Inspection on 28/06/07 for The Lighthouse

This inspection was carried out on 28th June 2007.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found no outstanding requirements from the previous inspection report, but made 1 statutory requirements (actions the home must comply with) as a result of this inspection.

Other inspections for this house

The Lighthouse 23/01/06

The Lighthouse 07/09/05

The Lighthouse 23/02/05

The Lighthouse 08/07/04

Similar services:

Thorndene

Insight - Eastchurch

Southfields

Magenta

Seabourne House

33 St John`s Church Road

Dovedale Court

Lyncol House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOME ADULTS 18-65 The Lighthouse 65 Hillfield Road Selsey Chichester West Sussex PO20 0LF Lead Inspector Gina Pickering Unannounced Inspection 28th June 2007 10.00 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address The Lighthouse DS0000014782.V338788.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Adults 18-65. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. The Lighthouse DS0000014782.V338788.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service The Lighthouse Address 65 Hillfield Road Selsey Chichester West Sussex PO20 0LF 01243 601602 01243 601632 Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Dignity Group Limited Ms Carol Ann Chivers Care Home 9 Category(ies) of Learning disability (9) registration, with number of places The Lighthouse DS0000014782.V338788.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 23rd January 2006 Brief Description of the Service: The Lighthouse is a care home registered to provide personal care for up to nine Service Users in the category Learning Disability. It is a detached property located within the village of Selsey and is close to both local amenities and the seafront. The property has been adapted for its current use. The accommodation is provided in nine single rooms which are located on the ground and first floors. The lounge and dining room are located on the ground floor. The home has its own private garden which is well maintained. The service is owned by The Dignity Group. The manager provided information that weekly fees for the service range from £597.62 to £718.32. The Lighthouse DS0000014782.V338788.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection process considered information received by the Commission about the service since the last key inspection on 23rd January 2006. Information received from the home in their completed Annual Quality Audit Assessment (AQAA) was used to inform the inspection process. An unannounced visit to home was made on 28th June 2007. The inspector spoke with three service users, three staff members, the manager, Carol Chivers as well as looking at a sample of documentation and looking at the environment of the home. What the service does well: What has improved since the last inspection? The service has commenced implementing personal centred planning that they believe will further promote the service users ability to make choices about their life styles. The Lighthouse DS0000014782.V338788.R01.S.doc Version 5.2 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. The Lighthouse DS0000014782.V338788.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–5) Individual Needs and Choices (Standards 6-10) Lifestyle (Standards 11-17) Personal and Healthcare Support (Standards 18-21) Concerns, Complaints and Protection (Standards 22-23) Environment (Standards 24-30) Staffing (Standards 31-36) Conduct and Management of the Home (Standards 37 – 43) Scoring of Outcomes Statutory Requirements Identified During the Inspection The Lighthouse DS0000014782.V338788.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 5 are: 1. 2. 3. 4. 5. Prospective service users have the information they need to make an informed choice about where to live. Prospective users’ individual aspirations and needs are assessed. Prospective service users know that the home that they will choose will meet their needs and aspirations. Prospective service users have an opportunity to visit and to “test drive” the home. Each service user has an individual written contract or statement of terms and conditions with the home. The Commission consider Standard 2 the key standard to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 1, 2, & 5. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good preadmission processes ensure that service users are confident that the home will meet their needs and that they have an understanding about the running of the home when they move into the home. EVIDENCE: A comprehensive pre admission process is initiated when a prospective service user expresses an interest in the home. Information is provided to the person in the form of the statement of purpose and other supporting documents. These detail the service provided by the home. The statement of purpose has not been reviewed for several years, the manager agreed to review and amend it ensure that it accurately describes the service provided by the home. Records of the last two service users admitted to the home evidence that they had several visits to the home including overnight and weekend stays before the decision was made by them that they wanted to live at The Lighthouse. During the visits to the home staff assess the prospective service user making the decision whether the home can offer the support and care that the individual needs. All service users have a service users guide to which their signed terms and conditions of residency at the home is attached. Details about the fee and who The Lighthouse DS0000014782.V338788.R01.S.doc Version 5.2 Page 9 pays the fee is left blank, this needs to be included. The manager agreed that these details would be added to the terms and conditions. The Lighthouse DS0000014782.V338788.R01.S.doc Version 5.2 Page 10 Individual Needs and Choices The intended outcomes for Standards 6 – 10 are: 6. 