Archived: Atlantis Care Home

Atlantis Care Home is a residential care home providing personal and nursing care to 19 older people at the time of the inspection. The service can support up to 20 people who may need support with their physical and mental health and may be living with a dementia. Atlantis Care Home is also registered to provide personal care, in the form of a domiciliary care service, to people in their own homes. On the day of the inspection 4 people were being supported in their own homes by the domiciliary care service [DCA]. Atlantis care home is an adapted building in a rural area.

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

People lived in an open, friendly, family atmosphere where they felt safe and well cared for. People had good relationships with staff and other people living at Atlantis Care Home. During the inspection we saw people engaging happily with laughter and good-humoured banter. People told us they received the support they needed in their own homes.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests; the policies and systems in the service supported this practice. Some people had a high level of dependence and staff supported them to make choices about their care and support, what they did each day and how they spent their time.

People received care and support from staff who knew them well. Staff were trained and competent in their roles and monitored people's health and wellbeing. When needed, referrals were made to other healthcare professionals. Staff responded to advice given to ensure people received the care they required. Health professionals told us the managers and staff were responsive when people’s health needs changed. People using the domiciliary care service [DCA] told us they were confident with the staff who visited them in their own homes.

People told us they received a good service and felt safe. Accidents and incidents were recorded, and risk assessments were in place. Arrangements were in place for the safe administration of medicines.

People could choose what to eat and drink and were supported to eat in a pleasant sociable environment. People living in their own homes were supported with meals by staff who understood their nutritional needs.

People's communication needs were being met and complaints were acted upon.

People were happy with the way the home was managed. There was a positive and inclusive culture within the service and the registered manager supported the staff and sought to improve the quality of care. The registered manager regularly sought and acted upon people's views of the care they received.

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

Rating at last inspection

The last rating for this service was Good (published 25 April 2017) .

Why we inspected

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 reinspection programme. If we receive any concerning information we may inspect sooner.

Atlantis Care Home provides care to older people. The home can accommodate up to twenty people. Atlantis Care Home is also registered to provide personal care, in the form of a domiciliary care service, to people in their own homes. On the day of the inspection 19 people lived in the home and 21 people were being supported in their own homes by the domiciliary care service.

A registered manager was employed to manage the service. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run.

The inspection was carried out in response to a concern raised with CQC that people living in Atlantis care home were not receiving support to read letters, make phone calls, go shopping, maintain their physical independence or partake in any activities.

At this inspection we found people received support, if they requested it, to read letters, make phone calls and go shopping. The registered manager told us they would ask staff to regularly offer these services to people, to help ensure people knew they were available. We also found people were able to maintain their physical independence as far as possible. Staff followed people’s wishes and recommendations from relevant professionals to help ensure people’s needs were met. Activities were available to people. Staff endeavoured to provide group activities as well as one to one time with people.

Our previous inspection found a breach of regulation. This related to care plans for people using the domiciliary care service not containing guidance and direction to staff about how to meet people’s individual needs. During this inspection, we found people’s care plans relating to the domiciliary service included detailed information about how people wanted and needed to have their needs met.

People received support from staff who knew them well and had the knowledge and skills to meet their needs. People and their relatives spoke highly of the staff and the support provided. Comments included, “The girls know what I want and what I need, all the time”

There was a positive culture within the service. The registered manager and provider had clear values about how they wished the service to be provided and these values were shared by the whole staff team. Staff talked about people with fondness and respect and valued the relationships they had built with people. People told us, “The staff cheer me on, they are wonderful”, “The staff are so nice, I wake up in the morning and can’t believe how lucky I am”.

People had their healthcare needs met. People had their medicines as prescribed and on time. A local GP attended the home once per week and had a clear overview of people’s needs and the medicines they required. People were also supported to see a range of health and social care professionals including social workers, chiropodists, district nurses and doctors. Healthcare professionals confirmed they were contacted in a timely manner and staff followed their recommendations.

People told us they felt safe using the service. There were risk assessments in place to help reduce any risks related to people’s care and support needs. Staff had received training in how to recognise and report abuse and were confident any allegations would be taken seriously and investigated to help ensure people were protected.

People were kept safe by suitable staffing levels. People and relatives told us there were enough staff on duty in the care home; and people receiving support from the domiciliary service told us they rarely experienced late calls. Recruitment practices were safe. Checks were carried out prior to staff commencing their employment to ensure they had the correct characteristics to work with vulnerable people.

Staff had received training which was relevant to their role and there was a system in place to remind them when it was due to be renewed or refreshed. Staff told us they received sufficient support to fulfil their role effectively and could always seek advice or request further training.

Staff were knowledgeable about the Mental Capacity Act 2005 (MCA) and how this applied to their role. People’s care plans gave clear information regarding which decisions people could or couldn’t make for themselves. However, mental capacity assessments had not been carried out to identify why people had been deemed not to be able to make certain decisions for themselves. Where best interests decisions had been made on behalf of people, there was no evidence how the decision had been made. This meant people’s rights may not have been respected.

There was a management structure in the service which provided clear lines of responsibility and accountability. A registered manager was in post who had overall responsibility for the service. They were supported by other senior staff who had designated management responsibilities.

The registered manager sought people’s feedback about the service informally on a regular basis and also used questionnaires to formally seek people’s views. Information gathered was used to aid learning and drive improvement across the service. People and their relatives told us the management team were approachable and included them in discussions about their care.

