Lighthouse is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Lighthouse does not provide nursing care. It is registered for up to 14 people who are living with a learning disability and have complex behavioural needs. At the time of our inspection there were 13 people using the service. The service was rated good at our last inspection in November 2015. At this inspection, we found the service had made continual improvements, therefore we rated it as overall outstanding.

There was a registered manager in post. 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 worked extremely well in partnership with others to ensure that people received support that met their complex needs. People received good quality healthcare tailored to meet their own individual requirements.

The building was undergoing many improvements; it was safe and was adapted to meet the needs of people using the service. There was good outside space where people could enjoy the well-kept gardens. People had as much choice and control over their lives as possible. The service worked in line with other legislation such as the Mental Capacity Act 2005 (MCA) and had completed mental capacity assessments and Deprivation of Liberties (DoLS) where required to ensure people’s rights and freedoms were respected and protected.

Staff were kind, caring and compassionate. They understood people’s individual circumstances and ensured that people were supported in a way that respected their dignity, privacy and independence. People were actively involved in every aspect of their lives; they made daily decisions about their care and support. Staff supported people emotionally and promoted their sense of well-being and pride.

People received exceptional person-centred care that was extremely responsive to their complex changing needs. The care and support plans ensured that people were encouraged and supported to develop and maintain the skills to lead a full and happy life. People enjoyed many activities both inside and outside of the service. They had good community links, and annual holidays both in England and abroad. There was a good complaints process in place and people felt able to raise any concerns, which were dealt with quickly.

The deputy managers worked together under the supervision of the registered manager to ensure that people received a high-quality service. Staff shared their vision to provide people with person centred care that gave them control, choice and independence and enabled any barriers to this aim to be removed. The quality assurance system and processes were exceptionally effective. The service had recognised where improvements were needed through their many audits, and had learnt from mistakes and taken the necessary steps to make continuous improvements. The registered manager, together with their two deputy managers ensured that all interested parties were kept fully involved and worked extremely well with other professionals to ensure that people received excellent person-centred care.

People were protected from the risk of harm and abuse. Staff were well trained and demonstrated an excellent knowledge of their responsibilities to protect people. There were policies and procedures in place and staff knew how to implement them. Risks were well managed, and people were supported to undertake every-day risks safely to enhance their lives and improve their independence. Staffing levels were extremely good and they enabled people to access the local community

People we spoke with told us that they were happy, safe and well cared for at Lighthouse.

We saw that care and treatment for each person was planned and reviewed with their involvement and consent as far as possible. Risks to the health, welfare and safety of people using the service were identified and well managed.

Staff were well trained and supported to care for people properly and to keep them safe.

The service was well managed and there were effective systems in place for monitoring and improving the quality and safety of the service, taking into account the views and suggestions of people living there.

This inspection took place on the 16 November 2015 and 17 November 2015 which was unannounced, the inspection team consisted of one inspector on both days.

Lighthouse is a residential care home registered to provide personal care and support for up to 14 people with learning disabilities and on the autism spectrum. In the last year the service has expanded from an eight [8] bedded service to a 14 bedded service with the addition of six [6] respite beds.

The service has a registered manager. ‘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 a legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.’

Suitable arrangements were in place to ensure that people received appropriate care and support to meet their needs. Staff knew the needs of the people they supported and they were treated with respect and dignity. People’s healthcare needs were well managed and they had access to a range of healthcare professionals.

People’s needs were met by sufficient numbers of staff. Suitable arrangements were in place to ensure that staff had been recruited safely; they received opportunities for training and supervision. People were safeguarded from harm; Staff had received training in Mental Capacity Act (MCA) 2005 and had knowledge of Deprivation of Liberty Safeguards (DoLS). The manager was aware of how and when to make a referral. People had sufficient amounts to eat and drink to ensure that their dietary and nutrition needs were being met.

People were provided with the opportunity to participate and engage in activities of their choice which met their needs. Relatives and people who used the service knew how to make a complaint and we felt reassured that all complaints would be dealt with and resolved efficiently and in a timely manner.

The service had a number of ways of gathering people’s views which included holding meetings with people, staff, and relatives. The manager carried out a number of quality monitoring audits to help ensure the service was running effectively and to help them make improvements.