Casa di Lusso

Updated 23 July 2020

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. This was a targeted inspection to check a specific concern we had about the risks relating to falling from height.

Inspection team

The inspection was carried out by two inspectors.

Service and service type

Casa Di Lusso is a ‘care home’. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Notice of inspection

We gave a short period notice of the inspection to ensure we could manage the risks related to Covid 19.

What we did before the inspection

We reviewed other information that we held about the service such as notifications. These are events that happen in the service that the provider is legally required to tell us about.

During the inspection

We completed observations of the home’s balconies. We spoke with six members of staff, the registered manager and the operations manager. We reviewed 12 people’s care plans and risks assessments relating to the risk of falling from height. We reviewed the providers risk assessments.

After the inspection

We requested additional information sent by the registered manager relating to the action they took following an incident.

Updated 23 July 2020

This inspection took place on 3 and 4 December 2018, the first day was unannounced.

We last undertook a comprehensive inspection at Casa Di Lusso in October 2017, at this inspection the service was rated ‘Requires Improvement’.

We undertook an unannounced focused inspection in June 2018 in response to concerns we had received about the service. At the focused inspection we inspected the service against three of the five questions we ask about services: is the service well led, safe and effective. We found two breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. Staff had not received all of the training required to ensure people and staff were safe during incidents and the systems in place to monitor and improve the quality and safety of the service had not been fully effective. We also found one breach of the Care Quality Commission (Registration) Regulations 2009. This was because the provider had not notified the Care Quality Commission and the local authority of safeguarding incidents in line with their legal responsibility.

During this comprehensive inspection we found that improvements had been made, and where improvements were required, the provider had systems in place that identified all except one of the improvements and actions needed.

Casa di Lusso is a purpose built 90 bedded care home specialising in the care of people living with a dementia. At the time of the inspection there were 65 people living at the home. The home is split into eight units all with Italian names, Colosseum, Tuscany, Positano, Pantheon, Pisa, Trevi, Vesuvius and Pompeii.

There was a manager in post who had submitted an application to become the registered manager. The first day of our inspection was the managers first day at the home. 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 Quality and Performance manager was responsible for managing the service prior to the manager being in post and they were continuing this through the managers induction.

Some areas of the care plans needed to be improved. Care plans did not always contain enough detail to inform staff on how to support people with all of their needs and preferences. The provider had a plan in place to address this.

People told us they felt safe living at Casa di Lusso, people’s relatives also thought they were safe. There were systems in place to analyse and review incidents when they occurred and action was taken following incidents to prevent a reoccurrence.

There were systems in place to protect people from harm and abuse. Staff understood their responsibilities to keep people safe from harm.

Risks to people were identified and management plans were put in place to reduce risks. People’s medicines were managed safely.

We received mixed feedback from people regarding the staffing levels at the home. Staff and relatives told us staffing levels had improved. Our observations were that there were enough staff available to respond to people and meet their needs.

There were systems in place to ensure suitable staff were recruited to the home.

There were systems to protect people from the risk of infection. There were a range of checks in place to ensure the environment and equipment in the home was safe. We found the water temperatures were not being consistently taken, the provider addressed this immediately and confirmed temperatures were within a safe temperature range.

People’s rights were protected because the correct procedures were followed where people lacked capacity to make specific decisions for themselves.

The provider had met their responsibilities with regards to the Deprivation of Liberty Safeguards (DoLS). DoLS is a framework to approve the deprivation of liberty for a person when they lack the mental capacity to consent to treatment or care and need protecting from harm.

People’s nutritional needs were assessed and their weights were monitored where required. Our observation of the mealtime experience was mixed. People commented positively about the food.

People were supported to access a range of healthcare professionals. The home maintained links with the local community.

Staff had access to a range of training to meet people’s needs. Although formal one to one supervision had not been completed consistently staff told us they felt supported. There were plans in place to ensure staff received regular one to one supervision.

People and their relatives spoke positively about the staff supporting them. People told us staff knew them well and treated them with dignity and respect. People were supported to make decisions about their day to day lives.

Relatives told us they were happy with the support they and their family members received at the end of their lives.

There were a range of activities on offer that people could attend if they chose. People and their relatives felt able to raise any concerns with staff. Complaints that were raised, were responded to.

People, their relatives and staff had the opportunity to provide feedback on the service.

Relatives, staff and health professionals commented positively about the management of the service.