7. 8. 9. 10. Service users know their assessed and changing needs and personal goals are reflected in their individual Plan. Service users make decisions about their lives with assistance as needed. Service users are consulted on, and participate in, all aspects of life in the home. Service users are supported to take risks as part of an independent lifestyle. Service users know that information about them is handled appropriately, and that their confidences are kept. The Commission considers Standards 6, 7 and 9 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 6, 7 & 9. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good care planning practices provides service users with the support to retain control for making choices about their life styles and how support is given to them in meeting their personal goals. EVIDENCE: Each service user has a plan of care that is developed from their initial assessment and on going assessments of their needs. As part of the case tracking process three care plans were looked at. Care plans are kept in the office, but service users spoken with are aware that they can access their care plans when they want to. Person centred planning is in the process of being implemented that the service believes will further promote the ability for service users to make choices about their lifestyles. The Lighthouse DS0000014782.V338788.R01.S.doc Version 5.2 Page 11 Care plans are reviewed six monthly with the involvement of the service users and their representatives (usually their parents), their key worker as well as the manager of the home. Service users have copies of their reviews in their bedrooms. Daily and monthly evaluations of the wellbeing of the service users are documented; these include details about the support needed to enable service users to make choices about their lives. Each service user has a key worker; on the day of the inspector’s visit to the home, one service user was out with his new key worker on a ‘getting to know you’ exercise. Service users spoke about their key workers as someone they could approach if they had any concerns and someone who understood their needs and their likes and dislikes . One service user discussed with the inspector how her key worker supports her in making decision about all aspects of her life; this ranges from the décor for her bedroom to work and leisure activities. Service users are encouraged to lead an independent life style as possible. Risk assessments in their care pans support their independent life style for example walking to work. Discussions with service users evidenced that they are able to make decisions about their life, for example making decisions about which college courses to enrol on, leisure activities and holidays. This year service users had chosen to take a holiday as a house groups with the support of all staff members rather than individual holidays with support. The Lighthouse DS0000014782.V338788.R01.S.doc Version 5.2 Page 12 Lifestyle The intended outcomes for Standards 11 - 17 are: 11. 12. 13. 14. 15. 16. 17. Service users have opportunities for personal development. Service users are able to take part in age, peer and culturally appropriate activities. Service users are part of the local community. Service users engage in appropriate leisure activities. Service users have appropriate personal, family and sexual relationships. Service users’ rights are respected and responsibilities recognised in their daily lives. Service users are offered a healthy diet and enjoy their meals and mealtimes. The Commission considers Standards 12, 13, 15, 16 and 17 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 12, 13, 15, 16 & 17. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service supports service users to hold down jobs, attend college courses, and to enjoy leisure activities within the local community. Service user benefit from a healthy diet. EVIDENCE: Care plans detail the daily activities of the service users that include work, educational, leisure and home-based activities. Organisations such as Mencap are used to assist service users find jobs and work experience. One service user works in the kitchen in a care home two mornings a week, as well as doing voluntary work in another care establishment. Another service user works in an animal hospital. Several service users are doing work experience at local supermarkets. Some service users attend college several days a week studying various subjects such as cooking, numeracy and literacy skills, beauty The Lighthouse DS0000014782.V338788.R01.S.doc Version 5.2 Page 13 courses and picture framing courses. Two of the service users proudly showed the inspector their certificates from courses completed at college. The manager and staff spoke of how the service is geographically well placed for the service users to be involved in the community. Most of the jobs, voluntary jobs and work experience are within the local community. Service users attend local clubs that include reading clubs and swimming clubs. During