Lucerne House

Updated 31 October 2019

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. We looked at the overall quality of the service and provided a rating for the service under the Care Act 2014.

Inspection team

The inspection was completed by one inspector, a specialist nurse advisor, two assistant inspectors and two Expert by Experiences. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Lucerne House 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.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection

This inspection was unannounced.

What we did before the inspection

We reviewed the information we held about the service. We used the information the provider sent us in the provider information return. This is information providers are required to send us with key information about their service, what they do well, and improvements they plan to make. This information helps support our inspections. We used this information to plan our inspection.

During the inspection

We spoke with 10 people who used the service and seven relatives about their experience of the care provided. We spoke with 16 members of staff including the registered manager, deputy manager, heads of unit, nurses, a physiotherapist, senior care workers, care workers, domestic staff and the chef. We used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

We reviewed a range of records. This included 10 people’s care records and multiple medication records. We looked at five staff files in relation to recruitment and staff supervision. A variety of records relating to the management of the service, including staff training, policies and procedures were reviewed. We spoke with three visiting professionals from the tissue viability and wheelchair services.

We received feedback after the in inspection visit from staff and relatives we had not been able to speak to and other professionals linked with the service. We received feedback from five relatives, three staff and one GP.

After the inspection

We obtained clarification from the provider to validate evidence found.

Updated 31 October 2019

About the service

Lucerne House is a residential care home providing personal and nursing care to 72 people at the time of the inspection. They provide care to younger and older adults. The service can support up to 75 people. The building has three units. During the inspection Shillingford (also known as Memory Lane) provided care to 30 people living with dementia, Ide provided predominately nursing care to 28 people and Alphinbrook care to 14 younger adults.

People’s experience of using this service and what we found

People received an outstanding, personalised, caring service. People told us they received very kind and respectful support from staff who promoted their abilities, knew them well and genuinely enjoyed their company. The whole staff group worked as a team to support people in a person-centred way. Care was planned, risk assessed and put in place with full consultation and involvement of people and their relatives where this was appropriate.

People were valued and placed at the heart of the service. Staff promoted people's privacy and dignity and enabled them to make choices and have as much control and independence as possible which helped build meaningful relationships.

Feedback about the service from people, family and linked professionals always mentioned the service in outstanding terms. People said, “The staff here have time for you. They are always relaxed and happy and have time to chat and even banter with you” and, “I can’t fault the care here. I know the care I get here, courtesy of the wonderful staff, is of the highest order.”

Relatives commented, “I feel the care my relative receives is individually suited to their needs, and they are very much treated as an individual”; “The staff keep me very well informed about my relative’s condition and what’s happening to improve things since they moved here from hospital” and, “I visit my relative daily and without fail, the atmosphere is lovely and all the staff are so friendly and welcoming”.

People received effective care and treatment from competent, knowledgeable and skilled staff who had the relevant qualifications to meet people’s needs. The provider had a good system to ensure all staff had regular training to keep them up to date with best practice. Training courses and events were relevant to the people living at the service and staff ensured they put learning into practice.

People were assured of their rights being upheld to the maximum level possible. The service applied the Mental Capacity Act 2005 (MCA) to the full. People were supported to have exceptional choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the training, management, policies and systems in the service supported this practice. Every person bar none were seen as individuals and the staff sought to identify goals and aspirations for each person, so they could live their life to the greatest extent of their ability while at Lucerne House. Every effort was then made to ensure those goals and aspirations could be realised.

The service was accredited for its care of people living with dementia. Staff were trained to understand dementia and were passionate in ensuring they continued to put this into practice. Each person’s individual life and dementia journey was important to staff and was used to inform best interests decisions. The service established relationships with and worked with local groups, including schools and tradespeople, to improve the experience and understanding of people living with dementia. As a result of this carers were also supported.

Activities were provided seven days a week by a passionate and experienced activity team. These offered a wide variety of relevant and meaningful activity both inside and outside of the service. Staff got to know people and ensured activities were enjoyed and meaningful, using past interests.

Medicines were generally managed safely. There were clear processes and systems to ensure they were ordered, stored, disposed of and administered safely. The service worked closely with a local GP to ensure people’s medicines were reviewed often to prevent over medication. The mood and pain of people was monitored closely to ensure they were well. This meant people living with dementia with behaviour that may challenge were assessed closely, and other approaches were used, like distraction or meeting pain needs, rather than using medicines to suppress these behaviours.

People had access to plenty of food and drinks throughout the day and there were individualised meals according to their tastes and needs. People told us the food was very good and there was plenty of choice. Meals were appetising and served in a calm and organised manner, creating a sociable and pleasant meal experience.

The service was very well-led. The registered manager, management team and staff were extremely open to hearing feedback on the service and acting to correct anything the inspection team identified, immediately. There was an open, caring culture that was passionate about maintaining their Outstanding rating. Everyone told us, that this culture emanated from the registered manager.

The provider's quality assurance processes were effective and there was a focus on continuous improvement and continuously seeking out ways to offer personalised care. People, relatives and staff all felt valued as individuals and partners in their care and the running of the service. The registered manager provided empowering and very good support for staff to be able to do their job effectively. They, the staff team and the provider, acted to ensure continuous excellent quality care for people living at Lucerne House.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection (and update)

The last rating for this service was Outstanding (The report was published 8 February 2017). On this inspection we found this rating had been maintained.

This was a planned inspection based on the previous rating.

Follow up

We will continue to monitor information we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.