homecare is run and managed from The Lighthouse Rehabilitation Centre by the same provider. The two services share policies as well as systems and processes. At the time of the inspection the homecare service was providing care and support for three people in supported living at the rehabilitation centre and four people living out in the community. We spoke with three people who used the service and one relative. We also spoke with two members of staff and the registered manager. Following the visit we spoke with an external social care professional.

People told us that they felt well involved in their care and support. They told us that they could make decisions and that these were respected. One person felt they had, �Done fantastically.�

Staff worked closely with other agencies and we saw evidence of good access to health and social care professionals.

We found effective recruitment processes in place. Staff told us they felt well trained and supported in their roles. Record keeping was found to be accurate and up to date.

Inspection carried out on 12 February 2013

During a routine inspection

When we visited we spoke with two people being supported in the community. All people using the service had access to The Lighthouse Rehabilitation Centre, run and managed by the same providers as Lighthouse Homecare. Both people we spoke with told us the staff were good and that they were happy with the support provided. One person said, �The way I wanted things is the way it is now,� and that being able to go to the rehabilitation centre was a really important part of their day.

The policies, procedures, staff training and meetings were shared between the two services. It was not clear whether the policies also applied to Lighthouse Homecare or where policies were specific to one service only.

There had been several changes in management over the last eight months. We spoke with the manager, the one member of staff employed for the homecare service at the time of the visit, together with one new recruit who was undertaking induction. Staff told us that it was important that people accessed community resources to enable better independence. There were agreed care plans in place relevant to each individual that were regularly discussed and reviewed. Medicines were managed safely with access agreed on an individual basis.

Limited staff training was in place. Staff recruitment and training was in progress. Following the visit we spoke with two external professionals who described how staff worked with each individual to support their needs.