The inspection took place on 24 January 2017 and was announced.

Princess Marina House is situated on the south coast, in Rustington, West Sussex. It is an exceptionally large, purpose built, detached property spread over two floors. It has communal lounges, dining rooms and gardens. It is owned by The Royal Air Force (RAF) Benevolent Fund and is a home that offers respite and short breaks for serving and former RAF personnel and their families, however, will also accommodate personnel from other services. Princess Marina House can accommodate 50 people and is registered to provide care for up to 30 people, for adults over 18, some of whom are living with physical disabilities or dementia and who may require support with their personal care needs. On the day of the inspection there was one permanent resident who lived at the home and 16 people who were staying at the home for a short break. People could fund their own care and stay or have their stay subsidised by the RAF Benevolent Fund.

The RAF Benevolent Fund had conducted research and consulted with people across the country to identify what people required and expected of the fund. As a result, a respite at home service was implemented in 2016 for people who lived in their own homes, to reduce the risk of social isolation. This provided support for people, some of whom required support with their personal care needs, and offered a respite service to them and their permanent carers. On the day of the inspection there were six people receiving this service.

During the inspection we inspected both the home as well as the respite at home service.

The home and respite at home service had the same registered manager. 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, who stayed at the home and those that used the respite at home service, received a service that was extremely responsive to their needs. People who used both services had access to a wide and varied range of activities and stimulation to meet their social and emotional needs. People were complimentary about the entertainment provided within the home, they told us, “There is always some form of entertainment. Every day you can get to the village on their bus” and “There are trips out and even when there are only two of us, they still take us out. There is plenty of entertainment”. People who used the respite at home service were supported to access the local community and partake in activities that they enjoyed. A relative of a person who used the service told us, “They do respond to all their needs. They pick my relative up and return them”.

The home and the respite at home service was extremely well-managed by both the provider and the registered manager. The registered manager strived to continually improve the service provided and welcomed feedback and used this to drive improvements and change. There were quality assurance processes in place to enable the registered manager to have oversight of the home and of the respite at home service, to ensure that people were receiving the quality of service they had a right to expect. People, relatives’ and staff were extremely complimentary about the leadership and management of the home and of the respite at home service. One person staying at the home told us, “The manager is on the ball. It’s beautifully run”.

People told us that they received a service that they valued and that had a positive impact on their lives. Comments from people staying at the home, included, “The service here is first class, it’s like coming on holiday” and “This place is the jewel in the crown. I would recommend it”. Positive comments continued from people and relatives who used the respite a

A single inspector carried out this inspection. The focus of the inspection was to answer five key questions; is the service safe, effective, caring, responsive and well led?

At the time of our visit there were two people using the service permanently and 21 people there for short stays, two of whom had no support needs and were accompanying their less able partners. We spoke with one person living there permanently and seven people using the service for a short stay. We also spoke with three staff, the team manager and the registered manager. We observed care practices and reviewed a selection of records. Below is a summary of what we found. The summary describes what people using the service and the staff told us, what we observed and the records we looked at.

If you want to see the evidence that supports our summary please read the full report.

Is the service safe?

People we spoke with told us that they felt safe in the service and one person said, “I feel really secure. I couldn’t wish for better”.

Care plans included information on how to maintain a safe environment for people using the service. The risks people were likely to face in daily living had been assessed and were reviewed regularly for those using the service permanently. Up to date guidance for staff was provided on the actions required to minimise the risks while maintaining people’s well-being safely.

The service had policies and procedures in place in relation to the Mental Capacity Act 2005 (MCA) and Deprivation of Liberty Safeguards (DoLS). The manager told us that there was no one subject to DoLS at the time of the inspection but relevant staff had received training to understand when an application should be made and how to submit one.

Procedures for the safeguarding of vulnerable adults were robust. We saw that staff received annual training on the subject and those we spoke with told us that they would not hesitate to report suspected abuse or concerns of poor practice in order to protect people’s safety.

From our discussions with staff and the evidence seen we found that staff received the appropriate training, supervision and support to care for people safely.

Quality assurance systems were in place to ensure that lessons were learnt from the outcome of service reviews and events such as accidents and incidents and comments and complaints. This reduced the risks to people and helped the service to improve.

Is the service effective?

People told us that they were satisfied with the care provided and said their needs were met. One person said, “I really relax when I’m here and they meet my every need”. Another told us, “They encourage me to be as independent as possible but are always there if I want them”.

