CQC report explained · a nursing home
What the CQC found at Casa di Lusso
Rated Good: inspectors found the home performing well and meeting their expectations.
What inspectors found, July 2020
Targeted inspection not rated; the previous Good rating remained, and balcony fall risks were being managed.
Inspectors visited the home on 25 June 2020 after a specific concern about people falling from balconies. They observed the balconies, spoke with staff and managers, checked 12 care plans and risk assessments, and reviewed the home's risk assessments.
They found that balcony risks had been assessed. Signs said balcony doors should stay locked, and people should only enter with a staff member present. Staff understood the safety procedures, and extra checks had been introduced after a recent incident.
This was a targeted inspection, not a full review of the home. The visit was marked 'Inspected but not rated'. The previous overall rating was Good, published in January 2019, and it remained Good.
Balcony risk controls
The home had assessed the risks of people accessing balconies and put controls in place.
“Risks relating to people accessing the balconies had been assessed and mitigated.” from the report
Staff understanding
Staff could explain the procedures they needed to follow to keep people safe.
“Staff were able to explain the procedures that should be followed to keep people safe.” from the report
Extra safety checks
The home had added checks to make sure balcony doors were properly secured, and managers carried out spot checks.
“A member of the maintenance team explained how further checks had been completed to ensure balcony access doors were fully secured when closed” from the report
Learning from an incident
Staff said learning from a recent balcony incident had been shared through meetings, supervision and briefings.
“They told us that learning from the incident had been undertaken through meetings, supervisions and briefings.” from the report
Inspectors raised no specific concerns in this report.
- 01How often are the balcony spot checks completed, and how are the results recorded?
- 02How do you make sure balcony doors stay locked and fully secured when closed?
- 03What specific changes were made after the recent balcony incident?
- 04How often are people's risk assessments about balcony access reviewed?
- 05How do you check that all staff continue to follow the balcony safety procedures?
This was a targeted inspection of the specific concern about falling from height and did not assess the whole Safe key question or the other key questions; the previous ratings carried over. This explanation was written from the published report of 23 July 2020 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk.
What inspectors found, January 2019
Casa di Lusso rated Good overall; inspectors found safe, kind care and better management, but care plans needed improvement.
Inspectors visited on 3 and 4 December 2018. The first day was unannounced. They spoke with people, relatives, staff and a visiting professional, observed care, and checked care records, medicines, staffing, training and management records.
The home was rated Good overall. Safe, Effective, Caring and Well-led were rated Good. Responsive was rated Requires Improvement because care plans did not always give enough detail about people's preferences, communication needs and care arrangements.
The inspectors found that improvements had been made since the previous focused inspection in June 2018. People generally felt safe and well cared for. Medicines were managed safely, staff were kind and respectful, and there were activities and healthcare support.
Some issues still needed attention. These included incomplete care plan information, mixed mealtime experiences, inconsistent staff supervision and some gaps in safety records. The home had plans or actions to address most of these issues.
Kind and respectful staff
People and relatives spoke positively about staff. Inspectors saw friendly interactions and found that people's dignity, privacy and choices were respected.
“People and their relatives told us staff were kind and caring.” from the report
Safer medicines management
Medicines were given as prescribed in the records checked. Staff had medicines training and their competence was checked.
“A sample of 20 people's MARs showed that they were given their medicines correctly as prescribed.” from the report
Improvements in management
The home had made progress since the June 2018 inspection. Audits and an action plan were being used to identify and address shortfalls.
“During this inspection we found improvements had been made.” from the report
Activities and community links
People could choose from activities inside and outside the home, including trips, creative activities, visits with children and one-to-one time.
“People had access to a range of activities and some people told us they chose to attend them, whilst others did not.” from the report
Care plans lacked detail
needs fixingSome care plans did not explain people's preferences, routines or communication needs clearly enough for unfamiliar staff. Some wound care instructions had not been followed in full.
“Care plans were person centred in places, but this was not seen consistently.” from the report
End-of-life preferences not always recorded
needs fixingSome end-of-life plans did not include personal, spiritual or special wishes. This could make it harder for staff to provide care that matches the person's choices.
“There were end of life plans in place but these did not always detail people's choices and preferences for how they wanted to be cared for at the end of their lives.” from the report
Mixed staffing feedback
needs fixingSome people and relatives said staff could be rushed or that call bells were not always answered quickly. Inspectors saw enough staff during the visit, but staff said sickness could leave them under pressure.
“We received mixed feedback from people and relatives regarding the staffing levels in the home.” from the report
Mealtime experience varied
minorPeople were offered food and drinks, but choices and staff interaction were not consistent. Inspectors saw one agency worker standing over a person while helping them eat until permanent staff intervened.
“Our observations of staff supporting people during their meal was mixed.” from the report
Some safety checks and records were incomplete
needs fixingThe home had not regularly checked water temperatures itself, although the temperatures were confirmed to be safe during the inspection. Thickening powder was also stored in an unlocked cupboard in a public area.
“We found the home had not completed their own regular checks on the water temperatures to ensure they remained within a safe range.” from the report
- 01How have you updated my relative's care plan to record their routines, personal care preferences and communication needs?
- 02How do you make sure agency and newly moved staff read and follow each person's care plan?
- 03Have all staff completed the training for supporting people who become anxious, and how is their competence checked?
- 04How often are water temperatures now checked and recorded by the home?
- 05How are end-of-life wishes, including spiritual or special wishes, discussed and recorded?
This was a comprehensive inspection covering all five key questions; it followed a focused inspection in June 2018 that looked at Safe, Effective and Well-led. This explanation was written from the published report of 4 January 2019 by an AI system and checked against the report text: every quoted line appears in the report. It is a guide to the report, not a substitute for it. Read the full report on cqc.org.uk. The report was longer than we could read in one go; the later sections may not be reflected.
Every inspection of Casa di Lusso
3 rated inspections over a year: the service has improved, from Requires improvement to Good.
- July 2020Inspected but not ratedcurrent ratingSafe: Inspected but not rated
- January 2019Goodup from Requires improvementSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- July 2018Requires improvementstayed Requires improvementSafe: Requires improvementEffective: Requires improvementWell-led: Requires improvement
- January 2018Requires improvementSafe: Requires improvementEffective: GoodCaring: GoodResponsive: GoodWell-led: Requires improvement
- October 2016
Registered with the Care Quality Commission on 7 October 2016.
Ratings and report dates from the Care Quality Commission, Open Government Licence v3.0. A home can also be visited without a new rating being published, so the timeline shows published inspections.
Weigh the report against the rest
Fees, photos and reviews from families
How to read CQC ratings and reports
What to check when you visit
76 live-in carers within about two hours of Somerset
These are self-employed carers on PrimeCarers, the introductory agency that runs this directory. Each has a profile with their own rates and reviews from families, and you choose who to talk to.
Most charge £1,020 to £1,370 a week. 62 can care for a couple. 12 years' experience on average.
“She looked after my mum, who can be incredibly challenging, so well and so gently, and we always felt confident that my mum was getting the best care available.”
“She was not phased by anything, she was adaptable, kind & gave us complete confidence to go away & not worry about a thing!”
Every carer has had an enhanced DBS check in the last 18 months, ID and right-to-work checks and an online interview. Their skills and training are for you to check with them. Carers set their own rates, and who is free changes week to week.