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0151 230 8957

Lighthouse Lodge

Service Provider

Athena Healthcare Group

Address

1 Alexandra Road, Wallasey, CH45 0JZ

Authorised Representatives

Tricia Harrison, Denise Williams, Elaine Evans

Acknowledgements

Healthwatch Wirral would like to thank Athena Healthcare Group for welcoming Healthwatch Authorised Representatives who visited to view the facility and talk to staff, patients and visitors on 25/04/2019.

Please note that this report relates to findings observed on the specific date and time of the visit. Our report is not a representative portrayal of the experiences of all service users and staff, only an account of what was observed and contributed at the time.

What is Enter and View?

Part of the Healthwatch Wirral’s work programme is to carry out Enter and View visits. Local Healthwatch representatives carry out these visits to health and social care services to find out how they are being run and make recommendations where there are areas for improvement.

The Health and Social Care Act allows local Healthwatch Authorised Representatives to observe service delivery and talk to service users, their families and carers on premises such as hospitals, residential homes, GP practices, dental surgeries, optometrists and pharmacies.

Enter and View visits can happen if people tell us there is a problem with a service but, equally, they can occur when services have a good reputation – so we can learn about and share examples of what they do well from the perspective of people who use the service first hand.

General profile of the service that was entered and viewed

Lighthouse Lodge is a large new purpose built residential and nursing care home situated close to local amenities in New Brighton. This new build was completed and opened in November 2018. The home has 4 floors serviced by a lift. Outside is a car parking area and the building is set in small landscaped gardens. Lighthouse Lodge provides residential and nursing care for up to 80 people. At the time of our visit there were 26 people living at the home.

Purpose of visit

Familiarisation

Type of Enter & View visit undertaken

Announced Visit

Methodology

The visit is not designed to be an inspection, audit or an investigation, rather it is an opportunity for Healthwatch Wirral and Elected members to get a better understanding of the service by seeing it in action and talking to staff, service users and carers/relatives. If during a visit, Healthwatch Wirral identifies any aspects of a service that it has serious concerns about, then these concerns are to be referred to the appropriate regulator or commissioners of the service for investigation or rectification. Any safeguarding issues identified will be referred to the Local Authority or Commissioner for investigation.

The rectification of less serious issues may be directly with the service provider on the day.

Enter and View visits are conducted in a way that works in accordance with Merseyside Safeguarding Adults Board’s principles and procedures. Information will be shared accordingly in order to safeguard adults at risk on Wirral and promote quality of local services.

Discussions, findings and observations

General Profile of Service

Lighthouse Lodge is a large new purpose built residential and nursing care home situated close to local amenities in New Brighton. This new build was completed and opened in November 2018. The home has 4 floors serviced by a lift. Outside is a car parking area and the building is set in small landscaped gardens. Lighthouse Lodge provides residential and nursing care for up to 80 people. At the time of our visit there were 26 people living at the home.

Discussion with Manager

We were welcomed by a member of staff who asked us to sign in and escorted us to the Manager’s office for a discussion about the home.

We were informed that Lighthouse Lodge works alongside health and social care commissioners and agencies to help provide the most appropriate care and support for people’s health and wellbeing. The care given is person centred and individual needs are assessed according to cultural background, language, gender, disability, age, sexuality, religion and beliefs.

The Manager reported that the facilities at Lighthouse Lodge are arranged over four floors to meet the varying needs of residents and each floor has a nurse station.

The home currently provides 41 residential beds, 18 Nursing beds and 21 EMI beds.

Healthwatch Authorised Representatives were informed that the two lower floors are designed for people with higher levels of dependency who require full assistance with daily life and personal care. This includes residents who may have Dementia, Alzheimer’s or Parkinson’s disease. It was also reported that the design of the home helps guide residents around the facilities and clever use of colour helps residents living with dementia manage spatial awareness.

As well as providing short and long term care Lighthouse Lodge provides respite care for people making the transition from hospital to home following medical treatment.

The home welcomes individuals and couples who may want to live in a care home setting but keep their independence. Lighthouse Lodge may also consider providing care for people with learning disabilities in the future.

The upper floors provide a ‘hotel-style’ level of service for residents who are more able and have a relatively low level of dependency.

We were informed that all of the bedrooms have en-suite facilities, specialist profile beds, wireless call systems, flat screen TV and telephone and internet connection. Married couples can be accommodated in the same bedroom and have a separate ‘living room’ Residents may also personalise their own rooms.

Visitors are made welcome and the home is in close proximity to New Brighton’s train station, making it easy for residents’ relatives to visit.

Care Plans

We were informed that care plans are person centred and reflect people’s needs and wishes. Staff use hand held devices to input data onto a residents care plan.

Staff and Training

We were informed that the home currently employs 32 care staff. The Manager reported that staffing levels are adequate to provide safe care to the 26 people currently residing in the home.

