This comprehensive inspection took place on 16 March 2017 and was unannounced. Arundel House is a ten bed service for people with a learning disability and supports people to live within their community. On the day of our inspection there were nine people using the service.

There was a manager in post at the time of the inspection. 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.

We received positive comments from people using the service where they were able to verbally express their views and their relatives about the staffing arrangements in the service. Staff followed instructions to minimise known risks to people’s health and well-being. Measures had been put into place to ensure risks were managed appropriately.

People were supported by staff who had received training and who had been supported to obtain qualifications. This ensured that the care provided was safe and followed best practice guidelines. Robust recruitment checks were in place to ensure new staff were suitable to work with people who used the service.

People received their medicines safely. Staff responsible for administering medicines had received relevant training.

Some staff we spoke with could not demonstrate a confident knowledge in the requirements, and their responsibilities in line with the Mental Capacity Act 2005. This was because they had not yet completed updates in training in this area, however this was planned for the future. Not all applications to apply for Deprivation of Liberty Safeguards (DoLS) to protect the rights of people had been submitted to the local supervisory body for authorisation.

People had access to a variety of food and drink which they enjoyed. People were supported to eat and drink sufficient amounts to help them to maintain good health.

People were supported to have access to a wide range of health care professionals and were involved where able in the planning and reviewing of their care. Care plans we saw included people’s personal history, individual preferences and interests and reflected. People’s care and support needs. They also contained specific information and guidance for staff to enable them to provide individualised care and support.

People told us, or indicated that they were happy living at the service. We saw people continued to pursue individual interests and hobbies that they enjoyed. People were able to choose whether they wanted the opportunity to participate in meaningful activities.

People using the service and their relatives knew how to raise complaints. The complaints procedure was displayed in different formats to support people’s preferred way of communicating.

Systems were in place to monitor and improve the quality of the service provided. The quality audits addressed areas of concern in ensuring the service maintained compliance with the regulations and was consistently meeting people’s needs.

This was an unannounced inspection. Arundel House is a small care home. It provides accommodation and personal care and support for up to 10 people who may have mental health needs. There were four people who lived in the service when we visited.

The home had a registered manager in post. 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 and associated Regulations about how the service is run.

This inspection took place on 3 December 2014. Arundel House was last inspected 6 November 2013. There were no concerns found at this inspection.

Health and social care professionals we spoke with were all positive in their comments about the support provided to people at Arundel House.

The service was meeting the requirements of the DoLS. Appropriate mental capacity assessments and best interest decisions had been undertaken by relevant professionals. This ensured that the decision was taken in accordance with the Mental Capacity Act (MCA) 2005, Deprivation of Liberty Safeguards (DoLS) and associated Codes of Practice. The Act, Safeguards and Codes of Practice are in place to protect the rights of adults by ensuring that if there is a need for restrictions on their freedom and liberty these are assessed and decided by appropriately trained professionals.

The home had robust systems in place to keep people safe. We saw that staff followed these guidelines when they supported people, for example when people became anxious, they knew how to safely support and comfort people.

Staff were aware of people’s individual risks and were able to tell us about the arrangements in place to manage these safely. There were sufficient numbers of care staff available to meet people’s care needs and people received their medication as prescribed and on time.

There was a process in place to ensure that people’s health care needs were assessed. This helped ensure that care was planned and delivered to meet people’s needs safely and effectively. Staff knew people’s needs well and how to meet these. People were provided with sufficient quantities to eat and drink and their nutritional needs were met.

People’s privacy and dignity was respected at all times. Staff were seen to knock on people’s bedroom doors and wait for a response before entering. We saw suitable ways were adopted to protect people’s dignity when providing personal care.

People were offered a variety of chosen social activities and supported to follow their interests and hobbies. People were encouraged to take part in activities that interested them and were supported to maintain contacts with the local community so that they could enjoy social activities outside the service.

People and their relatives were involved in making decisions about their care and support. Care plans reflected people’s care and support requirements accurately and people told us their healthcare needs were well managed.

Throughout the inspection we observed that staff interacted with people in a caring, respectful and professional manner. Where people were not always able to express their needs verbally we saw that staff were skilled at responding to people’s non-verbal requests promptly and had a detailed understanding of people’s individual care and support needs.

There were systems in place to manage concerns and complaints. No formal complaints had been received in the last year. Informal concerns received from people had been recorded and included the action taken in response.

There was an open culture and the manager and staff provided people with opportunities to express their concerns and did what they were able to reduce people’s anxiety. People understood how to make a complaint and were confident that actions would be taken to address their concerns.

The provider had a robust recruitment process in place to protect people from the risk of avoidable harm. Records we looked at confirmed that staff were only employed within the home after all safety checks had been satisfactorily completed.

Checks had been completed for things such as gas and electrical safety in the home. This ensured that the service was a safe place for people, staff and visitors.

The provider had effective quality assurance systems in place to identify areas for improvement and appropriate action to address any identified concerns. Audits, completed by the provider and registered manager and subsequent actions had resulted in improvements in the service. Systems were in place to gain the views of people, their relatives and health or social care professionals. This feedback was used to make improvements and develop the service.

We gathered evidence of people’s experiences of the service by speaking with them, observing how they spent their time and we noted how they interacted with other people who lived in the home and with staff. Some people had complex needs and were not able to talk to us but we saw that staff were friendly and respectful in their approach and interacted with people who used the service in a confident and considerate manner.

During the course of our inspection we saw that people were supported to express their views and choices by whatever means they were able to, and staff clearly understood each person’s behaviours and their way of communicating their needs.

We saw that the people appeared happy.

We saw that people received care in ways that met their individual needs. There were processes in place to ensure that care was delivered safely and that they received adequate nutrition. One volunteer told us the home was: “Very good indeed. The staff are lovely here.”

It was evident that staff knew people well and we saw that there were caring conversations between members of staff and people who lived in the home. We saw that staff listened to people and treated them with respect. When people were anxious staff understood what to do to help them relax.

People were protected against the risks associated with medicines because the provider had appropriate arrangements in place to manage medicines.

We found that there were enough trained, skilled and experienced staff to meet people's needs. Staff received the training they needed to provide care and support safely and were able to demonstrate that they understood the specific needs of the people who used the service. We saw that staff treated people with respect.

We saw there was an effective complaints system available and that people were protected from the risks of unsafe or inappropriate care and treatment because accurate and appropriate records were maintained.

Arundel House was well managed and the registered manager had systems and processes in place which ensured people received a good service that took into account their needs and preferences.

We used a number of different methods to help us understand the experiences of people using the service. This was because the people living at the home had complex needs which meant that they were not able to tell us their experiences. We spoke to people living at the home and were able to observe staff supporting people.

We saw that the people living at the home were supported and encouraged to exercise choice in their day to day lives. Independence was also promoted and staff worked with people to achieve this. People received the care, support and treatment they needed and this was provided in an individual way.

During the course of our visit we saw that people were supported to express their views and choices by whatever means they were able to and staff clearly understood each person’s behaviours and their way of communicating their needs. Staff looked after people's healthcare needs in a proactive way.

The staff team were well trained and supported to carry out their role.

The provider had effective systems in place to monitor the quality and safety of service that people received.

People told us that they really liked living at Arundel House and felt supported by the staff. One person said "I feel safe here and the staff help me." People were enabled by the staff to make choices and decisions about everyday tasks and activities and things that were important to them. One person told us "I like the pictures in my care plan as they help me understand hard words." People appeared relaxed and comfortable in their home.