The Lighthouse Selsey, a nine-place residential care home for people with learning disabilities and/or autism, retained its overall Good rating across all inspected key questions (Safe, Effective, Well-led) at a focused inspection on 27–28 April 2023. The service demonstrated strong person-centred culture, safe medicine management aligned with STOMP principles, effective safeguarding, and robust governance led by a visible and capable registered manager.
Strengths
· Active support approach promotes people's independence, participation in daily life and community inclusion, including voluntary employment
· Staff know people well, understand individual communication needs, and support people using Makaton and pictorial prompts
· Medicines managed safely with STOMP principles applied; competency checks and audits in place
· Robust safeguarding processes with staff confident to report concerns internally and externally
· Effective MCA and DoLS governance with capacity assessments well-documented and least-restrictive practices evidenced
Quality-Statement breakdown (16)
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and management; Learning lessons when things go wrongGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced dietGood
effective: Supporting people to live healthier lives, access healthcare services and supportGood
effective: Adapting service, design, decoration to meet people's needsGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: How the provider understands and acts on the duty of candourGood
well-led: Managers and staff being clear about their roles, and understanding quality performance, risks and regulatory requirementsGood
well-led: Engaging and involving people using the service, the public and staffGood
well-led: Continuous learning and improving care; Working in partnership with othersGood
The Lighthouse Selsey, a nine-bed residential care home for people with learning disabilities and/or autism, was rated Good across all five key questions at its inspection on 30 December 2019. The service demonstrated consistent person-centred practice, safe medicines management, strong community integration, effective multi-agency working, and a transparent, well-structured governance and leadership culture.
Strengths
· People felt safe and staff had thorough knowledge of individuals' needs, including complex conditions such as epilepsy and diabetes
· Medicines were managed safely with annual competency reviews and person-centred administration protocols including photographs and individual preferences
· Person-centred care plans captured likes, dislikes, communication needs and preferences; regularly reviewed and updated
· Staff supported people to develop independence skills, including self-medication, cooking, shopping and accessing community activities
· Strong culture of openness, transparency and person-centred leadership modelled by the registered manager
Quality-Statement breakdown (22)
safe: Systems and processes to safeguard people from the risk of abuseGood
safe: Assessing risk, safety monitoring and management; Learning lessons when things go wrongGood
safe: Staffing and recruitmentGood
safe: Using medicines safelyGood
safe: Preventing and controlling infectionGood
effective: Assessing people's needs and choices; delivering care in line with standards, guidance and the lawGood
effective: Staff support: induction, training, skills and experienceGood
effective: Supporting people to eat and drink enough to maintain a balanced diet
The Lighthouse Selsey was rated Good across all five key questions at its February 2017 inspection, with no breaches of regulation identified. The service demonstrated strong person-centred care, effective governance, and had successfully resolved the premises safety concern noted at the previous inspection.
Strengths
· Premises were safe and well maintained, with previous safety concern about unlocked cupboard resolved
· Sufficient staffing levels maintained, including dedicated one-to-one care where assessed as needed
· Medicines safely managed with competency assessments for staff and supported self-administration where appropriate
· Staff trained in safeguarding, MCA, DoLS, and a range of relevant courses; five of eight staff held or were studying NVQ level 2 or above
· Regular staff supervision with a planned schedule; staff felt supported and able to raise concerns
The Lighthouse Selsey was rated Good overall following an unannounced inspection in November 2014, with all key questions rated Good except Safe which requires improvement due to illegible controlled drug records and an unassessed dual-mechanism fire door handle. The service demonstrated strong person-centred care, effective community integration, and well-led governance, with no formal enforcement action taken.
Concerns (3)
moderateMedication management: “Records in the controlled drugs book were not always legible and easy to follow. Pages had not always been completed in full before a new page was started, without any obvious explanation.”
moderateRecord keeping: “medication records were not always legible and accurate and therefore could not be used to monitor that people received their medicines safely.”
minorStaff training: “Staff told us that they had not received training on Autism despite providing care for two people with autism.”
Strengths
· People felt safe and staff demonstrated clear understanding of safeguarding responsibilities
· Robust risk assessments and personalised support plans promoted independence and autonomy
· Strong person-centred culture with care plans written in the first person reflecting individual preferences
· Sufficient staffing levels maintained with thorough recruitment checks in place
· People actively involved in decisions about their care, meals, and the running of the home
Good
effective: Staff working with other agencies to provide consistent, effective, timely care; Supporting people to live healthier livesGood
effective: Adapting service, design, decoration to meet people's needsGood
effective: Ensuring consent to care and treatment in line with law and guidanceGood
caring: Ensuring people are well treated and supported; respecting equality and diversityGood
caring: Supporting people to express their views and be involved in making decisions about their careGood
caring: Respecting and promoting people's privacy, dignity and independenceGood
responsive: Planning personalised care to ensure people have choice and control and to meet their needs and preferencesGood
responsive: Meeting people's communication needsGood
responsive: Supporting people to develop and maintain relationships; support to follow interests and take part in activitiesGood
responsive: Improving care quality in response to complaints or concernsGood
responsive: End of life care and supportGood
well-led: Promoting a positive culture that is person-centred, open, inclusive and empoweringGood
well-led: Managers and staff being clear about their roles; continuous learning and improving care; duty of candourGood
well-led: Engaging and involving people, the public and staff; working in partnership with othersGood