People’s care and support needs were assessed with them, and people confirmed they had been involved in writing their care plans and these reflected their current needs. We saw that their written consent was obtained for the care and support to be provided. Their verbal consent was also sought before any care and support was delivered and staff respected their right to refuse their help.

Specialist equipment was available when required and the design of the premises enabled people with physical impairments to move around freely and safely.

Evidence showed that staff received the relevant training and support to provide effective care for people using the service. It was clear from what we saw and from speaking with staff that they had a good understanding of people’s care and support needs and knew how to respond effectively in an emergency situation.

Is the service caring?

People were supported by caring and attentive staff. We saw that care workers treated people with dignity and respect and were friendly, patient and positive in their interactions with them. One person said, “The carers are good at their jobs and care for you so well. I wouldn’t go anywhere else”. Another said, “I feel loved and cared for”.

People’s preferences and diverse needs were recorded and care and support was provided in accordance with their wishes.

The atmosphere at Princess Marina House was relaxed and cheerful. Several staff we spoke with told us that they had been working in the service for several years and loved their jobs and enjoyed caring for people.

Is the service responsive?

Everyone had a person centred care plan and for people using the service permanently, these were reviewed and updated regularly and in response to their changing needs. Records confirmed that people received the care and support as described in the plan.

People were able to undertake a range of activities both within and outside the service if they wished. There was a library, wi-fi access and a licensed bar. The service also had three minibuses to enable people to access the community both locally and further afield for organised trips.

Staff were responsive to people’s changing health care needs. Several people gave examples of how the service had responded effectively when they were unwell by obtaining help and advice quickly from the appropriate health care professionals.

Is the service well led?

The service had a quality assurance system in place which included audits and reviews carried out by the manager and the provider. The evidence showed that any concerns or shortfalls identified were addressed quickly and that improvements were implemented when required.

People who use the service, staff and visiting professionals were asked their views about the care and support provided and we found examples where action had been taken to improve the service provided as a result of their responses.

Staff we spoke with were clear about their roles and responsibilities and all said they were well supported by their manager and a good team who all worked effectively together.

During our inspection we spoke with two of the three people who lived at the service on a permanent basis and one of the people who used the service on a respite basis.

People told us that they were happy with the care and support they received.

One person told us, "It couldn't be better, I get all the help I need".

Another person told us, "They are very good, you only have to ask".

We looked at people's individual care records. We saw that there was guidance for staff on how care and support should be provided in order to meet people's individual needs.

Staff demonstrated that they knew how care was to be delivered in line with people's wishes and preferences.

We spoke with five of the 20 people who were accommodated at Princess Marina House. People told us they were very satisfied with the care and services provided. One person said, "This is a perfect place to have a break. The carers are amazing." Another person commented, "I have no complaints. I believe the home is well run."

We spoke with two members of staff, who were on duty. We found that they had a good understanding of their roles and responsibilities.

We also gathered evidence of people's experiences of the service by looking at a selection of records. This included care records, medication records and records of complaints that had been received. We found that care records needed some improvements to ensure they provided care staff with appropriate information to follow with regard to the can to be delivered. This would mean individual needs would be met. We also found they demonstrated that people had given consent to the care they had received.

The manager demonstrated they had in place a system for recording and investigating any complaint that been made.

Medication records we examined demonstrated people had received medication that had been prescribed to them. They also demonstrated a robust system for recording medication that that been received and that unused medication had been disposed of safely.

We spoke with two people who live at the home and two people staying temporarily on respite care. All were happy with the care and support provided. One person said, “You wouldn’t get better in a five star hotel”. Another told us that they “couldn’t have found a better place”. All the people we spoke with confirmed that they were treated with respect and their privacy and dignity were maintained. They also confirmed that they felt safe from harm whilst living at the home and felt able to raise concerns with staff if they needed. One person said that" Staff sit and listen. They are very caring”. All the people we spoke with told us that there was a wide variety of social activities available to choose from. One person said, “I like it so much I want to come back for Christmas”.

People told us they liked living at the home and that the service met their needs. Reference was made to the kindness of the staff and the good relationship that people who stay at the home had with the staff.

People told us the staff were very good and their needs were met. People said they had no concerns about the staffing levels at the home, they told us that staff were kind and caring and that there was always someone around to provide help and support.

Comments included the following: “This is a fantastic service. It’s a home from home.” “I could not be in better hands.” “The staff are brilliant.” “I could not fault anything. The staff are so good.” and “I regularly come here for a short stay. It’s wonderful”.

People said that they had no complaints about the service and that if they did they would speak to a member of staff.