The Lighthouse

Updated 14 March 2024

The Lighthouse is a 4 bedded child and adolescent mental health unit based in Darwen, Lancashire. The service is an independent hospital delivered by Associated Wellbeing. The service aims to provide step-down from child and adolescent mental health inpatient units as well as a placement for children to be admitted during a crisis to avoid hospital admission. Young people are not detained under the Mental Health Act at the service.

The service is registered to provide the following regulated activities:

• Treatment for disease, disorder, or injury
• Accommodation for persons who require personal and/or nursing care.

At the time of inspection, an acting registered manager was in place and going through the application process.

The service was last inspected In June 2023 and found to be good in all key questions.

In February 2022 the service was rated as Requires Improvement overall. The service was rated

Good for Effective, Caring and Responsive. Safe and Well Led were rated as Requires Improvement.

In November 2021 there was a warning notice issued in relation to the safe domain.

What people who use the service say

Children described The Lighthouse as being a good experience overall. They said that staff were excellent at engaging with families and keeping relationships going. They felt that keyworkers were respectful and that they were matched well with the children, being able to easily establish a rapport with them. They also said there was a good mix of male and female staff to meet the needs of the children.

However, children also commented that they felt there was not enough vehicles to facilitate leave and that this was postponed at times. Children felt that medication was not managed well and that medicines were not given and ordered late. Children reflected that they felt agency staff and new staff did not always use a calm approach and would utilise restraint too soon without attempting de-escalation first.

Carers said that overall, the service was good and that their children were progressing well. Carers commented that the staff displayed caring attitudes and that their children felt safe. Incidents were dealt with appropriately and the correct actions taken such as de-escalation and wound treatment.

However, carers commented that they did not have copies of their child’s care plan and that they were not always kept informed of incidents or changes to care plans. One carer strongly felt that The Lighthouse did not communicate well with other external services which had a detrimental impact on their child and their own wellbeing.

Updated 14 March 2024

Our rating of this service stayed the same. We rated it as good because:

• The service provided safe care. The ward environments were safe and clean. The wards had enough nurses and doctors. Staff assessed and managed risk well. They minimised the use of restrictive practices and followed good practice with respect to safeguarding.
• Staff developed holistic, recovery-oriented care plans informed by a comprehensive assessment. They provided a range of treatments suitable to the needs of the patients and in line with national guidance about best practice. Staff engaged in clinical audit to evaluate the quality of care they provided.
• The ward teams included or had access to the full range of specialists required to meet the needs of patients on the wards. Managers ensured that these staff received supervision and appraisal. The ward staff worked well together as a multidisciplinary team and with those outside the ward who would have a role in providing aftercare.
• Staff treated patients with compassion and kindness, respected their privacy and dignity, and understood the individual needs of patients. They actively involved patients and families and carers in care decisions.
• Staff planned and managed discharge well and liaised well with services that could provide aftercare. As a result, discharge was rarely delayed for other than a clinical reason.
• The service was well led and the governance processes ensured that ward procedures ran smoothly.

However:

• Medicines were not always ordered in a timely way.
• Staff did not fully understand and discharge their roles and responsibilities under the Mental Capacity Act 2005. They were unsure of good practice with respect to young people’s competency and capacity to consent to or refuse treatment.
• Internal meetings did not have set agendas and it was unclear whether previous actions had been completed.
• Children felt that some agency staff and some new staff were not always keen to engage with them and were too hasty to apply restraint before fully utilising de-escalation techniques.
• The service recently discharged a child to a service that was not fully OFSTED registered.
• The service lacked adequate transport so that children could access community activities easily.

Updated 14 March 2024

See overall summary