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Inspection on 15/11/05 for Atlantis

Also see our care home review for Atlantis for more information

This inspection was carried out on 15th November 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 made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

What follows are excerpts from this inspection report. For more information read the full report on the next tab.

What the care home does well

The registered providers are committed to having a trained work force and statutory and good practice training is regularly provided. The training is provided from a nearby college and health care professionals also provide training to the home.

What has improved since the last inspection?

All the good practice recommendations of the inspection report dated the 14th April 2005 have been addressed.

What the care home could do better:

The registered providers are reminded that a protection of vulnerable adults check (at a minimum) is to be obtained prior to the commencement of any new staff member being employed in the home. Although service users gave positive comments on the standard of care at the home some of the service users suggested that they wish to do more. The registered provider has agreed to review the social care needs of all the service users.

CARE HOMES FOR OLDER PEOPLE Atlantis Polperro Road Polperro Cornwall PL13 2JE Lead Inspector Elaine Bruce Unannounced Inspection 15th November 2005 08:30 X10015.doc Version 1.40 Page 1 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 Atlantis DS0000008956.V253959.R01.S.doc Version 5.0 Page 2 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. Atlantis DS0000008956.V253959.R01.S.doc Version 5.0 Page 3 SERVICE INFORMATION Name of service Atlantis Address Polperro Road Polperro Cornwall PL13 2JE Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) 01503 272243 01503 272243 Mr Steven Paul Brailey Mrs Catherine Brailey Care Home 20 Category(ies) of Dementia - over 65 years of age (10), Mental registration, with number Disorder, excluding learning disability or of places dementia - over 65 years of age (10), Old age, not falling within any other category (10) Atlantis DS0000008956.V253959.R01.S.doc Version 5.0 Page 4 SERVICE INFORMATION Conditions of registration: Date of last inspection 14th April 2005 Brief Description of the Service: Atlantis provides care for twenty older people, ten of whom can be admitted to the home with a dementia or mental disorder. Communal accommodation for the service users with a dementia and or a mental disorder is in a separate locked facility. Atlantis is a large detached house, part of which is a more recent extension. It stands in its own large grounds consisting of lawned areas, orchard with views over the surrounding countryside and distant sea views. Parking is available in the grounds of the home. Garden furniture offering seating and table facilities is available on the level patio area outside the front entrance and the garden is accessible to service users by the way of slopes and steps. Accommodation is provided on two floors which are connected by stairs and a stair lift. There are sixteen single rooms with six of these being en-suite and two double rooms having en suite facilities. Day care, respite care and meals on wheels are provided within the home, collecting and returning service users to their home for day care. There are three communal lounge areas, one of which can also be used to dine within and one of which is a sun lounge. There is a separate dining room but service users are able to exercise choice and can choose to eat in their own private room. Atlantis DS0000008956.V253959.R01.S.doc Version 5.0 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The inspection took place on the 15th November 2005 over four and a quarter hours and was carried out as an unannounced inspection. Service users spoken to during the course of the inspection expressed positive comments on the kindness of the staff at the home. Care records, staff files and policies and procedures were inspected. One of the registered providers was present during the course of the inspection as were two of the senior management team. What the service does well: What has improved since the last inspection? What they could do better: Atlantis DS0000008956.V253959.R01.S.doc Version 5.0 Page 6 The registered providers are reminded that a protection of vulnerable adults check (at a minimum) is to be obtained prior to the commencement of any new staff member being employed in the home. Although service users gave positive comments on the standard of care at the home some of the service users suggested that they wish to do more. The registered provider has agreed to review the social care needs of all the service users. 