the inspectors visit to the home two service users were planning the evening out at a disco. Both of them spoke about how much they enjoyed socialising at discos. During conversations with the inspector service users spoke about the friends they meet at clubs, college and work. By taking part in activities outside the home, service users are able to meet and mix with their peers. Meal times are a social event at the home with service users and staff sitting down to eat meals together. A six weekly rotating menu for the evening meal is in place, though this is flexible and alterations to the menu are recorded in a daily diary. Service users help themselves to breakfast as they get up, usually consisting of cereal and toast or bread. Lunch times are flexible dependant on the wishes of the service users present in the home at the time. Built into each service users plan of care and routine of activities is the plan of when they help, in the kitchen and in the house. All service users are allocated two days a week to do their own washing and ironing. Service users help with the shopping, preparation and cooking of the meals along with the clearing up after meals. Service users were assisting with the washing up after lunchtime and making cups of tea and coffee during the inspector’s visit to the home. The Lighthouse DS0000014782.V338788.R01.S.doc Version 5.2 Page 14 Personal and Healthcare Support The intended outcomes for Standards 18 - 21 are: 18. 19. 20. 21. Service users receive personal support in the way they prefer and require. Service users’ physical and emotional health needs are met. Service users retain, administer and control their own medication where appropriate, and are protected by the home’s policies and procedures for dealing with medicines. The ageing, illness and death of a service user are handled with respect and as the individual would wish. The Commission considers Standards 18, 19, and 20 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 18, 19 & 20. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Good care planning, support with health care and medication practices ensure that service users’ health and personal care needs are met. EVIDENCE: Care plans detail the support service users need regarding personal care and health care, describing the manner in which they like assistance. Service users that the inspector had conversations with said that they can have baths/showers when they want. One service user was getting ready to go out to a disco that the evening so was attending to her personal care in the way she prefers during the afternoon with staff support . She showed the inspector the clothes she had chosen to wear that evening for the disco. All service users registered with a local GP. Contacts with health professionals are recorded ion the person care planning documents. Service user spoken with said that the staff at the home help them to manage their own health care The Lighthouse DS0000014782.V338788.R01.S.doc Version 5.2 Page 15 needs; supporting them to attend medical appointments and in one case providing support for a service user to manage her own medications. As part of the case tracking process two medication administration record sheets were looked at. These are completed accurately ensuring that service users receive the medications they are prescribed at the correct times. Details about effects of the medications and what to look for are attached to the medication administration records. The manager said she sees the prescriptions before delivering prescriptions to pharmacy; this ensures the service users are receiving the medications that they are prescribed for. A record is kept of all medications received by the home and those returned to the pharmacy. Polices and procedures are in place for service users to take responsibility for the administration of medications themselves. One service user at the home does take responsibly for managing her own medications; the relevant procedures are followed. All staff have had training about the safe handling and administration of medications provided by a local further education college. The Lighthouse DS0000014782.V338788.R01.S.doc Version 5.2 Page 16 Concerns, Complaints and Protection The intended outcomes for Standards 22 – 23 are: 22. 23. Service users feel their views are listened to and acted on. Service users are protected from abuse, neglect and self-harm. The Commission considers Standards 22, and 23 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 22 & 23. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users are confident that complaints will be listened to and investigated. Service users are protected from the effects of abuse by a workforce that has a good understanding about the protection of vulnerable persons. EVIDENCE: Each service has a pack of information about the home in their bedroom. Included in this pack are details about how to make a complaint. All service users, that the inspector had a conversation with, expressed that they would have no concerns raising their concerns or a complaint to the manager of the home. They said that they are confident that concerns and complaints will be dealt with promptly. Staff spoken with are aware of the complaints procedure. If they are unable to resolve complaint they will refer the complainant to the manager or the senior carer on duty. Discussion with the manager and information provided in the AQAA evidenced that no complaints have been received