Arundel Domiciliary Care Services Limited is registered to provide personal care to people living with a learning disability and other complex needs, including autism and mental health. The service model is based on supported living with people receiving personal care and support from staff employed by the provider. People have their own service user/tenancy agreements. The service supports people across locations in East and West Sussex and Surrey.

At our last inspection in September 2016 we rated the service Good. At this inspection we found the evidence continued to support the rating of Good and there was no evidence or information from our inspection and ongoing monitoring that demonstrated serious risks or concerns. This inspection is written in a shorter format because our overall rating of the service has not changed since our last inspection.

People felt safe and received care and support from staff who understood and managed their risks appropriately. Lessons were learned and improvements made when things went wrong. Staffing levels were sufficient to meet people’s needs and new staff had checks made on their suitability to work in a care setting. Medicines were managed safely. People were encouraged to be independent by participating in housekeeping duties such as laundry or cooking and keeping their rooms clean.

Technology was used to aid people’s communication. Staff completed a range of training to meet people’s care and support needs and attended supervision meetings with their line managers. People had sufficient to eat and drink and were encouraged with healthy diets and lifestyles. They had access to a range of healthcare professionals and services. People had personalised their rooms and had access to communal areas. 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.

People were supported by kind and caring staff and positive relationships had been developed. People were involved in all aspects of their care and were encouraged to make decisions and choices. They were treated with dignity and respect.

Care plans provided detailed information about people and guidance to staff. Positive behaviour support was used by staff to manage or prevent any incidents of challenging behaviour. Communication systems had been developed that were personalised and effective. People’s diverse needs were catered for. People were involved in a range of activities, the majority of which were out in the community. Planners were organised to enable people to choose what they would like to do in line with their interests. Complaints policies were accessible and easy for people to understand.

Staff felt supported by their managers and spoke positively about working for the organisation. They were clear about their roles and responsibilities and feedback from a staff survey was positive. People and relatives were asked for their comments about the service and results were favourable. Audits were effective in monitoring and measuring the service and in driving continuous improvement.

Further information is in the detailed findings below.

The inspection took place on 13 and 16 September 2016 and was announced.

Arundel Domiciliary Care Services is registered to provide personal care to people living with a learning disability and other complex needs, including autism and mental health. The service model is based on supported living with people receiving personal care and support from staff employed by the provider. People have their own service user/tenancy agreements. At the time of our inspection, the service was supporting 42 people across 14 locations in East and West Sussex and Surrey.

A registered manager was 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 and were protected from harm. Staff were trained to recognise the signs of potential abuse and knew what action to take. People’s risks were identified, assessed and managed appropriately. People who were at risk of displaying challenging behaviour had their risks assessed and staff had clear guidance on how to manage challenging behaviour. There were sufficient numbers of staff available to support people safely and staff were available 24 hours a day within the supported living houses. A robust recruitment system was in place to ensure new staff had all the necessary checks completed before they were allowed to commence employment. Medicines were managed safely by trained staff.

Staff received all essential training to support people’s needs effectively. New staff completed the Care Certificate, a universally recognised qualification. Staff were encouraged to pursue additional qualifications by the provider. Staff had at least four supervision meetings a year and attended team meetings. Staff had a good understanding of the Mental Capacity Act 2005 (MCA) and their responsibilities under this legislation. People had sufficient to eat and drink and had access to a range of healthcare professionals and services.

People were supported by kind and caring staff who knew them extremely well. People spoke highly of the staff who looked after them and said they were treated with dignity and respect. People were involved in all aspects of their care and were supported to express their views. Person-centred plans were in place in a range of accessible formats.

People were encouraged to pursue activities of interest to them, for example through education, and to have a social life. They were supported by staff in the community. Care plans included comprehensive, detailed information about people, their care needs and how they wished to be supported. People had monthly meetings with their keyworkers to discuss all aspects of their care. Where needed, behaviour support plans were in place and the senior management team worked closely with a range of healthcare professionals, at initial assessment and through continual monitoring of people’s healthcare needs. Complaints were investigated and managed appropriately in line with the provider’s policy.

People were involved in developing the service and their feedback was obtained through service user questionnaires; relatives were also asked for their views about the service. Staff were asked about their conditions of work by the provider through a formal survey. The culture of the service was person-centred, inclusive and empowering. Good management and leadership was visible and endemic throughout the service. Staff felt supported and listened to and there was an open culture. High quality care was delivered and a range of audits identified any improvements that might be needed, together with actions that were required to be taken to drive continual improvement.

Arundel Domiciliary care services looked after 39 service users in 14 different locations providing support in daily living schemes. During our visit we spoke with the registered manager, the director of the care service and the behavioural support manager. We also spoke with four members of support staff, four people who used the service, and spoke with four relatives over the telephone after the visit ended. We visited four different locations. The people who used the service told us they were happy with the care and support provided by the agency and that they had been involved in assessments to decide if the service could meet their needs. The people we spoke to felt in control of their decisions and felt they had been provided with opportunity to maintain their independence.

One relative told us, “They are very flexible, caring and responsive and extremely professional. In my opinion, they are faultless”. Another relative told us “They regularly keep me informed and they are doing a really good job. They do much more for that I ever could”

Staff also told us they attended relevant training courses to inform and direct their work, and they received regular supervision and annual appraisal. Staff told us they knew how to raise concerns and would not hesitate to do so if they were concerned. The provider had a number of systems in place to review the quality of the service provided and that the standard of care within the service was meeting people’s needs.

We used a number of different methods to help us understand the experiences of people using the agency as some people had complex needs which meant they were not able to tell us their experiences. We spoke with three people who received a service from the agency. We also spoke with relatives of two people. We also gathered evidence of people’s experiences of the service by reviewing the results of the agency's 2012 surveys.

Everyone spoken with told us that their care was personalised to their needs and that their dignity and independence was respected. For example, one person told us, "They (referring to the care workers) help me be more independent. They treat me like an adult. They encourage me to do more for myself".

People also expressed satisfaction with infection control practices when care workers supported them. They told us that care workers appeared appropriately trained and used equipment including disposable gloves and aprons when needed.

Everyone that we spoke with told us that they knew of ways to raise concerns if they were unhappy with the service they received. They also told us that they were confident that if they raised concerns these would be acted upon. For example, one person said, "If there were any problems we would go to the management. We never have needed to though. Little niggly things have always been sorted quickly when we have raised them".

Evidence obtained during our inspection supported the views expressed by people.

We did not on this occasion speak with people so cannot report what the people using the agency said. We spoke with a health professional and 3 staff. The health professional had very positive comments to make on the agency and the care offered. The staff all confirmed that the agency is a supportive place to work and that there is comprehensive induction, training and supervision in place.