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. Atlantis DS0000008956.V253959.R01.S.doc Version 5.0 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 Outcomes Statutory Requirements Identified During the Inspection Atlantis DS0000008956.V253959.R01.S.doc Version 5.0 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 the following standard(s): 1,2 and 3 The home’s statement of purpose and service user guide documentation as well as a brochure provide prospective service users with details of what the home provides helping an informed decision about admission to the home. A contract of care is provided to each service user/family which details the terms and conditions of their placement. The registered provider assesses all service users prior to admission to the home to ensure that the home will be able to meet their care needs. EVIDENCE: The home has a statement of purpose document in place that meets all the requirements of The Care Homes Regulations (2001). The statement of purpose document is available in the home. A service user guide document is available for each service user and all potential service user admissions to the home. In addition a brochure is provided. All service users have been issued with a contract of care that details the terms and conditions of their placement. All information is included in the Atlantis DS0000008956.V253959.R01.S.doc Version 5.0 Page 9 contract as required by the standard to include reference to the bedroom that is being occupied. The home has in place an admission procedure to guide staff. Each service user has an assessment of care needs undertaken prior to admission by senior staff to ensure that the home can meet individual needs. Atlantis DS0000008956.V253959.R01.S.doc Version 5.0 Page 10 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 the following standard(s): 7,8,9,10 and 11 The service user’s health, personal and social care needs are being met by the staff and multidisciplinary staff as required. Medication is being administered correctly to the service users. Service users spoken to during the course of the inspection expressed positive comments on the kindness of the staff. EVIDENCE: Full and comprehensive individual plans of care are in place for each service user. The service user and their representative are involved in care planning. Evidence is in place of regular reviews taking place. The care plans are supplemented by day and night recording. It is noted that consideration has been given to including a life history on each service user. Each service user has a risk assessment in place that pays particular attention to the risk of fall frequency. All care staff are involved in recording. Care planning clearly evidences health care needs of the service users and how these are being met. Evidence is available of visits and telephone Atlantis DS0000008956.V253959.R01.S.doc Version 5.0 Page 11 conversations with external professionals. Dental and optician services are provided in the home or locally if required. Chiropody services are available monthly in the home. Service users are regularly weighed. Health care professionals are involved in staff training to the home. A medication policy and procedure is available in the home to guide staff on good practice. All senior staff who have responsibility for medication administration have recently received updated accredited training. Medication administration records were found to be completed appropriately on the day of the inspection. The staff list of signatures and initials is up to date. Service users spoken to during the course of the inspection expressed very positive comments on the kindness of the staff in the home. A policy and procedure is in place at the home to guide staff on the sensitive area of death and dying. The policy and procedure makes important references to the principles of care re privacy and dignity. Atlantis DS0000008956.V253959.R01.S.doc Version 5.0 Page 12 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 the following standard(s): 12,13 and 14 The home provides the service users with opportunities to meet their social care needs but some of the service users wish to do more. A review of social activities will take place by the registered provider. EVIDENCE: The social care needs of the service users are identified through a detailed life history which staff have spent a considerable time completing. A record of social activities is kept which evidences individual and group activities. Entries include information such as played cards, walking in the grounds of the home etc. Over the Christmas period there are plans for a pantomime visit and a local school and choir to visit the home. During the course of the inspection the service users expressed very positive comments on the standard of the care they are receiving but three of the service users said they would like to do more as the home is very quiet. This was discussed with the registered provider who has agreed to review their social care needs. It is noted that there are plans for manicures to take place soon. Atlantis DS0000008956.V253959.R01.S.doc Version 5.0 Page 13 Visitors are welcome to the home and entries are in place when the service users have received a visitor. All visitors are asked to sign in to the home when they arrive and guidance is displayed on visiting hours. Atlantis DS0000008956.V253959.R01.S.doc Version 5.0 Page 14 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 the following standard(s): 16,17 and 18 The home has a satisfactory complaints procedure provided to the service users in the service user guide. Information is provided in the service user guide on the “rights” of the service users in the home. The home has in place adult protection policy and procedures and training to provide staff with the knowledge and understanding of adult protection issues to protect service users from abuse. EVIDENCE: The home has a complaints policy and procedure in place and each service user and their representative has received this documentation in their service user guide. Included in the service user guide is a charter of rights for each service user admitted to the home. The home has in place an adult protection policy and procedure. Documentation on whistle blowing is also available. All the staff in the home who are undertaking or have completed NVQ training have studied in detail adult protection issues. There are plans for two staff to