All current ALM versions since ALM 12.2x have patches that are cumulative (that means that they contain all the fixes from the previous patches), so in order to patch to the latest level all one needs to do is apply the most recent patch and it will contain all the previous version fixes. There is no longer a need to install patches in cumulative sequential order as has been the case in the past.
Since version 12.2x all patches are also full installers so the patching process is actually an uninstall of the previously installed version and installation of the newest patch level for that version. The installer will prompt you regarding this during the patch installation. This also answers your last questions as since the version is uninstalled and reinstalled then the services will be restarted after the installation as they are stopped during the uninstall.
For future reference, during an upgrade you can just install using the latest patch release and save yourself the stage of patching after the install (unless the directions specify otherwise for some specific reason spelled out within the directions, but I haven't seen such a note in any version released since version 11).
Hope this answers your inquiry and let me know if works well for you,