About the service Arundel House is a care home providing personal care for up to 12 adults who may have learning difficulties and/or a physical disability. At the time of the inspection there were 11 people living at the home.
The service has been developed and designed in line with the principles and values that underpin Registering the Right Support and other best practice guidance. This ensures that people who use the service can live as full a life as possible and achieve the best possible outcomes. The principles reflect the need for people with learning disabilities and/or autism to live meaningful lives that include control, choice, and independence. People using the service receive planned and co-ordinated person-centred support that is appropriate and inclusive for them.
The service was a large home, bigger than most domestic style properties. It was registered for the support of up to 12 people. Eleven people were using the service. This is larger than current best practice guidance. However. the size of the service having a negative impact on people was mitigated by the building design fitting into the residential area and the other large domestic homes of a similar size. There were deliberately no identifying signs, intercom, cameras, industrial bins or anything else outside to indicate it was a care home. Staff were also discouraged from wearing anything that suggested they were care staff when coming and going with people.
People’s experience of using this service and what we found
People and their relatives were positive about the service. A person said, "I like it here." A relative told us, “The staff are exceptional. [Relative’s name] calls it home and that says a lot.”
Staff, new to the service, completed an induction. However, we found the induction process did not provide staff with the necessary training to meet people's needs and keep them safe. This was immediately addressed, and a full induction training programme was purchased by the provider ensuring new staff would receive training in subjects considered as essential for the role.
People were supported by enough staff, however, people had mixed views on the staffing levels. Some people told us the service was short staffed. We discussed these comments with the management team who told us this was due to a temporary reduction in their staffing levels which would be resolved in a matter of weeks. Prior to this, people were happy with the staffing levels and were having all their needs met. When the situation was resolved, people would receive the same level of support again.
There was an open and transparent culture within the service. Quality assurance and governance systems were in place to assess, monitor, and improve the quality and safety of the services provided. However, systems and processes had not been fully effective to ensure staff had been provided with the necessary training to keep people safe.
People told us they felt safe living at Arundel Hose. People looked comfortable with staff and staff were friendly, respectful and attentive to people's needs. People who could not tell us, showed in their expressions and behaviours, they enjoyed the company of staff. Staff respected people's privacy and protected their dignity.
There were appropriate systems in place to protect people from the risk of abuse. Staff knew how to safeguard people and were confident to raise any concerns. The provider had effective systems in place to ensure safe recruitment practices.
Risks to people were well known and there were robust assessments to address concerns. People received personalised support centred around their support needs, preferences and choices. This was regularly reviewed with people, their relatives and professionals.
People received the support they needed to stay healthy and to access healthcare services. People's nutritional needs were consistently met, and guidance given by professionals followed by staff. People were offered choices at mealtimes and supported with a specialist diet where appropriate.
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.
The service applied the principles and values of Registering the Right Support and other best practice guidance. These ensure that people who use the service can live as full a life as possible and achieve the best possible outcomes that include control, choice and independence.
The outcomes for people using the service reflected the principles and values of Registering the Right Support by promoting choice and control, independence and inclusion. People's support focused on them having as many opportunities as possible for them to gain new skills and become more independent.
People living at Arundel House participated in activities and were actively involved in their local community.
People knew how to complain, and any complaints had been resolved to people's satisfaction. People were asked their opinions on the service by attending meetings and completing surveys and suggestions had been acted upon.
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 31 December 2016).
Why we inspected
This was a planned inspection based on the previous rating.
Enforcement:
We found a breach of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014 in relation to safe care and treatment. Please see the ‘action we have told the provider to take’ section towards the end of the report.
Follow up
We will continue to monitor intelligence we receive about the service until we return to visit as per our re-inspection programme. If we receive any concerning information we may inspect sooner.