People living in the care home told us they enjoyed the food. Mealtimes were a positive experience, which people told us they looked forward to. People told us meals were of sufficient quality and quantity and there were always alternatives on offer for them to choose from. People’s feedback on the food was sought and acted upon to help ensure it catered for everyone’s tastes.

People supported in their own homes told us staff tried to be flexible around call times, were rarely late and treated their home and belongings with respect.

We have made a recommendation about the providers following the principles of Mental Capacity Act 2005 (MCA).

At this inspection because we only looked at care records we were unable to answer all of our five questions. Is the service caring? Is the service responsive? Is the service safe? Is the service effective? Is the service well led?

Below is a summary of what we found. If you wish to see the evidence supporting our summary please read the full report.

From a records perspective we were able to make a judgement that Atlantis Care Home was safe.

We looked at six people's care plans to check for improvements, four records for people living in the care home and two records for people in receipt of a domiciliary care package. We found that each care plan had been reviewed and updated into a new format and there was a plan in place to keep all care records under regular review. Care plans gave clear instructions for staff to follow to ensure people's needs and wishes were met.

We found that people were protected from the risk of unsafe or inappropriate care because care plans contained accurate information about how care should be provided by staff to meet people's needs.

This is a summary of what we found-

Is the service safe?

People we spoke with who lived at Atlantis told us they felt safe and people who used the care agency, confirmed staff were kind and caring. We found the manager and provider operated a recruitment procedure to ensure people who were employed were suitable to work with vulnerable people. People who lived at Atlantis were cared for in an environment which was safe, clean and hygienic.

The Care Quality Commission monitors the operation of the Deprivation of Liberty Safeguards (DOLs) which applies to care homes. Through our conversations with the manager it was clear that she had an understanding of her responsibilities with regards to DOLs. We saw documentation in people's care plans which evidenced that the appropriate professionals had been involved when an application regarding the restriction of someone's liberty was required.

Is the service effective?

People we spoke with who lived at care home were complementary of the care and support they received from staff. Comments included, 'they're all lovely' and 'staff are very friendly and helpful'. We spoke with a visiting relative who also told us they were happy with the care their X received and told us staff appeared to be kind and caring. One person who lived at the home told us, they would like it if staff could spend more time with them, but told us they understood staff had many others to provide care for as well as them. Another, person when asked if the home could improve anything, told us they would like more exercise and therapies.

People, who used the care agency, were complementary of the care staff who visited them in their own homes. Comments included, 'excellent, I couldn't fault it in anyway' and 'yes happy with the service'. One relative told us, 'with the help coming from Atlantis I think she leads a very good lifestyle'.

Is the service caring?

We observed people who lived at the care home were supported by kind and caring staff who communicated with people in an adult to adult manner. We observed the provider and manager had a 'hands on approach' and took time to talk to people and to visitors. Staff we spoke with were passionate about working at the care home. They told us, 'I love it', 'it's a job you can't do unless you enjoy talking to people' and 'a satisfying job'.

We spoke with one relative who's X had recently moved into the care home. They were complementary of the manager and of the staff at the home. They told us, 'they've got my confidence. I know what they are doing is great; they are so friendly and so lovely. It's not that they're just looking after X, they are looking after the wider family'.

The manager and provider talked to us about their recruitment process and spoke passionately about the qualities they looked for before someone joins the team.

People who used the care agency were also complementary of the staff who visited them in their own home, as were some relatives we spoke with, comments included, 'staff are very good, very willing' and 'I look forward to them coming'.

Is the service responsive?

We saw staff, working in the care home were responsive to people when they required assistance. We observed people who lived at the care home approach staff fondly to ask for assistance. Care records detailed that people were able to access services out with the care home to ensure their health and wellbeing.

People who used the care agency confirmed staff were always willing to assist them. One person gave an example of how a member of staff had quickly responded when they had had a problem with the lock on their front door and the carer had been unable to get in. The manager also gave examples through-out the inspection of the support they gave to people's wider family to ensure they were always kept informed of any concerns.

We found, care records and risk assessment for both the care home and care agency were not always reflective of people's care needs. This meant that the manager and provider could not demonstrate that the care which was being delivered was in line with people's choice, wishes and expectations. A compliance action has been set in relation to recording keeping and the provider must tell us how they plan to improve.

Is the service well-led?

The service had a manager who was registered with the Care Quality Commission. People who lived at the care home as well as people who used the care agency told us they found the manager approachable. People did not have any concerns or complaints, but were confident that they could speak with the manager at any time. However, we found not everyone was aware of what the complaints procedure was. We found the manager had systems in place to monitor the quality of the service being provided. We found that the monitoring and auditing of care records required improvement. Staff we spoke with told us they enjoyed working for the manager and the provider, comments included, 'a good organisation to work for, I am happy', 'it's an absolutely lovely organisation' and 'if I have any queries or questions I always get an answer'.

During our inspection we spoke with the registered manager about the care and support they provided. We also spoke to the administrator about training. We spoke to two staff and briefly to a visiting community psychiatric nurse and care co-ordinator from adult care, health and wellbeing (social services).

We observed staff helped people in a discreet manner and spoke to people with respect. We saw call bells were answered very promptly.

We saw care plans were detailed and directed staff as to the care and support people needed. They had been regularly reviewed. We were told about the range of activities available in the home.

People who used the service were protected from the risk of abuse, because the provider had taken reasonable steps to identify the possibility of abuse and prevent abuse from happening

Medicines were handled appropriately, kept safely, safely administered and were disposed of appropriately.

We saw the provider had effective systems in place to assess the quality of the service provided.

The home was clean and tidy, with light and spacious communal areas.