This inspection took place on 28 March 2017 and was unannounced. At our last inspection in April 2015 the service was rated ‘Good’. At this inspection we found the service remained ‘Good’.

Arthur Lodge is a care home for adults with learning disabilities, including those with a dual diagnosis of a mental health condition. The maximum number of people the service can accommodate is 11.

There was a registered manager in post. 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.

People told us they were well treated at the home and risks to their safety had been identified and ways to mitigate these risks had been recorded in people’s care plans.

Relatives were positive about the family who ran the home and the domestic nature of the accommodation. Everyone we spoke with told us the service was very homely and relaxed. Staff turnover was low and everyone knew each other very well.

Staff were aware that the people they supported were vulnerable and they understood their responsibilities to keep people safe from potential abuse.

There were systems in place to ensure medicines were handled and stored securely and administered to people safely and appropriately.

Staff turnover was low and staff were positive about working at the home and told us they appreciated the support and encouragement they received from the registered manager.

Staff understood the principles of the Mental Capacity Act (MCA 2005) and knew that they must offer as much choice to people as possible in making day to day decisions about their care. This included making sure people who had difficulty communicating verbally were as involved in their care and decision making as everyone else.

People told us they enjoyed the food provided and that they were offered choices of what they wanted to eat.

People had regular access to healthcare professionals such as doctors, dentists, chiropodists and opticians.

Staff treated people as unique individuals who had different likes, dislikes, needs and preferences.

People told us that the management and staff listened to them and acted on their suggestions and wishes.

Both people using the service and their relatives told us they were happy to raise any concerns they had with any of the staff and management of the home.

People were included in monitoring the quality of the service and we saw that their suggestions for improvements and preferences about how they wanted to live their lives were respected and acted on.

This inspection took place on 14 April 2015 and was unannounced. At our last inspection in April 2013 the service met all the standards we looked at.

Arthur Lodge is a care home for adults with learning disabilities, including a dual diagnosis of a mental health condition. The maximum number of people they can accommodate is 11. On the day of the inspection there were eight people residing at the home.

There was a registered manager in post. 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.

People told us they felt safe at the home and safe with the staff who supported them. They told us that staff were patient, kind and respectful. They said they were satisfied with the numbers of staff and that they didn’t have to wait too long for assistance.

The registered manager and staff at the home had identified and highlighted potential risks to people’s safety and had thought about and recorded how these risks could be reduced.

Staff understood the principles of the Mental Capacity Act 2005 (MCA) and told us they would presume a person could make their own decisions about their care and treatment in the first instance. Staff told us it was not right to make choices for people when they could make choices for themselves.

People had good access to healthcare professionals such as doctors, dentists, chiropodists and opticians and any changes to people’s needs were responded to appropriately and quickly.

People told us staff listened to them and respected their choices and decisions.

People using the service and staff were positive about the registered manager and management of the home. They confirmed that they were asked about the quality of the service and had made comments about this. The management took people’s views into account in order to improve service delivery.

Some people who used the service communicated through non-verbal methods. In response to a question about the staff, one person smiled and nodded when asked if they liked them. Another person told us "like it here." During our inspection in December 2012, we were concerned that the registered manager shouted at the inspection team in front of people using the service. We were also concerned that people were not confident to express their views in relation to their care and treatment. During this inspection, we found the provider had taken appropriate steps to address these concerns. Systems were in place to meaningfully gather people's views.

During the last inspection, the provider had previously failed to notify us of incidents of injuries and deaths in a timely manner. We saw that the home now has systems in place to ensure we are notified appropriately and promptly.

We found that care plans and assessments of risks to people who use the service were regularly reviewed. Staff demonstrated the knowledge and skills needed to protect people from abuse. One person told us "yeah, feel safe here." We found that staff received appropriate training to work with people who use the service in relation to their individual care needs. The provider had a system in place to regularly assess and monitor the quality of service that people receive.

The provider might like to note that one person's care plan did not identify the steps staff should take in an emergency situation.

People we spoke with told us they were generally happy with the service. For example, one person said, they were “happy here” We spoke with five people who use the service. Some people were positive about the service and the care provided. We found that some people were not involved in the care delivered to them. Staff did not always have due regard for people's dignity.

Care plans reflected people's current needs. We found that care plans and assessments of risks to people who use the service were regularly reviewed. The provider was managing safeguarding in line with it's own procedures.

Recruitment processes were robust. There was an effective complaints system available. The provider had failed to notify us about injuries and incidents.

We observed that people were involved and consulted about decisions affecting their care. A pictorial format has been used so that people could be involved and their choices reflected in their care plans. People said that they received the care and support they needed. A person said, “Staff will spend time with you.” Care plans gave clear guidance for staff about how they should meet people's learning disability needs.

People spoken to confirmed that they trusted staff and felt safe. A person told us, “I am safe here.” Staff knew how to respond to safeguarding concerns to keep people safe and promote their rights. People felt that staff knew how to meet their needs. People’s suggestions would be used as the basis to improve the care provided by the home.