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Lighthouse Lodge Requires improvement

Reports


Inspection carried out on 16 September 2020

During an inspection looking at part of the service

About the service

Lighthouse Lodge is a care home that provides accommodation for up to 80 people who need help with their personal care. At the time of the inspection 48 people lived in the home. Some of the people living in the home, lived with dementia.

People's experience of using this service:

At the last inspection, the provider was rated requires improvement with a breach of regulation 17 of Health and Social Care Act 2008 (Regulated Activities) Regulations 2014, with regard to record keeping. At this inspection, although care plans and risk assessments had improved this work was still ongoing. Enough improvement had been made however for the provider to no longer be in breach of regulation 17.

People’s risks were assessed but, information in some people’s care files was sometimes contradictory. Information on people’s medical conditions and the signs and symptoms to spot in the event of ill-health was very limited and required improvement.

Medicines were managed safely with people’s ability to manage their own medication positively supported. Some people required their drinks to be thickened with a thickening agent to prevent them from choking. Records relating to this were not always clear. The competency of staff to administer medicines also needed to be re-assessed. We spoke with the manager and the regional manager about this and both of these issues were acted upon without delay.

People’s daily records showed that they received the care and support identified in their care plan. People looked well looked after, relaxed and comfortable in the company of staff.

Staff recruitment was managed well. Staff spoken with were knowledgeable about people’s needs and the people they were caring for.

The home was safe, well maintained and clean. Infection control arrangements were in place to prevent and mitigate the risk of Coronavirus. Appropriate personal protective equipment (PPE) was place and staff were using this appropriately in the day to day delivery of care.

The systems in place to monitor the quality and safety of the service had improved since our last inspection. They were being used effectively to make improvements to the service. Since our last inspection, a new manager and regional manager had come into post and during our inspection they were approachable, open to feedback and committed to continuous improvement.

Rating at last inspection and update

The last rating for this service was requires improvement (published 30 January 2020). At their last inspection we identified a breach of regulations 17 (Good governance). After the inspection, the provider completed an action plan to show us what they would do and by when, to improve. At this inspection, the provider had achieved the improvements identified in their action plan.

Why we inspected

This was a planned focused 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 reinspection programme. If we receive any concerning information we may inspect sooner.

Inspection carried out on 6 November 2019

During a routine inspection

About the service

Lighthouse Lodge is a residential care home providing personal care to 47 people at the time of the inspection. The service is registered to support up to 80 people in one adapted building. The home is located over four floors.

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

Staff knew people well and included them in decisions about their care preferences. However, care plans were not always completed to reflect the person-centred care being given to people.

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 and the policies and systems in the service supported this practice. However, mental capacity assessments were not always completed in line with legislation and it was not always clear what decisions were being assessed. DoLS had been applied for appropriately to keep people safe, however one care plan contained inaccurate information with regard to this. We found no evidence people had been restricted of their freedom unlawfully.

Due to the large volume of new staff recruited in the home, and with an issue with the induction process, not all staff had completed induction training. The registered manager had put measures in place to ensure staff were safe and competent to carry out their role and had arranged for extra induction training sessions to take place before the end of the year. The induction process had been changed recently and staff would be able to access training in a more timely way. Clinical training for nursing staff was up to date and it was clear there was a continuous drive to seek out further training to ensure clinical practice was kept up to date.

Audits and checks were completed by the registered manager; however, these were not always effective at identifying concerns. We made a recommendation about this. The registered manager was responsive to our feedback during the inspection.

The home was clean and well maintained and the environment was pleasant. However, on one floor the decoration of the environment had not been fully considered for those living with dementia. We made a recommendation about this.

Risks to people were assessed and appropriate plans were in place to keep people safe. There were clinical governance procedures in place which ensured risks to people were identified and addressed in a timely way. Checks on the environment and most equipment were completed to ensure they were safe to use. However, we found pressure relieving mattresses had not been checked regularly, and checks had not been recorded. We made a recommendation about this.

Most staff had been recruited safely. However, two records we looked at did not include a full employment history and not all gaps in employment had been accounted for. We made a recommendation about this.

There were enough staff to meet people's needs. We saw people had good relationships with the staff that supported them. People were treated with dignity and respect. Staff supported people to be as independent as possible and express their views about the service and their care. Some relatives felt there had been a reduction in staff numbers since the home first opened, but the registered manager explained the home had been staffed based on full occupancy from opening which may give the impression staffing had reduced. This had not always been communicated effectively to people and their relatives.

People told us they felt safe living at Lighthouse Lodge and they liked living there. There was a range of activities available for people.

Staff understood their role and had confidence in the registered manager. Staff told us they worked well together as a team, and there was good morale amongst them.

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

Rating at last inspection and update

This service was registered with us on 09/11/2018 and this is the