about the service in the last 12 months. The manager confirmed to the inspector that if a complaint is received she will document the complaint, the investigation process and the outcome as well as letting the complainant know the outcome. The Lighthouse DS0000014782.V338788.R01.S.doc Version 5.2 Page 17 All staff have received training about the protection of vulnerable adults; this was confirmed in conversations with staff members and looking at staff training records. Staff are able to correctly describe the actions to take if they suspect an act of abuse has occurred. The manager, in conversation, demonstrated that she has a good understanding about safe guarding adults procedures. The Lighthouse DS0000014782.V338788.R01.S.doc Version 5.2 Page 18 Environment The intended outcomes for Standards 24 – 30 are: 24. 25. 26. 27. 28. 29. 30. Service users live in a homely, comfortable and safe environment. Service users’ bedrooms suit their needs and lifestyles. Service users’ bedrooms promote their independence. Service users’ toilets and bathrooms provide sufficient privacy and meet their individual needs. Shared spaces complement and supplement service users’ individual rooms. Service users have the specialist equipment they require to maximise their independence. The home is clean and hygienic. The Commission considers Standards 24, and 30 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 24 & 30. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Service users benefit from living in a home that is maintained in a safe manner and provides a homely environment for them to live in. EVIDENCE: The home is situated in a quiet residential area of Selsey within walking distance of the beach, village centre and local amenities. All service users’ private accommodation is in single bedrooms. Two service users showed the inspectors their bedrooms. The décor and furnishing reflected their individual interests and they confirmed were of their own choosing. Each service user has a key to their bedroom and staff do not enter their bedrooms unless invited in by the service user. There are bathing and toilet facilities on each floor of the two-floored house. A large lounge and dining room form the communal areas, both of which are decorated in a pleasant manner. Patio doors open onto a well The Lighthouse DS0000014782.V338788.R01.S.doc Version 5.2 Page 19 maintained large garden with it’s own herb and vegetable area. There is a large kitchen to which service users have access. The preparation and cooking of meals is a shared task between service users and staff members. All internal doors are fire doors and close automatically. Any doors held open are done so with approved retainers that release in the event of a fire. The laundry is situated so that all service users can access it and no dirty laundry has to go through food preparation areas. Service users are supported to do their own washing; a rota ensures that each service user has opportunity to do their own washing twice a week. The laundry was clean and free from malodours . Hand washing facilities are available to the staff members as well as the service users. Fresh towels are distributed daily. The home was clean and tidy during the visit; service users and staff are responsible for the cleanliness of the home. Staff records indicate that all staff have had training about the control of infection. The Lighthouse DS0000014782.V338788.R01.S.doc Version 5.2 Page 20 Staffing The intended outcomes for Standards 31 – 36 are: 31. 32. 33. 34. 35. 36. Service users benefit from clarity of staff roles and responsibilities. Service users are supported by competent and qualified staff. Service users are supported by an effective staff team. Service users are supported and protected by the home’s recruitment policy and practices. Service users’ individual and joint needs are met by appropriately trained staff. Service users benefit from well supported and supervised staff. The Commission considers Standards 32, 34 and 35 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 32, 34, 35 & 36 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff at the home are trained and employed in sufficient numbers to meet the needs of those living at the home. Good recruitment procedures protect the welfare of service users. EVIDENCE: Staff work to a set six week rotating rota that has been developed by the staff team at the home. This ensures that sufficient staff are on duty at all times to meet the needs of the service users. Staff said that there is enough staff to meet the personal and social needs of the service users. This is a view that was expressed by the service users spoken to during the visit and by the observations of the inspector during the visit. Two staff files were looked at, evidencing that good recruitment procedures are followed to ensure the welfare of service users is protected by staff employed at the home. Documentary evidence was seen in the files indicating that staff The Lighthouse DS0000014782.V338788.R01.S.doc Version 5.2 Page 21 receive formal supervision on a two monthly occurrence. This was confirmed in conversations with staff members. All but one staff member have achieved at least NVQ level 2 in care. The one member of staff who does not have this qualification is recently appointed and is the process of completing an induction programme that follows the Learning Disability Award Framework, promoting a good understanding of the needs of the service user group living at the home. Records evidence that staff receive ongoing training in mandatory topics such as moving and handling, fire safety and health and safety as well as topics relating to the specific needs of the service user group. The Lighthouse DS0000014782.V338788.R01.S.doc Version 5.2 Page 22 Conduct and Management of the Home The intended outcomes for Standards 37 – 43 are: 37. 