Inspection on 08/09/05 for Lugano

This inspection was carried out on 8th September 2005.

CSCI has not published a star rating for this report, though using similar criteria we estimate that the report is Good. The way we rate inspection reports is consistent for all houses, though please be aware that this may be different from an official CSCI judgement.

The inspector found there to be outstanding requirements from the previous inspection report but made no statutory requirements on the home.

Other inspections for this house

Lugano 24/05/07

Lugano 08/03/06

Lugano 17/03/05

Lugano 22/04/04

Similar services:

Claremont House

Oak Ridge

Sun Court Nursing Home

Ashville House

Bilney Hall

Hill Barn

Mabbs Hall Nursing Home

Henrietta House

Extracts from inspection reports are licensed from CQC, this page was updated on 09/07/2008.

CARE HOMES FOR OLDER PEOPLE Lugano 3, Powell Road, Buckhurst Hill, Essex. IG9 5RD Lead Inspector Jacqueline Graves Unannounced 8 September, 2005 th The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. Lugano I56-I06 S17873 Lugano V247922 080905 Stage 4.doc Version 1.40 Page 3 SERVICE INFORMATION Name of service Lugano Address 3 Powell Road Buckhurst Hill Essex IG9 5RD 020 8505 2695 020 8506 0754 Telephone number Fax number Email address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Mr David Pearce Mr Michael Brook Mr David Pearce Mr Michael Brook Care Home 27 Category(ies) of OP Old age (27) registration, with number DE(E) Dementia (1) of places Lugano I56-I06 S17873 Lugano V247922 080905 Stage 4.doc Version 1.40 Page 4 SERVICE INFORMATION Conditions of registration: To provide accommodation and care to one service user with dementia (whose identity is known to the CSCI). Date of last inspection 17th March, 2005 Brief Description of the Service: Lugano is a care home providing personal care for twenty-seven older people. It is situated in Buckhurst Hill, near to the station and local shops. The home is a three-storey Edwardian house with lovely views of the local countryside. The home has been extended with some of the original features maintained. There are three double and twenty-one single bedrooms. Four rooms have en suite facilities and two have direct access to a pleasant terrace area. The home is in good decorative order and well maintained. There is a large lounge and a separate dining area. A shaft lift provides access to all floors. Both the lounge and dining area open out onto a terrace and there is a large, well-kept garden to the rear of the property. The registered providers have installed a summerhouse in the garden although access to the garden is limited for some service users. There is room for some parking to the front of the home and street parking. Lugano I56-I06 S17873 Lugano V247922 080905 Stage 4.doc Version 1.40 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection was routine and unannounced. It lasted approximately four hours. The inspector spoke to residents in their rooms and around the home, to a manager, the deputy and some carers. She looked at communal areas, some bedrooms, the laundry and garden. Some records and care plans were sample checked and people’s care case tracked. The inspector would like to thank the manager, staff and residents for their help with the inspection. What the service does well: What has improved since the last inspection? Two rooms have been completely redecorated since the last inspection to provide consistent standards of decoration for all residents. Those staff spoken to said they feel well supported by management and receive regular supervision to help them in their work. They are given opportunities to give their views on how the home is run, at staff meetings. Lugano I56-I06 S17873 Lugano V247922 080905 Stage 4.doc Version 1.40 Page 6 What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. Lugano I56-I06 S17873 Lugano V247922 080905 Stage 4.doc Version 1.40 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Standards Statutory Requirements Identified During the Inspection Lugano I56-I06 S17873 Lugano V247922 080905 Stage 4.doc Version 1.40 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 3,4,5 and 6 The development of current good practice on the care of people with dementia would enhance the care provided. EVIDENCE: The home is popular, with a waiting list of people who wish to be admitted. Prospective residents are assessed before admission to ensure their needs can be met in the home. The home has agreed to look at how people who have dementia may be helped to find their way around the building, recognise their rooms, take part in suitable activities and so on. A resident confirmed that they had been able to visit the home to help them reach a decision about moving in and that they entered the home for a trial period. Lugano does not admit people for intermediate care. Lugano I56-I06 S17873 Lugano V247922 080905 Stage 4.doc Version 1.40 Page 9 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 7 and 10 Care plans inform staff about what care people need but could be improved with the participation of residents in drawing them up. EVIDENCE: Care plans seen, clearly outlined the care needed. Necessary risk assessments had been carried out. The inspector and manager discussed the usefulness of reviewing care plans when peoples’ needs change, rather than automatically every month, which can just be a bureaucratic exercise for staff. The resident/relatives had not signed to show their approval for one care plan seen. Those residents spoken to said staff treat them with respect. Staff were observed to talk to residents politely and to allow them to make decisions about what they wished to do. Staff knocked and waited for a reply before entering rooms, showing respect for peoples’ privacy. Lugano I56-I06 S17873 Lugano V247922 080905 Stage 4.doc Version 1.40 Page 10 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 12 and 15 The home provides good meals in a pleasant setting. Various activities are available to the residents. EVIDENCE: A list of activities showed a good variety of things to do, although there were no planned activities on the day of the inspection. Residents are encouraged to pursue their own hobbies and interests. Some of those residents spoken to said they had enough to do but some said they would like more stimulation, particularly opportunities to talk to other people. A few of those residents spoken to said they get opportunities to go out with family and friends and some go out with staff. Those people who have developed dementia would benefit from activities to suit their needs and the home plans to develop these (see standard 4). Residents praised the quality and variety of food and said they get enough to eat. Staff advised that sometimes residents are