This inspection took place on 14 January 2019 and was unannounced. Arundel House is a ‘care home’. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. Arundel House provides a residential care and respite service for up to 18 adults with learning disabilities. At the time of our visit, there were 14 people using the service.

Arundel House has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen. The care home is divided into four units. Each unit had its own separate kitchen/dining area and a lounge for people to socialise and relax. The service was designed in a way that allowed people to do the things they want and live as independently as possible whilst also getting support where needed.

At the last inspection of 24 May 2016 and 06 June 2016, we rated the service good. At this inspection we found the evidence continued to support the rating of good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection report is written in a shorter format because our overall rating of the service has not changed since our last inspection. We found the service remained Good.

There was a Registered Manager at this location. 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 registered manager met their statutory responsibilities to the CQC.

There were enough experienced staff available to support people. Staff managed peoples’ medicines in a safe way. Staff had received training in safeguarding adults at risk and knew of actions to take to protect people from abuse. Risks to people were assessed and managed adequately. Lessons were learnt from incidents and when things go wrong. Staff followed infection control procedures to reduce risks of infection.

People’s needs were assessed and planned for following recommended guidance. People were supported with their meals and to meet their dietary needs. People were supported to access health and social care services they required to maintain their health and well-being. Staff worked closely with other services to ensure people’s care and support were effectively delivered.

Staff received adequate training, support and supervision to be effective in their roles. Staff and the registered manager understood their roles and responsibilities under the Mental Capacity Act (MCA) 2005. People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible; the policies and systems in the service support this practice. People were supported appropriately to made decisions about their care and support. DoLS applications were made where necessary and the conditions of DoLS authorisations were followed.

The service had facilities suitable for people. People’s rooms were well decorated with personal items such as photographs. Staff treated people with dignity and respect. People were involved in their day-to-day care; and staff respected their choices. Staff encouraged and supported people to maintain relationships important to them. Staff communicated with people in the way they understood.

People had support plans in place which contained details about how their individual care and support needs would be met. People’s needs were regu

Arundel House operates a range of services for adults with learning disabilities. The site offers a residential care home for a maximum of 18 people. The care home is divided into four units, three of which provide long-term residential care and a further separate unit that provides respite (short-term care) for up to five people. The provider also operates an outreach service to people either living in the community in their own homes or in supported living accommodation. There are three supported living flats on the same site as the care home.

Due to ongoing discussions about Surrey County Council’s role as a direct provider of care, the services at Arundel House have not recently been actively marketed. As such, at the time of our inspection there were 11 people living in the care home and four people regularly accessing the respite service. Twelve people were in receipt of outreach services, of which only one person currently received a service within the definition of regulated care.

The inspection took place over two days on 24 May 2016 and 06 June 2016. The first inspection day was unannounced.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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.

Arundel House had a strong leadership team which effectively managed all the services provided at this location. People benefitted from a culture within the service that was open, inclusive and valued their views. There were good systems in place to continually audit and monitor the service which facilitated development and the delivery of high quality care.

Staffing levels were provided flexibly and were responsive to people’s needs and activities. Appropriate systems were in place to ensure only suitable staff were employed and all staff received relevant training to enable them to undertake their roles.

People received personalised care that was responsive to their needs. Each person had a detailed plan of care that was kept under regular review. Risks to people were identified and managed in a proactive and enabling way that balanced their safety and independence.

People spent their time participating in activities that were meaningful to them and enjoyed the ability to pursue their own individual hobbies and interests. The service had a clear statement of purpose which supported people to lead their lives as they chose and work towards achieving maximum independence.

The service had a relaxed and friendly atmosphere which was reflected in the laughter and sense of fun. Staff were kind and caring towards people and had a good understanding of people’s needs. Staff provided sensitive support to people in a way that upheld their privacy and dignity at all times.

People were protected from the risk of abuse, avoidable harm or discrimination because staff understood their roles and responsibilities in protecting them. Staff understood the importance of gaining consent from people and acted in accordance with the principles of the Mental Capacity Act 2005.

People were supported to maintain good health. The service had good links with other health care professionals to ensure people kept healthy and well. Medicines were managed safely and there were good processes in place to ensure people received the right medication at the right time.

People had choice and control over their meals and were effectively supported to maintain a healthy and balanced diet. Specialist dietary needs were managed well.

Our inspection of this care service helped answer 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. The summary is based on our observations during the inspection, talking to people who used the service, the staff supporting them and from looking at records.

