The inspection took place on 1 February 2017 and was unannounced.

The Lighthouse Selsey provides care and accommodation for up to nine people and there were six people living at the home when we inspected whose ages ranged from 20 to 62 years. People had needs associated with learning disability and mental health. The service promoted people to be independent and to access community facilities. The service is also registered to provide personal care to people who live in the community in their own homes; at the time of the inspection there were no people in receipt of personal care in their own homes.

All bedrooms were single. Six bedrooms had an en suite toilet and one had an en suite shower and toilet. Communal toilets and bathroom s were also provided on each floor. There was a communal lounge and dining area which people used.

The Lighthouse Selsey was last inspected in November 2014 and was rated “Good” overall. At this inspection we found that the service remained “Good” overall. At the last inspection there was a concern raised with the provider about the safety of the premises which has now been resolved.

The service did not have a registered manager at the time of the inspection but there was a manager in post who had applied for registration with the Commission. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

Staff were trained in adult safeguarding procedures and had a good awareness of what to do if they considered people were at risk of harm or if they needed to report any suspected abuse. People said they felt safe at the home.

Care records showed any risks to people were assessed and there was guidance of how those risks should be managed to prevent any risk of harm.

There were sufficient numbers of staff to meet people’s needs. Staff recruitment procedures were adequate and ensured only suitable staff were employed.

Medicines were safely managed. People were supported and monitored to handle their own medicines where this was assessed as safe.

Staff were trained and supervised so they provided effective care to people.

The CQC monitors the operation of the Mental Capacity Act (MCA) 2005 and the Deprivation of Liberty Safeguards (DoLS) which applies to care homes. Staff were trained in the Mental Capacity Act 2005 and the Deprivation of Liberty Safeguards (DoLS). People’s capacity to consent to their care and treatment was assessed and applications made to the local authority where people’s liberty needed to be restricted for their own safety.

People were involved in choosing and preparing meals with the support of staff.

People’s health care needs were assessed, monitored and recorded. Referrals for assessment and treatment were made when needed and people received regular checks such as dental and eyesight checks.

People said they were treated well by the staff and were fully involved in planning their care and lifestyle. The service promoted people to develop independence and to access community facilities.

Care plans were individualised and showed people received person centred care. Person centred care ensures the person is at the centre of arrangements for their support taking account of their individual wishes, needs, circumstances and health choices. People attended a range of activities based on what they wanted. The service promoted to people to access employment and support groups.

People said they had opportunities to express their views or concerns. There was a record to show complaints were looked into and any actions taken as a result of the complaint.

The culture of the service was person centred. Staff demonstrated values of treating people as individuals and promoting people having a

This inspection focused on the domiciliary care agency operated from The Lighthouse Selsey as the agency had not been inspected since the service was registered with us to operate from this location. Since our last inspection, a new manager had been registered for both the domiciliary care agency and the residential care home. During our inspection we spoke with the manager, the deputy and two care workers. The manager informed us that although the domiciliary care agency provided a service to a number of people in their own homes, only one received support with personal care. As part of our inspection we visited this person in their own home and talked to them about the service they received from the agency. They told us that their support was personalised to their needs and that the care workers were well trained and understood their needs. They also told us that they felt safe, and if they had concerns, they would speak with either the deputy or manager of the agency. Overall, they said, "I'm happy with the help I get." Our evidence supported the comments made by this person.

We spoke with three of the seven people who lived at the service. They all told us that they were happy with the support they received. They also told us that lots of changes had taken place at the service, all of which they were happy about. As one person explained, "The new manager is lovely. There has been lots of decoration and new carpets. We are so busy here, its lovely". Another person told us, "Everything is great here, I'm very happy thank you". The evidence we gathered during our inspection supported the comments made by people.

People that we spoke with expressed the view that staff were appropriately trained to meet their needs. Observations that we made during our inspection supported people's views. Staff were seen responding appropriately to meet people's needs. Also, when talking to the manager she appeared knowledgeable of people's conditions.

We spoke with five of the people who lived at the service. They all said that in the main they were happy with the service they received. They said that they were given choices with regards to meals, activities and other aspects of their care. Our evidence supports this. One person told us, “We have house meetings monthly to talk about what we want to do. In the past we had to go to bed at 10pm but now we can stay up till what time we choose”.

Everyone told us that they had a key worker who supported them and helped them make decisions about their care. For example, one person said, “X is my key worker; she is a nice lady and always comes to my reviews. I chose her; she talks nicely to me and is very helpful”.

