Lighthouse Professional Care Ltd

Lighthouse Professional Care Ltd is a domiciliary care agency providing personal care to people in their own homes. At the time of the inspection, the provider was supporting up to 55 people. However, after the first day of inspection this was reduced to 5 people due to action from local authorities after following their processes.

Not everyone who used the service received personal care. Care Quality Commission (CQC) only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do we also consider any wider social care provided.

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

Relatives and those important to people were generally positive about the support they received. However, systems were still not always effective to keep people safe and ensure they received quality care. One potential safeguarding, although managed, had not been alerted to relevant bodies such as the local authority and Care Quality Commission. Concerns being identified by the management systems were not always being resolved in a timely manner. The provider’s own policies and procedures were not always being followed.

Staff knew how to mitigate risks although there was limited or no guidance to ensure consistent care. Not all medicine was managed safely. Whilst staff knew when changes to people’s needs occurred these were not always recorded.

Staff now had recruitment folders. However, recruitment was still not completed in line with legislation. Staff were positive about the training and support they now received from the management. The management had invested time into helping staff acclimatise when moving to a new country.

Relatives and those important to people reported that they were informed if staff were running late and they had regular reviews of care. Staff supported people with meals when required.

People were supported to have maximum choice and control of their lives and staff them in the least restrictive way possible and in their best interests; the policies and systems in the service did not always support this practice because records lacked guidance for staff.

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

The last rating for this service was requires improvement (published 17 December 2021).

The provider completed an action plan after the last inspection to show what they would do and by when to improve. At this inspection we found some improvements had been made. However, the provider remained in breach of regulations.

Why we inspected

The inspection was prompted in part due to concerns received about staffing issues including modern day slavery and immigration concerns. A decision was made for us to inspect and examine those risks. No evidence of modern day slavery and immigration concerns were identified at this inspection.

We received concerns in relation to staffing issues as well as concerns from the previous inspection. As a result, we undertook a 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 has remained requires improvement based on the findings of this inspection. We have found evidence that the provider needs to make improvements. Please see the safe, effective and well led sections of this report.

Enforcement and Recommendations

We have identified breaches in relation to recruitment, assessing risks, medicine management and governance.

We have served two warning notices around governance and recruitment to drive improvement. The provider has three months to make the required improvements and we will follow this up.

We have recommended that the provider familiarise themselves with current guidance, standards and law and update care plans accordingly.

Follow up

We will speak with the provider following this report being published to discuss how they will make changes to ensure they improve their rating to at least good. We will work with the local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.

Lighthouse Professional Care Ltd is a domiciliary care service providing personal care to seven people at the time of the inspection.

Not everyone who used the service received personal care. CQC only inspects where people receive personal care. This is help with tasks related to personal hygiene and eating. Where they do, we also consider any wider social care provided.

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

Not all records were accurate or up to date. We found some shortfalls in training documentation. Not all monitoring systems were accurate and up to date, we found shortfalls in accidents and incident logs and notifiable events. The provider did not always operate safe and robust recruitment practices. These areas were a breach of regulation.

Consent was gained from people whilst planning, reviewing and delivering their care. 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. However, we found shortfalls in training and in staff understanding of Liberty Protection Safeguards, which will become law in April 2022. We have made a recommendation about this.

The service was due to move office and was transferring data and documentation onto a new system for quality monitoring and training. We discussed this with the registered manager at the time of the inspection who told us these improvements would be made a priority.

People and the relatives we spoke with were very happy with the service they received. They told us the staff were very caring and listened to them. They told us the staff were cheerful and brightened their mood. They told us they felt safe and well looked after.

There had been no complaints since the service registered with CQC. People and their relatives knew how to complain but told us they hadn’t needed to. They said communication was good and they knew the staff, including the office staff well.

Staff had access to training, supervision and day to day support. There were sufficient numbers of staff to meet the needs of the seven people they supported. The service was continually recruiting, but in the current climate of staff shortages was finding this difficult.

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

Rating at last inspection

The service was registered with us on 22 April 2020 and this is the first inspection.

Why we inspected

This was a planned inspection based on our inspection schedule.

We have found evidence that the provider needs to make improvement. Please see the relevant key question sections of this full report.

You can see what action we have asked the provider to take at the end of this full report.

We found no evidence during this inspection that people were at risk of harm from this concern. Please see the safe, effective and well-led sections of this full report.

Enforcement

We are mindful of the impact of the COVID-19 pandemic on our regulatory function. This meant we took account of the exceptional circumstances arising as a result of the COVID-19 pandemic when considering what enforcement action was necessary and proportionate to keep people safe as a result of this inspection. We will continue to monitor the service.

We have identified breaches in relation to accurate and up to date record keeping, monitoring and training systems and recruitment documentation.

Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan for the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.