This inspection took place on 12 and 13 July 2018. It was unannounced. This was the first inspection at Appleton House since it re-registered with a new provider.

Appleton House is a care home. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. The Care Quality Commission regulates both the premises and the care provided, and both were looked at during this inspection.

Appleton House is registered to provide residential and personal care for up to seven people with mental health needs. The home is situated in a residential district of Southampton with nearby public transport links. Facilities include an enclosed garden for people to enjoy at the rear of the home, a dining room and shared lounge, and a quiet sitting area. At the time of the inspection there were six people living at the home, with one person in hospital.

There was a registered manager in post. A registered manager is a person who has registered with 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.

The provider had arrangements in place to protect people from risks to their safety and welfare, including the risks of avoidable harm and abuse. Staffing levels were sufficient to support people safely. Recruitment processes were in place to make sure the provider only employed workers who were suitable to work in a care setting. There were arrangements in place to protect people from risks associated with the management of medication and the spread of infection.

Care and support were based on thorough assessments and care plans, which reflected professional standards and were reviewed regularly. Staff received appropriate training and supervision to maintain and develop their skills and knowledge to support people according to their needs. Staff advised people to eat a healthy diet while respecting their individual food choices. People were supported to access healthcare services, such as GPs and specialist mental health teams. 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 supported this practice.

Care workers had developed positive relationships with people they supported. People were supported to take part in decisions about their care and treatment, and their views were listened to. Staff respected and promoted people’s independence, privacy, and dignity.

People’s care and support took into account their abilities, needs, preferences and choices, and reflected their physical, emotional and social needs. People were able to take part in a range of leisure activities and entertainment. People were aware of the provider’s complaints procedure, and complaints were managed professionally.

The provider had a clear vision and strategy, which was shared with staff and people using the service. Systems were in place to make sure the service was managed efficiently and to monitor, assess, sustain and improve the quality of service provided.