38. 39. 40. 41. 42. 43. Service users benefit from a well run home. Service users benefit from the ethos, leadership and management approach of the home. Service users are confident their views underpin all self-monitoring, review and development by the home. Service users’ rights and best interests are safeguarded by the home’s policies and procedures. Service users’ rights and best interests are safeguarded by the home’s record keeping policies and procedures. The health, safety and welfare of service users are promoted and protected. Service users benefit from competent and accountable management of the service. The Commission considers Standards 37, 39, and 42 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): 37, 39 & 42. Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The manager of the home is totally committed to ensuring that the service is run to meet the needs and wishes of those living there. Health and safety practices have not been totally protecting service users. EVIDENCE: The manager, Carol Chivers, has been in post since the opening of the home. She has been registered by the Commission as manager of the home and has obtained NVQ level 4 in care and the registered managers award. She said she has clear lines of accountability, has good access to her line manager; this was evidenced by telephone conversations she had during the inspector’s visit to the home. The Lighthouse DS0000014782.V338788.R01.S.doc Version 5.2 Page 23 Service users clearly influence the running of the home. The home is managed around their needs i.e. employment, work experience, college courses and social events as well as their health needs and general wishes. House meetings are held monthly. Service users contribute to the agenda for these meetings as well as staff members. Records form these meetings show how service users are able to influence the running of the home. Examples of this include service users influencing the decision to continue employing two members of staff on site during the night and decisions about social activities in the home. The service has good contacts with the parents or representatives of the service users. Parents and representatives are invited to attend reviews of the service users placement and care at the home. Service user review forms evidence that this happens. Parents and representatives are able to comment and influence the running of the home during the review process and through general contact with the home. The manager explained that she operates an open door policy. Service users and staff can access her at all times. During the inspector’s visit to the home staff and service users were observed entering the manager’s office to speak to her about a variety of subjects. Health and safety procedures and policies are in place. Records evidence that all staff have had training about health and safety issues. Fire safety records detail that all staff have regular training about fire safety. But records of fire safety checks have not been kept up to date; the last entry for fire safety checks was May 2007. Fire safety checks must be documented in accordance with recommendations from the Fire and Rescue authority to ensure the continued safety of all at the home. The manager told the inspector that she would ensure these checks are carried out and documented. Records are available to evidence that all fire safety equipment is professionally serviced at the required intervals. Service users are able to describe the action they should take in the event of a fire happening at the home. Service certificates evidence that appliances and services are maintained at the manufacturers recommended intervals ensuring the safety of those at the home. All substances hazardous to health such as cleaning fluids are stored securely; service users have access to them under a risk management strategy i.e. for housework and laundering. The Lighthouse DS0000014782.V338788.R01.S.doc Version 5.2 Page 24 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Adults 18-65 have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 3 2 3 3 x 4 x 5 2 INDIVIDUAL NEEDS AND CHOICES Standard No 6 7 8 9 10 Score CONCERNS AND COMPLAINTS Standard No Score 22 3 23 3 ENVIRONMENT Standard No Score 24 3 25 x 26 X 27 X 28 X 29 X 30 3 STAFFING Standard No Score 31 x 32 3 33 X 34 3 35 3 36 3 CONDUCT AND MANAGEMENT OF THE HOME Standard No 37 38 39 40 41 42 43 Score 3 3 X 3 x LIFESTYLES Standard No Score 11 x 12 3 13 3 14 X 15 3 16 3 17 3 PERSONAL AND HEALTHCARE SUPPORT Standard No 18 19 20 21 Score 3 3 3 x 3 X 3 X X 2 x The Lighthouse DS0000014782.V338788.R01.S.doc Version 5.2 Page 25 no Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1 Standard YA42 Regulation Requirement Timescale for action 10/08/07 23(4(c(v))) Fire safety checks must be documented RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard YA1 Good Practice Recommendations The statement of purpose should be reviewed at regular intervals to ensure it clearly describes the service provided by the home. 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