The home uses bank staff or their own staff to cover any absences.

Staffing Levels

  • Day – 1 RGN, 2 SCA’s and 4 HCA’s
  • Night – 1 RGN, 2 SCA’s and 3 HCA’s

All staff receive an induction, 6 supervisions per year, or more if required, and an annual appraisal.

Training

All staff have up to NVQ level 3 and have received mandatory training in core subjects.

We were informed that the home uses state of the art technology and on-site training facilities to provide staff with the latest qualifications which include Care Planning, MCA, COSSH, Fire Safety, Food Safety, GDPR, H&S, Infection Control, Challenging Behaviour, Medicines Management, Nutrition and Hydration, SOVA and Moving & Handling.

Staff have completed the End of Life workshop but the home does not currently participate in the ‘6 Steps’ End of Life training. However, the home intends to do so in the near future.

This home does not currently participate in the Tele-triage System Scheme but intends to join soon.

Health and Safety
Lighthouse Lodge uses the PEEPs evacuation procedure and practices the procedure along with conducting regular fire drills.

The home employs a maintenance person who manages and looks after the equipment and building maintenance requirements.

The local fire service also provide the home with advice and support.

Medication Management

It was reported that the home stores medicines and controlled drugs securely in a locked cabinets in locked rooms. Nurses and senior care assistants administer and manage medication.

Nutrition and Hydration

We were informed that Lighthouse Lodge has a team of chefs who produce home-cooked meals. Meals are balanced and nutritious in accordance with the needs and any special dietary requirements of the residents.

Snacks and drinks are available throughout the day and family and friends are welcome to join residents for meals by prior arrangement.

Dietary intake is monitored using the MUST tool (Malnutrition Universal Scoring Tool) Residents are weighed when they arrive at the home and their weight is regularly monitored and recorded. When applicable, dietary supplements are provided. All staff are aware of the need for adequate hydration and nutrition for residents and drinks are offered on a regular basis. Care staff are on hand to assist residents with their dietary needs. We were informed that residents are given a good choice of food and staff know individual preferences.

Safeguarding

The Manager informed Healthwatch Representatives that all alerts are reported and investigated.

Complaints

The home has a complaints policy and all staff and residents are aware of how to proceed if they wish to make a complaint.
Complaints are dealt with in house and the manager has an open door policy.

The Manager reported that all complaints are investigated and the outcomes are fed back to the person or family making the complaint.

DoLS and DNAR’s

The home follows legal requirements and best practice guidelines.

Falls Management

Falls are recorded in the on line care plan system. Risk assessments are carried out and the home uses specialist equipment such as alarmed mats to prevent falls. Residents may also be referred to the Community Falls Team.

Visiting Services

We were informed that Lighthouse Lodge has a good relationship with visiting professionals who provide a range of services for the benefit of the residents.

Management and staff work closely with local health and social care providers who visit the home on a regular basis or who make visits by prior arrangement. These include local GPs, district nurses, an optician and chiropodist.

Residents, who come to live at the home, have a choice of remaining on the list of their previous GP (subject to the practice agreeing to this) or they can choose a local GP.

Activities

We were informed that Lighthouse Lodge employs Activities Co-ordinators for 60 hours per week and will be recruiting a further 25 hours for activities for the top floor. The home provides a full programme of activities for residents to enjoy. These include trips out to local cafes and visits to the cinema, local parks, markets and shops in and around New Brighton as well as organised excursions to local places of interest.

Residents are also encouraged to continue with their pastimes and interests.

It was reported that Lighthouse Lodge organises its own activity groups in the care home such as knitting, dancing, painting and exercises. There are regular celebrations for landmark days, birthdays and events.

Other services available

Lighthouse Lodge is equipped with its own hairdressing salon and a dedicated hairdresser is available for appointments.

Quality Monitoring

It was reported that Lighthouse Lodge monitors the quality of the service it provides by conducting weekly and monthly audits, monitoring complaints, daily meetings, management walk arounds, unannounced weekend and night visits and visits from the Regional Manager.

Environment

Reception

The entrance to the home was via a secure door controlled from within the building. On entry, Healthwatch Authorised Representatives were asked to sign in the visitors’ book.

We noticed that there were no facilities to clean our hands with sanitiser. This was brought to the attention of the Manager who informed us that the sanitisers were on order.

The reception staff were welcoming and friendly.

There was a small notice board displaying statutory notices and information in the entrance area.

The reception area was large, bright and clean. This area was decorated to a high standard and comfortably furnished. Items were on display in the ‘Curiosity Shop’ and there was also a ‘Bistro Cafe’ area for residents to use.

The corridors were clean, fresh and free from obstruction. They were well lit, had hand rails and were wide enough to enable residents to move around safely.

Glass display cabinets were inset along the corridors and ‘Rummage bags’ and other items were attached to the walls on the dementia unit/floor. Signage was dementia friendly in the appropriate areas.

