22 Argyll Street

22 Argyll Street is a 'care home'. People in care homes receive accommodation and nursing or personal care as a single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection. 22 Argyll Street provides accommodation and support for up to nine adults, who have a learning disability, physical disability and/or Autism. At the time of the inspection, there were nine people living at the home.

We expect health and social care providers to guarantee people with a learning disability and autistic people respect, equality, dignity, choices and independence and good access to local communities that most people take for granted. ‘Right support, right care, right culture’ is the guidance CQC follows to make assessments and judgements about services supporting people with a learning disability and autistic people and providers must have regard to it.

People’s experience of using this service and what we found

Risks associated with people's care were not always fully assessed and some care plans lacked sufficient detail to mitigate those risks. This included safely supporting people and nutritional risks that could impact on people's health. The provider took immediate action to make the improvements needed.

Systems in place for storing and administering medicines were safe. Staff had received training and had their competency to administer medicine safely, checked. However, information about when people had ‘as and when required’ medicines required more detail. This was to ensure staff would always be able to recognise when this type of medicine needed administering.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible and in their best interests. However, the policies and systems in the service did not always support this practice. Mental capacity assessments (MCA) were not always in place where they should be.

People's nutritional needs were met, and they were supported to have a healthy and varied diet. However, information about known risks such as when people required a modified diet, were not always sufficiently detailed. The provider took immediate action to make the required improvements.

The provider’s governance processes in place failed to identify all the shortfalls we found. The provider took immediate action to make the required improvements.

Right Support: People were supported have choice, control and independence. They were supported to participate in activities they enjoyed and be active members of their community.

Right Care: It was clear staff knew people well and provided caring support to each person. We observed staff speaking to people with kindness and patience and using some of the agreed communication techniques described in care plans. People were supported by staff who respected their dignity, privacy and human rights and were involved in decisions about their own life.

Right Culture: The vision, values, attitudes and behaviours of the management team and care staff, supported people to be confident and empowered in living in the community. However, some care records needed to be improved to consider language used and demonstrate an improved understanding of the MCA.

There were enough staff to meet people's needs safely and provide person centred care. Staff had received appropriate training and support to enable them to meet people’s needs. They received supervision and had their competency checked, to ensure they developed and maintained their skills and were supported in their role.

People’s needs had been assessed and care plans were person centred and contained information about their life history, care needs, what and who was important to them, and how their needs would be met. End of life care plans were in place, which were person centred and captured people’s wishes well.

People told us they liked the staff and felt safe with them. Staff had received training in safeguarding and were able to describe what actions they would take should they witness or suspect abuse. Accidents, incidents and safeguarding records were made and there were processes in place to ensure these were reviewed and any lessons learnt if required. There was a complaints policy and people, and their relatives knew how to raise concerns.

The home was clean and tidy and in good repair; this meant infection control risks were managed. Staff wore PPE when needed.

A new manager was commencing work in the service and was being supported by the service manager. The senior management team demonstrated they were committed to continuous learning and improving the service, to ensure action was taken where we identified improvements were needed.

For more details, please see the full report which is on the CQC website at www.cqc.org.uk

Rating at last inspection

This service has a new provider and was registered with us on 19 December 2022, and this is the first inspection. The last rating for the service under the previous provider was Outstanding, published on 8 March 2019.

Why we inspected

The inspection was prompted in part due to concerns received about medicines and the management of the service. A decision was made for us to inspect and examine those risks.

We looked at infection prevention and control measures under the Safe key question. We look at this in all care home inspections even if no concerns or risks have been identified. This is to provide assurance that the service can respond to COVID-19 and other infection outbreaks effectively.

Enforcement

We have identified a breach in relation to good governance at this inspection. Please see the action we have told the provider to take at the end of this report.

Follow up

We will request an action plan from the provider to understand what they will do to improve the standards of quality and safety. We will work alongside the provider and local authority to monitor progress. We will continue to monitor information we receive about the service, which will help inform when we next inspect.