attend adult protection training from Cornwall Social Services Department with other staff to attend at a later date. It is recommended that evidence is clearly provided that staff have read the adult protection policy and procedure. Atlantis DS0000008956.V253959.R01.S.doc Version 5.0 Page 15 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 the following standard(s): The environmental standards were not assessed at this inspection. It was though noted that the standard of cleanliness in the home was high. EVIDENCE: Atlantis DS0000008956.V253959.R01.S.doc Version 5.0 Page 16 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 consider all the above are key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 27,28,29 and 30 Staffing levels are appropriate to meet the needs of the service users. Staff training is very much encouraged by the registered providers and is ongoing. The staff team are a stable group with very few changes since the last inspection. EVIDENCE: On the day of the inspection four care staff were on duty in addition to the management team, the cleaner and cook. The home employs two waking night staff. The home has in total three overseas staff who have settled into the home well. The inspection of staff files evidenced that the correct recruitment procedures are being followed but the registered providers are reminded that staff must not be employed before a check on the adult protection register is undertaken. Staff are encouraged to undertake NVQ training and nine staff have obtained this qualification with three more studying to obtain it. In addition five staff have an NVQ 3 and one is also working to obtain this qualification. The registered providers are committed to having a trained work force. Training is brought in from Saltash college covering a wide range of subjects. In addition training is provided by health care professionals and this has recently included dementia training. Statutory training to include fire prevention, moving and handling and first aid is all up to date. Infection control training is presently taking place and several staff are waiting for certificates following their recent health and safety training. Induction training is taking place but it is Atlantis DS0000008956.V253959.R01.S.doc Version 5.0 Page 17 recommended that this is spread over a longer period as recommended in the standards. (six weeks). Atlantis DS0000008956.V253959.R01.S.doc Version 5.0 Page 18 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 31, 33, 35 and 38 the key standards to be inspected at least once during a 12 month period. JUDGEMENT – we looked at outcomes for the following standard(s): 31,32,35 The registered providers and their two senior management staff are all family members. Each member of the family has specific roles and responsibilities. The recently evolved management structure appears to be working well. EVIDENCE: One of the registered providers is a first level nurse and an NVQ assessor and verifier. She is presently in the process of studying for the registered managers award. Both the registered providers are very involved in the running of the home to include working alongside staff (hands on) as and when required. The registered providers are supported in their duties by two senior management staff members who are family members. Both of these staff have NVQ 3 in care and are studying for their NVQ 4 (care and management). They have specific management responsibilities/duties in the running of the home. Atlantis DS0000008956.V253959.R01.S.doc Version 5.0 Page 19 All staff are involved in the running of the home to include attendance at staff meetings. The registered providers do not handle any money for any service users. This is all dealt with by family members, representatives or solicitors. If required, the registered providers will assist service users with paying bills for example hairdressing/chiropody and then invoice the representative accordingly. Atlantis DS0000008956.V253959.R01.S.doc Version 5.0 Page 20 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 Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 3 3 x x N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 3 DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 2 13 3 14 3 15 x COMPLAINTS AND PROTECTION Standard No Score 16 3 17 3 18 3 x x x x x x x x STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 3 3 x x 3 x x x Atlantis DS0000008956.V253959.R01.S.doc Version 5.0 Page 21 Are there any outstanding requirements from the last inspection? NO 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. Standard Regulation Requirement Timescale for action 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. Refer to Standard OP12 OP18 OP29 OP30 Good Practice Recommendations To review the social care needs of the service users to ensure that these needs are being met at all times. To ensure that all staff have read the adult protection policy and procedure and this information is evidenced. To ensure that staff do not commence employment at the home without a check on the adult protection register. To evolve the induction training new staff receive over a longer period ie six weeks. Atlantis DS0000008956.V253959.R01.S.doc Version 5.0 Page 22 Commission for Social Care Inspection St Austell Office John Keay House Tregonissey Road St Austell Cornwall PL25 4AD 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 Atlantis DS0000008956.V253959.R01.S.doc Version 5.0 Page 23 - 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. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. 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