Communal Lounges/Dining Area

The communal lounges viewed were spacious, bright, tidy and clean. The rooms were decorated to a high standard and the seating looked comfortable. The chairs were placed in groups to aid conversations and any group activities. These areas felt homely and were laid out to give a social space and privacy if needed.

Each of these rooms had a kitchenette and dining area which were spacious and appeared to be clean and tidy. Dining areas were well presented and menus displayed showed a plentiful choice of food.

Call bells were placed within reach for residents using these facilities.

Toilets and Bathrooms

The toilets and bathrooms viewed on the day were clean, tidy, fresh and were equipped with appropriate specialist bathing facilities and safety equipment. Call bells were placed within reach for residents using these facilities.

However, one of the toilets had no toilet tissue and this was reported to the Manager who had it replaced straight away.

Bedrooms

The bedrooms viewed were decorated and furnished to a high standard and were clean and tidy.

All the residents’ rooms viewed were spacious and had an ensuite wet room. Call bells were within reach and all rooms had specialist profile beds. Residents have input into how their rooms are decorated and it was evident that they can personalise their own rooms.

Kitchen

The kitchen had an environment rating of 5. It was clean and organised and appeared to be well equipped. Staff informed us that they were aware of residents’ nutritional needs and preferences and all residents have food passports.

Laundry

Laundry is done on site and the laundry room was tidy and organised. Staff, residents and relatives all understand laundry arrangements at the home.

Lifts

The two lifts were bright and clean and had call bells to use in an emergency. One lift was large enough to accommodate a stretcher.

Balcony / Terrace

The balcony area on the top floor was furnished to a high standard and provided panoramic views across the river.

External Areas

The external areas included small paved areas, gardens and a carpark. They appeared to be well maintained

Staff Observations

During our visit staff throughout the home were observed treating residents with dignity and respect.

Activities were being carried out in a room on the second floor and on the top floor, and staff were observed interacting well with residents.

We spoke to several members of staff who reported that they were happy working at Lighthouse Lodge and that they felt supported by management. Two newly recruited care staff reported that their induction and training was comprehensive.

Residents

The residents looked clean and tidy and appeared to be happy.

Several residents on the top floor were being entertained by another resident who was playing the piano.

Residents who spoke to Healthwatch at the time of the visit said that they liked living in Lighthouse Lodge and that staff treated them well.

Conclusions

  • Within the limits of a short visit, Healthwatch representatives found that residents appeared to be well cared for, happy and contented.
  • The atmosphere was welcoming and friendly
  • The impression gained during our visit was that the staff were appropriately trained and motivated.
  • Residents we spoke to were very satisfied with all aspects of their care, and felt that they could approach staff with any concerns that they may have.
  • Overall the impression was of a new high quality facility with a caring and motivated Manager who appeared to be closely involved with all aspects of the home.

Recommendations and Considerations

  • Install hand sanitiser throughout the home.
  • Liaise with other organisations to access further ideas to enhance the Dementia Friendly Environment within the home.
  • Access the End of Life 6 Steps training programme.
  • Participate in the Teletriage Scheme

Post-visit supplementary feedback from the provider

I would like to thank the Team from Health Watch for their kind words, it was a pleasure to host your visit to Lighthouse Lodge. I can confirm that following your visit hand sanitisers have been installed throughout the home. I can also confirm that we have been asked by the Advanced Nurse Practitioner to take part in a pilot scheme which utilises Skype to allow residents access to GP services, this is something I am very excited about. I would like to thank the team at Health Watch for the information they have sent me regarding the House of Memories training which I will be taking advantage of.

Healthwatch follow-up action

  • Provide the home with the contact details for the Dementia Lead Matron at the local Hospital Trust – done
  • Provide the home with the contact details for the House of Memories Dementia Training Programme – done
  • Provide Manager with Healthwatch Checklist ‘How to create a dementia friendly environment in a care home’ – done
  • Revisit in 12 months to see how the home evolves as occupancy increases and review implementation of planned training programmes.

Glossary

COSHH – Control of Substances Hazardous to Health
DNAR – Do Not Attempt Resuscitation
DOLs – Deprivation of Liberty Safeguards
EMI – Elderly Mentally Infirm
GDPR – General Data Protection Regulation
H&S – Health and Safety
HCA – Healthcare Assistant
MCA – Mental Capacity Act
MUST – Malnutrition Universal Screening Tool
NVQ – National Vocational Qualification
PEEPS – Personal Emergency Evacuation Plan
RGN – Registered General Nurse
SCA – Senior Care Assistant
SOVA – Safeguarding of Vulnerable Adults

Distribution of Report

Healthwatch Wirral will submit the report to the Provider, Commisioner and to CQC.

Healthwatch Wirral will publish the report on its website and submit to Healthwatch England in the public interest.

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