CQC report explained · a nursing home
What the CQC found at Lucerne House
Rated Outstanding: inspectors found the home performing exceptionally well.
- Safe?
- Good
- People were protected from abuse and avoidable harm, and inspectors found enough staff, safe recruitment and good infection control. Some medicines records and air mattress settings were not always correct, but these issues were addressed quickly.
- Effective?
- Outstanding
- Assessments were thorough and staff had relevant training and skills. Inspectors found exceptional support for choice, decision-making, dementia care, health needs, food and drink.
- Caring?
- Outstanding
- People were treated with kindness, dignity and respect. Staff knew people very well and supported their choices, relationships, faith, privacy and independence.
- Responsive?
- Outstanding
- Care was highly personalised and people and families were involved in care planning. Activities, communication support and end-of-life care were tailored to individual needs.
- Well-led?
- Outstanding
- Inspectors found open and supportive leadership, strong teamwork and effective checks on quality and safety. The home worked with families, professionals, community groups and local organisations.
What inspectors found, October 2019
Rated Outstanding; inspectors found exceptionally kind, personalised care, with a Good rating for safety and some medicines recording issues fixed during or after the inspection.
This was an unannounced inspection on 17 and 18 September 2019. Inspectors spoke with people living in the home, relatives, staff and visiting professionals. They observed care and reviewed care plans, medicines records, staff files and management records.
The home was rated Outstanding overall. Effective, caring, responsive and well-led were all rated Outstanding. Inspectors found that people were treated as individuals, supported to make choices and helped to maintain their independence, relationships and interests.
Safety was rated Good. Medicines were generally managed safely, but some records did not always show why as-required medicines were given or refused. There were also problems with some covertly administered medicines, monitoring records and allergy information. These issues were addressed quickly.
The overall Outstanding rating was maintained from the previous inspection, published on 8 February 2017. The report says the home will continue to be monitored and may be inspected sooner if concerning information is received.
Kind, individual care
Staff knew people well and supported them as individuals. People and relatives consistently described the care as respectful, warm and personal.
“People received an outstanding, personalised, caring service.” from the report
Strong dementia support
The home had specialist dementia training and used people's life histories to guide care and best-interest decisions. It also supported people with dementia and carers in the wider community.
“Staff were trained to understand dementia and were passionate in ensuring they continued to put this into practice.” from the report
Meaningful activities
Activities were available seven days a week and included community visits, music, exercise, clubs and one-to-one support. Staff linked activities to people's past interests and wishes.
“Activities were provided seven days a week by a passionate and experienced activity team.” from the report
Open leadership
The management team welcomed feedback and acted on issues. Quality checks and a supportive culture helped maintain high standards.
“The service was very well-led.” from the report
Medicines records
needs fixingStaff did not always record why as-required medicines were given or refused. Medicines needing a higher level of monitoring could not always be traced through the recording system, although both issues were resolved quickly.
“We identified staff were not always recording the reason PRN was given or refused.” from the report
Equipment and allergy records
needs fixingSome air mattresses were not set correctly, and allergies were not clearly recorded on the homely remedies form. These issues were corrected and systems were reviewed.
“We identified one unit's air mattresses were not always set correctly.” from the report
- 01How do you now check that the reason for giving or refusing as-required medicines is recorded?
- 02How do you make sure medicines given covertly are suitable to be altered and remain effective?
- 03How are medicines needing a higher level of monitoring traced and audited?
- 04How do you check that air mattresses are set correctly for each person?
- 05How would you tailor care, activities and communication support to my relative's specific needs?
This was an unannounced planned inspection covering all five key questions, with both the premises and the care provided looked at. This explanation was written from the published report of 31 October 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.
What inspectors found, February 2017
Rated Outstanding overall; inspectors found exceptionally caring, personalised care, with safety rated Good.
The inspection was unannounced and took place on 21 November and 1 December 2016. Inspectors spoke with people living at the home, relatives, staff and health professionals. They observed care and checked care, medicine, staff and quality records.
The home was rated Outstanding overall. Effective, Caring, Responsive and Well-led were all rated Outstanding. Safe was rated Good. Inspectors found enough staff, safe medicines systems, good training, kind care and strong support for people's independence and interests.
Activities were personalised and helped people stay connected with the community. Inspectors also found that complaints were taken seriously and used to improve the service.
The previous inspection in October 2014 had rated Responsive as requiring improvement. Inspectors found extensive improvement by this inspection and rated it Outstanding.
Kind and respectful care
People and relatives consistently described staff as caring and compassionate. Inspectors saw staff spending meaningful time with people and respecting their privacy and choices.
“Without exception, people and visiting relatives told us the staff were extremely caring, compassionate, attentive and dedicated in their approach.” from the report
Personalised activities
Activities were based on people's individual interests and abilities. Staff helped people continue hobbies, attend community events and develop new opportunities.
“People had access to and were involved in developing personalised activities that complemented their individual hobbies and interests.” from the report
Support for independence
The home supported people to make choices and remain as independent as possible. Some people became independent enough to return to live in the community.
“It was not unusual for some people to become so independent that they eventually were able to go home to the community.” from the report
Skilled and supported staff
Staff received training, supervision and regular checks of their skills. The home also had a care practitioner role to support clinical care and staff development.
“Staff competency to do their role was regularly assessed and staff received clear and constructive feedback to enable them to improve their practice when necessary.” from the report
Open leadership
Managers were visible and encouraged people, relatives and staff to share their views. Quality checks led to action and learning when concerns were found.
“There were very effective systems in place to monitor the quality and safety of the care provided.” from the report
Activity records could be clearer
minorInspectors suggested that activity records should be documented by individual person, rather than mainly by activity. The activity coordinator responded immediately by creating an individual form.
“As records were written based on the activity, we suggested it would be easier to document by the individual.” from the report
Past delay with end-of-life medicines
needs fixingThere had recently been a delay in obtaining Just in Case medication. The manager responded by ordering medication earlier and contacting GPs sooner to prevent a repeat.
“There had been a recent concern following an incidence of a delay in obtaining 'Just in Case' medication.” from the report
- 01How are people's individual activities and interests recorded and reviewed now?
- 02How do you make sure Just in Case medicines are ordered early enough and are available when needed?
- 03What staffing levels are in place on each unit, including at night and for one-to-one support?
- 04How are people supported to maintain independence or work towards returning to the community?
- 05How are relatives involved in care reviews, best-interest decisions and activity planning?
This was an unannounced inspection of the overall service across its three units, including care, medicines, staffing, activities, records and quality systems. This explanation was written from the published report of 8 February 2017 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 Lucerne House
3 rated inspections over 5 years: the service has improved, from Good to Outstanding.
- October 2019Outstandingcurrent ratingstayed OutstandingSafe: GoodEffective: OutstandingCaring: OutstandingResponsive: OutstandingWell-led: Outstanding
- February 2017Outstandingup from GoodSafe: GoodEffective: OutstandingCaring: OutstandingResponsive: OutstandingWell-led: Outstanding
- January 2015GoodSafe: GoodEffective: GoodCaring: GoodResponsive: Requires improvementWell-led: Good
- June 2014
Report published without a new overall rating.
- May 2014
Report published without a new overall rating.
- October 2013
Report published without a new overall rating.
- June 2012
Report published without a new overall rating.
- October 2011
Report published without a new overall rating.
- September 2011
Report published without a new overall rating.
- February 2011
Registered with the Care Quality Commission on 15 February 2011.
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.
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17 live-in carers within about an hour of Devon
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 £1,270 a week. 15 can care for a couple. 13 years' experience on average.
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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.