involved in food shopping so they can choose favourite foods. The dining room is attractive. Lugano I56-I06 S17873 Lugano V247922 080905 Stage 4.doc Version 1.40 Page 11 Residents can eat some meals in the garden during warm weather, if they wish. There was a suggestion that squashes other than orange be available at meal times. Lugano I56-I06 S17873 Lugano V247922 080905 Stage 4.doc Version 1.40 Page 12 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 16 The home has satisfactory arrangements for people to raise any concerns. EVIDENCE: Residents spoken to said they would discuss any concerns with managers or the deputy and that they are approachable. The home has a complaints procedure, which is available to all in the home. No complaints have been recorded at the home and none made direct to CSCI since the last inspection. Lugano I56-I06 S17873 Lugano V247922 080905 Stage 4.doc Version 1.40 Page 13 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 19,21,23,24 and 26 A comfortable, homely environment is provided. There are high standards of cleanliness. EVIDENCE: The home is maintained, decorated and furnished to high standards. All areas of the home visited were clean and smelled pleasantly. The laundry was very clean and well organised to promote good hygiene. Those residents’ bedrooms seen, had been made personal with their own furnishings and possessions and residents said they were happy with their accommodation. The possibility of having nets/blinds at windows for privacy was raised in discussion with residents. The deputy agreed that such could be provided at residents’ request. Lugano I56-I06 S17873 Lugano V247922 080905 Stage 4.doc Version 1.40 Page 14 The garden is very attractive and well maintained; residents said they enjoy using it, eating out there and looking at the garden birds and wildlife. Those residents with mobility difficulties have to access the garden via the side or front of the building. The need for further adapted bathing facilities has been raised at previous inspections. The breakdown of the lift in the week of the inspection highlighted the need for alternative bathing facilities on different floors. The manager said the home is considering adapting an existing bathroom. Lugano I56-I06 S17873 Lugano V247922 080905 Stage 4.doc Version 1.40 Page 15 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission considers Standards 27, 29, and 30 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 27 There are sufficient staff to care for residents and to maintain the building. EVIDENCE: Some of the staff have worked at the home for a considerable time so know the residents and systems of working well, which benefits the residents. A resident commented that they found the staff, ‘ Lovely. Very nice.’ The home’s existing staff covers care staff vacancies, as the home prefers not to use agency staff. A new cook has been appointed and there is sufficient domestic staff to keep the home clean and tidy. Lugano I56-I06 S17873 Lugano V247922 080905 Stage 4.doc Version 1.40 Page 16 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for standard(s) 31,36 and 38 The home is well managed and efficiently run. EVIDENCE: Residents made positive comments about the management of the home and felt the two managers and deputy run the home well. The deputy is working towards achieving the qualification required of managers. Current gas and electricity safety certificates were seen. The home advised that water temperatures are checked to prevent the risk of Legionella and scalding, although records were not seen on this occasion. The home plans to have thermostatic valves fitted to baths and has carried out risk assessments prior to this work being done. The lift has been regularly maintained but broke down just before the inspection. It was repaired shortly afterwards. Lugano I56-I06 S17873 Lugano V247922 080905 Stage 4.doc Version 1.40 Page 17 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME ENVIRONMENT Standard No 1 2 3 4 5 6 Score Standard No 19 20 21 22 23 24 25 26 Score x x 3 2 3 N/A HEALTH AND PERSONAL CARE Standard No Score 7 2 8 x 9 x 10 3 11 x DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 x 14 x 15 4 COMPLAINTS AND PROTECTION 3 x 2 x 3 2 x 3 STAFFING Standard No Score 27 3 28 x 29 x 30 x MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score Standard No 16 17 18 Score 3 x x 3 x x x x 3 x 3 Lugano I56-I06 S17873 Lugano V247922 080905 Stage 4.doc Version 1.40 Page 18 Yes Are there any outstanding requirements from the last inspection? STATUTORY REQUIREMENTS This section sets out the actions which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. 1. 2. Standard OP37 OP1 Regulation CSA 28 4 Requirement Both pages of the registration certificate must be displayed in the home. The registered provider must ensure that the Statement of Purpose and Service Users Guide contain information on the home’s physical standards. This refers to numbers of bathrooms assisted and non-assisted, showers and toilets provided for service users in the home. This is a repeat requirement which was not inspected. The registered provider must ensure service users are provided with sufficient number of baths and showers. This refers to the need for additional assisted bath/shower facilities in the home.This requirement is twice repeated and under consideration by the home. The home records relating to proof of identity for staff must be kept in the home. Not inspected. Timescale for action 15/10/05 Carried forward to the next inspection 3. OP21 23(j) 1/1/06 4. OP29 29(2)(1) Carried forward to the next inspection Lugano I56-I06 S17873 Lugano V247922 080905 Stage 4.doc Version 1.40 Page 19 RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1. 2. 3. 4. 5. Refer to Standard OP4 OP7 OP8 OP11 OP24 Good Practice Recommendations Consider approriate activities and ways of helping people with dementia orientate to the building, based on current good practice. Care plans should be drawn up with the resident and be signed by them/or their representative to show their approval. That residents’ weight is recorded on admission and subsequently, on a periodic basis. Not inspected. That the last wishes concerning terminal care and arrangements after death are recorded for all residents. Provide net curtains or blinds in bedrooms if residents request such. Lugano I56-I06 S17873 Lugano V247922 080905 Stage 4.doc Version 1.40 Page 20 Commission for Social Care Inspection Kingswood House Baxter Avenue Southend on Sea Essex SS2 6BG National Enquiry Line: 0845 015 0120 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI Lugano I56-I06 S17873 Lugano V247922 080905 Stage 4.doc Version 1.40 Page 21 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. 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