We inspected the service on 11 December 2018. The inspection was unannounced. Argyle Road is a ‘care home’. Argyle Road provides accommodation and support with personal care on a respite basis for up to six people with a learning disability. People in care homes receive accommodation and nursing or personal care as single package under one contractual agreement. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

At the time of the inspection there was one person using the service.

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

The service did not have a registered manager in place. However, a new manager had been recruited and would register with CQC. 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.

Risk assessments had been completed for each person and staff were aware of the steps they were required to take to minimise the risks. Staff understood the service's safeguarding procedures to ensure incidents of abuse were reported. Incidents, accidents and complaints were recorded, monitored, and lessons learnt to ensure there was a continued improvement.

There were enough staff to support people. Staff were properly checked to ensure they were safe to work with people. Staff benefitted from the training and support arrangements available to them.

Arrangements were in place for safe management of medicines.

People and relatives were involved in developing people's care plans. Care plans were personalised and contained people's goals and how they wanted staff to support them. People's communication needs were recognised and appropriate support provided through the assessment of needs and care planning systems.

The provider was compliant with the principles of the Mental Capacity Act 2005. Staff encouraged and supported people to make decisions about their care. They treated people with respect and ensured people's privacy and dignity was maintained.

The provider worked in partnership with health professionals and ensured people were assisted to access medical help, when needed.

People's nutritional and dietary needs were met. People could choose what, when and where to have their meals.

There were auditing and quality monitoring systems in place to ensure the service was managed effectively.

Equality and diversity of people was promoted and there was no evidence that people were discriminated against.

There were arrangements in place to ensure the spread of infections was controlled and the service was clean and safe.

This unannounced inspection took place on 30 June 2016. At our last inspection on 7 January 2014, we found that the provider breached regulations relating to meeting nutritional needs. Following this inspection, the provider sent us an action plan to tell us the improvements they were going to make. Argyle Road provides accommodation and support with personal care on a respite basis for up to six people with a learning disability. At the time of the inspection there were three people using the service.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission (CQC) 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 and relatives told us that they felt safe using the service. They told us the staff were good and trustworthy. We noted the service had policies and procedures on adult safeguarding and staff were of how to follow and implement the policies. Staff told us they had received training for their roles and had regular supervision which allowed them to discuss training and practice issues. Staff and the records we checked showed that staff had attended training in Mental Capacity Act 2005 (MCA), medicine administration, health and safety, and moving and handling. We noted that there was a good staff recruitment system in place which ensured that new staff were appropriately checked and received induction before they started work at the service.

Staff completed and reviewed assessments of needs and care plans. Care files showed that people and their representatives were involved in the assessments and care plans. People and relatives told us they received care that reflected their needs. Staff delivered care in a manner that ensured people’s dignity and privacy.

Staff ensured that people’s health care needs were met. Records showed staff support people to make and attend healthcare appointments. People told us the food provided reflected their preference and they could decide when and what to eat. We saw all parts of the service were clean and people could access communal areas.

The service had a complaints procedure. People and relatives told us staff were approachable. They told us they knew how to make a complaint. We noted complaints were appropriately investigated and responded to. There were systems for auditing the service and gathering feedback from people. The registered manager was also developing new systems for obtaining feedback from people and relatives to improve the quality of the service.

At the last inspection in July 2013 we found that people had been placed at risk because robust action had not been taken to safeguard them from abuse. In addition accurate and appropriate records were not being kept and medication administration procedures did not ensure that they received their prescribed medication safely.

On this follow-up visit we found that systems were in place to protect people from abuse. Staff told us that they had received in house safeguarding training. They understood how to recognise and report abuse. People who used the service told us they felt safe there. One person said “yes I feel safe. They look after me well.” A relative told us “he is absolutely safe and well cared for. He would tell me if he was not happy.”

The provider had reviewed their medication administration procedures and changes had been made to ensure people received their prescribed medication safely. For example, improvements have been made to the way the medication administration was recorded. Additionally, the service had ensured that clear and detailed information about people’s medicines was obtained from the pharmacy.

Personal records had been reviewed and updated. We found that they contained accurate and up to date about people’s needs. This meant that people were protected from the risks of unsafe or inappropriate care

Overall people’s care, health and welfare needs were being met. They told us they were happy with the quality of care that they received. One person who used the service said “I am quite happy with the way the place is run. I like it here.” Another said “it’s nice here. Staff treat me kindly and are fair. It’s a good place with lot of things to do.” A relative told us “he is well looked after and loves it there.”

People who used the service thought that it was a safe place to be. One person said “it’s a safe place.” Another said “I am always calm and relaxed here." The three relatives and carers we spoke to agreed with this. One told us “oh yes she is definitely safe there.” However we found that the service had not taken the appropriate action when a safeguarding issue was raised and had not taken robust action to protect people as a result of this. People who used the service and staff were placed at risk because of this.

Staff had received training to enable them to administer medication appropriately and there were systems in place to support them with this. However they were not robust enough to ensure that people received all of their prescribed medication appropriately and safely.

People were not always protected from the risks of unsafe or inappropriate care because accurate and appropriate records were not maintained.

The views of people who use the service and their carers were considered in the planning and delivery of care. People are encouraged to take an active part in the running of the home and maintain their independence by cooking, taking care of their rooms and travelling independently to local groups, shops and cafes. We found that that steps were taken to protect people and that safeguarding was given high priority. Staff were supported to meet the needs of people who use the service. The management had arrangements in place to monitor the quality of care delivered.

One person who used the service told us that they liked living at Argyle Road. We saw that staff treated the person with dignity and respect. There was good links with the local community learning disability service.

People using the service and their relatives made positive comments about the service. One person said, “Staff are nice, food is nice and my room is good. They help me look for jobs and for college courses. We had a Halloween party at the weekend and lots of people came. We had fun. It’s very nice and I can come and go as I want. Staff always ask you what you want and they care. If I was not happy I would talk to the staff.”

Relatives said:

“They do very good work. My sister really enjoys going there. She sometimes goes for a few weeks at a time. When she’s at home she will sometimes ask me to pack a bag so that she can go there. If my sister doesn’t like something or it’s not comfortable for her she will say so. She would not to go there if it was not good. It’s very homely and the ladies are nice and kind. Happy to send her there. It’s a decent environment and very homely.”

“I can’t praise it enough. My daughter was apprehensive at first and so were we but she had an introductory visit for tea and was happy to go there. It’s given her a lot more independence. There are good activities. She picks what she fancies from the list and we arrange for her to go there. We don’t worry about her when she’s there. We feel confident for her to go there. Its good back up and staff are lovely and really good.”

“It’s very, very good, I can’t find any faults. My son is safe and he loves going there. I’m very pleased with how they deal with him. They understand him. When I was ill suddenly and had to go into hospital they stepped in at short notice and I didn’t have to worry about him at all while I was there. They just got on with it.”

“Our son wasn’t too keen to go initially but now he loves it. He looks forward to going and now goes through the calendar when it arrives and chooses what he wants to do and we book. They encourage him to do things. They are good about phoning us and about supporting him to phone if he wants to. It’s friendly and welcoming and is a very valuable service. He has a great time there.”