People told us they felt safe living at the service. Our evidence does not support this. For example, appropriate action had not been taken to reduce risks to peoples health needs, staff had not been trained to meet people’s needs safely and effective monitoring of the service had not taken place.

We also spoke with the acting manager, the nominated individual and the two care assistants who were on duty. They agreed with the areas of non compliance that we identified. For example, the manager said, “I have only been here two weeks and my priority has been reviewing the care plans. There is no quality assurance in place, no audits completed and staff have not had any training as far as I can see for a long time”.

We spoke to people who use the service and also some relatives. People told us that they like living at The Lighthouse Selsey and that the staff were kind. They said that staff treat them well and that there was always someone around to help. People said they are happy with the care they received, that staff help them do things and that they are assisted in their preferred way

People said they were consulted about their care, although people were not aware if they had a care plan or if they had agreed to it. All of the people we spoke with knew they had a keyworker (this is a named members of staff who gives one to one support) and knew who this person was.

Family members told us that their relatives were supported by the staff to receive the care they needed. They said that people were given as much choice as possible and that they were encourages to live as independently as possible.

Families told us they knew what action they should take if they had any cause for concern and they said that they felt that the home would respond appropriately to any concerns that may be raised.

Staff said that they would always respect people’s wishes and when asked what they would do if they felt there may be a conflict between a person’s wishes and their care needs they told us that they would speak with the manager.

The inspection was unannounced and took place on 11 and 20 November 2014.

The Lighthouse Selsey is a nine bed residential care home that provides support to adults with learning disabilities and autism. People have different communication needs; however, everyone was able to verbalise their thoughts and feelings. The main ethos of the home is to support people to gain further independence and social skills. A domiciliary care agency is also operated from the same address as the care home, but has separate office facilities to avoid encroaching on the lives of people who live in the care home. At the time of this inspection, there were six people living at the home and one person who was receiving personal care from the domiciliary care agency.

During our inspection the manager was present. The manager had been in post for a month prior to our inspection. We were informed that the manager would not be registering with the Care Quality Commission and that a new person who had been recruited to manage the home would be submitting an application. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The service had good systems in place to keep people safe. People told us they felt safe. Staff were aware of their responsibilities in relation to safeguarding. The manager was clear about when to report concerns and the processes to be followed in order to keep people safe.

People were able to make choices, to take control of their lives and be supported to increase their independent living skills. Risk assessments and support plans were in place that considered potential risks to people. Strategies to minimise these risks were recorded and acted upon. People were safely supported to manage their medicines independently or with support if needed. People were supported to access healthcare services and to maintain good health.

There were enough staff on duty to support people and meet their needs. Appropriate recruitment checks were completed to ensure staff were safe to support people. Staff were sufficiently skilled and experienced to effectively care and support people to have a good quality of life. People told us that they were happy with the support they received from staff. Staff received training, supervision and appraisal that supported them to undertake their roles and to meet the needs of people.

The Lighthouse Selsey met the requirements of the Deprivation of Liberty Safeguards (DoLS) and people confirmed that they had consented to the care they received. Staff were kind and caring and people were treated with respect. Staff were attentive to people and we saw high levels of engagement with them. Staff knew what people could do for themselves and areas where support was needed.

People were supported to express their views and to be actively involved in making decisions about their care and support. Everyone had a key worker who they met with on a monthly basis to discuss the previous month’s events and also to plan the next months. Staff knew in detail each person’s individual needs, traits and personalities. People were supported to access and maintain links with their local community. The importance of community links and social inclusion was reinforced in peoples support plans. Support plans were in place that provided detailed information for staff on how to deliver people’s care. The files were well- organised, containing current and useful information about people.

The Lighthouse Selsey was well-led by a manager who encouraged people to work collaboratively to provide an holistic approach. Care was personalised and empowering, enabling people to take control of their lives and make decisions and choices. The manager was committed to providing a good service that benefited everyone.

Regular meetings were held with people, staff and relatives and friends of people which encouraged open and transparent communications between them and management. In addition, quarterly newsletters and annual questionnaires were used to find out people’s views, and where necessary make changes to the service and drive improvements. People were routinely listened to and their comments acted upon. Monthly meetings took place where people could raise issues and a pictorial complaints procedure was in place that supported people to understand formal complaint processes.

Quality assurance audits were completed for both the care home and the domiciliary care agency which helped ensure quality standards were maintained and legislation complied with. Accidents and incidents were acted upon and reviewed to prevent or minimise re-occurrence.