Lighthouse Professional Care Ltd

Updated 13 September 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

Inspection team

This inspection was carried out by two inspectors on site and an Expert by Experience who made phone calls to relatives. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

The start of the inspection was aligned with other professional bodies including immigration, the police, the department of business and trade and local authorities.

Service and service type

This service is a domiciliary care agency. It provides personal care to people living in their own houses and flats and specialist housing.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced on the first day at the office and announced on the second day.

Inspection activity started on 3 July 2023 and ended on 24 July 2023. We visited the location’s office on 3 and 20 July 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. We sought feedback from the local authority, police and other professionals who work with the service. We used the information the provider sent us in the provider information return (PIR). This is information providers are required to send us annually with key information about their service, what they do well, and improvements they plan to make. We used all this information to plan our inspection.

During the inspection

We looked at 3 staff recruitment files and looked at 5 care plans. We spoke with 6 staff in depth and others whilst in the office. We spoke with 5 relatives and/or friends of people receiving care on the telephone. We looked at a range of records used to run the service including policies, training records and governance records.

Updated 13 September 2023

About the service

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.