If you want to see the evidence supporting our summary please read the full report.

Is the service safe?

People were treated with respect and dignity by the staff.

Systems were in place to make sure that managers and staff learn from events such as accidents and incidents, complaints, concerns, whistleblowing and investigations. The provider reported safeguarding alerts to the local authority and notified CQC. This reduced the risks to people and helped the service to continually improve.

The registered manager sets the staff rotas, they take people's care needs into account when making decisions about the numbers, qualifications, skills and experience required. This helped to ensure that people's needs were always met.

Is the service effective?

People's health and care needs were assessed with them, and they were involved in writing their plans of care. We saw evidence that where it was appropriate relatives had also been involved in the care planning when their family member first started to receive care from the service. We saw details that reviews were held by the service to ensure that care plans reflected their current needs.

Is the service caring?

People using the service, their relatives, friends and other professionals involved with the service completed an annual satisfaction survey. Where shortfalls or concerns were raised these were addressed.

People's preferences and interests had been recorded and care and support had been provided in accordance with people's wishes.

Is the service responsive?

We looked at the complaints record and found there had been no complaints made to the provider. We were told that the complaints policy was displayed at the various locations where the service provided care. The complaints policy we looked at had been designed, written and developed to be user friendly in an easy read pictorial format. It was noted however that the provider had made clear provisions to ensure that people could be assured that if a complaint had been received there was a system in place which would ensure investigation and action.

Is the service well-led?

The service worked well with the other processional bodies and authorities that had placed people with them. This ensured people received their care in a joined up way.

The service had a quality assurance system, records seen by us showed that identified shortfalls were addressed promptly. As a result the quality of the service was continuingly improving.

Staff told us they were clear about their roles and responsibilities. Staff had a good understanding of the ethos of the service and that quality assurance processes were in place. This helped to ensure that people received a good quality service at all times.

The people who lived at the service received care that was inclusive and person centred based on their known choices, future needs wishes. The service had care plans which had been written with input from people who used the service their families or representatives. They included information gathered from initial assessments, health care professional to ensure that they were person centred. They also include goal plans, and guidance on how people would be supported to achieve these.

The service had safeguarding procedures in place linked to Surrey County Council safeguarding vulnerable adults from abuse procedures. The service also had a whistle blowing procedure in place and staff had completed training in Mental Capacity Act 2005 and deprivation of liberty safeguards (DOLS).

The service was completing a refurbishment programme. It was noted that not all areas were benefiting from the refurbishment and that some were being left with potential trip hazards, damage and stains.

The staff confirmed that their employment and development was reviewed and discussed with them during their supervision or their annual performance appraisal.

We saw that the service had systems in place to monitor the quality of care and support and any future improvements. The registered manager told us that the people who used the service had regular daily contact with all staff. Staff told us that this enabled them to identify any issues and to resolve any problems immediately.

We spoke to three family members of the people who live Arundel House. They told us that their relatives were "given appropriate information and support regarding their care or treatment". They felt that the way the service carried out there "initial assessments and the planning of care was good and highlighted their relatives needs".

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We were told that people where supported by staff to individualise and to decorated their bedrooms in their favourite colours.

People also told us they liked the staff, their rooms, and felt safe living at their home and would go to their key-worker if anyone upset them.

We were told about community activities the people who live at the service were involved in, such as going to day centres, parties, outings and shopping.

On the day of the visit the limited levels of verbal communication did not allow us to talk to or ask questions from the people who use the service. We were able to observe interaction between the people who use the service and staff.

All the people we saw appeared relaxed and involved in preparations for their day’s activities, the day centre, personal undertakings and shopping independently or with staff.

We saw people choosing where to sit and relax in the home.

We observed good interactions between staff and people who use the service.

We observed that staff were attentive to those at home and they demonstrated a good understanding of their communication styles or body language.

Staff were seen to offer appropriate support and guidance in a sensitive, knowledgeable and caring manner.

All the people we spoke to appeared relaxed and involved in preparations for their day’s activities, the day centre, personal undertakings and shopping independently or with staff.

We saw people choosing where to sit and relax in the home.

We observed good interactions between staff and people who use the service.

We observed that staff were attentive to those at home and they demonstrated a good understanding of their communication styles or body language.

Staff were seen to offer appropriate support and guidance in a sensitive, knowledgeable and caring manner.