Arundel House

Updated 7 April 2023

The inspection

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. We checked whether the provider was meeting the legal requirements and regulations associated with the Act. We looked at the overall quality of the service and provided a rating for the service under the Health and Social Care Act 2008.

As part of this inspection we looked at the infection control and prevention measures in place. This was conducted so we can understand the preparedness of the service in preventing or managing an infection outbreak, and to identify good practice we can share with other services.

Inspection team

The inspection was carried out by one inspector and one Expert by Experience. An Expert by Experience is a person who has personal experience of using or caring for someone who uses this type of care service.

Service and service type

Arundel House is a ‘care home’ for people with mental health support needs. People in care homes receive accommodation and nursing and/or personal care as a single package under one contractual agreement dependent on their registration with us. Arundel House is a care home without nursing care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

Registered Manager

This provider is required to have a registered manager to oversee the delivery of regulated activities at this location. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Registered managers and providers are legally responsible for how the service is run, for the quality and safety of the care provided and compliance with regulations.

At the time of our inspection there was a registered manager in post.

Notice of inspection

This inspection was unannounced.

Inspection activity started on 2 February 2023 and ended on 13 February 2023. We visited the location’s service on 2 February 2023 and 8 February 2023.

What we did before the inspection

We reviewed information we had received about the service since the last inspection. The provider did not complete the required Provider Information Return (PIR). This is information providers are required to send us annually with key information about the service, what it does well and improvements they plan to make. We contacted Heathwatch for any information they might hold about the service. Healthwatch is an independent consumer champion that gathers and represents the views of the public about health and social care services in England.

We used all this information to plan our inspection.

During the inspection

We spoke with 6 people, and 6 relatives about their experience of the support provided. We received information from 5 health professionals involved with the service. We spoke with 8 members of staff, this included the providers and registered manager. We reviewed a range of records including 5 people’s care plans, risk assessments and health records. We looked at a variety of records relating to the management of the service, including policies and procedures and 4 staff files in relation to recruitment and supervision.

Updated 7 April 2023

About the service

Arundel House is a residential care home providing accommodation and support for people who require personal care and are living with mental health needs. One person had a learning disability. It is a large Victorian property spread over 3 floors and has some outside space which is available for people to use. Most people shared communal bathrooms though some people had their own bathroom. There was a communal lounge and separate dining room. The service provides support for up to 15 people. At the time of our inspection there were 13 people using the service.

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

People were not always kept safe from risks associated with fire.

We were not assured the provider was promoting safety through the hygiene practices for the premises or ensuring infection outbreaks would be effectively prevented or managed.

Risks were not always identified and managed, meaning people were potentially at risk of harm. There was a lack of good governance and oversight of the service. Staff appeared to understand and meet people’s needs and preferences, however, they had not received training about some people’s needs, for example, epilepsy, and learning disability.

Medicines were managed safely despite a lack of audits.

The home facilitated visits from family members and relatives told us staff were welcoming, friendly and helpful.

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. However, the policies and systems in the service were not always in place to support this practice.

People and relatives told us they thought the service was well led, and that they (or their relatives) felt people received safe care and were happy living there.

We expect health and social care providers to guarantee autistic people and people with a learning disability the choices, dignity, independence and good access to local communities that most people take for granted. Right support, right care, right culture is the statutory guidance which supports CQC to make assessments and judgements about services providing support to people with a learning disability and/or autistic people. We considered this guidance as there were people using the service who have a learning disability and or who are autistic.

We have made a recommendation about ongoing DBS (Disclosure and Barring Service) checks in staff recruitment.

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 2019).

Why we inspected

We received concerns in relation to people’s safety and how well the service was managed. As a result, we undertook a focused inspection to review the key questions of safe and well-led only. As a result of what we found during our site visit, we opened up the inspection to review the key question of effective as well.

The overall rating for the service has changed from good to requires improvement based on the findings of this inspection.

You can see what action we have asked the provider to take at the end of this full report.

On our first day of inspection, we asked the provider to carry out some urgent actions to ensure people’s safety, for example, removing broken glass from a person’s bedroom and boarding the window safely. They took some action that day to start making improvements.

You can read the report from our last comprehensive inspection, by selecting the ‘all reports’ link for Arundel House on our website at www.cqc.org.uk.

Enforcement

We have identified breaches in relation to the provision of safe care and treatment, adherence to the Mental Capacity Act, and the governance of the service at this inspection.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.