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 or an autistic spectrum disorder. At the time of the inspection, there were nine people living at the home.

The inspection was conducted on 18 December 2018 and was unannounced.

The home is a converted house and is based on two floors. There was a choice of communal rooms where people were able to socialise and most bedrooms had en-suite facilities.

There was a registered manager in place. 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.

At our last inspection we rated the service as Good. At this inspection we found evidence which demonstrated ongoing and continuous improvements in the responsiveness and leadership of the service and therefore the overall rating is now outstanding.

The service went the extra mile to provide a family orientated and homely environment for people. Staff had developed strong relationships with people and know them exceptionally well. People were involved in everything that happened in the home and were supported by the staff to maintain positive relationships with each other. Staff understood people’s needs and aspirations and had found creative ways to enhance people’s skills and independence and fulfil their interests and wishes.

Staff knew people exceptionally well and delivered care and support in a way that met those needs and promoted equality. The staff team clearly understood the needs of different people and worked in partnership with them, to achieve personal goals and develop skills.

Staff used appropriate techniques to communicate effectively with people so that they felt listened to and valued. People’s unique communication styles were understood and respected by staff.

Care and support was planned proactively and in partnership with the people, their families and multidisciplinary teams where appropriate.

The service was committed to ensuring that there was equality and inclusion across the workforce and for the people who used the service. People were fully included in everything in relation to the service and encouraged and supported to be actively involved in the development of the service. The service had established strong links with the community.

The home has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen.

The provider and registered manager were fully committed to ensuring the service continually improved and was proactive in implementing change.

Staff were clear about their safeguarding responsibilities and knew how to recognise and report potential abuse. Staff carried out their roles and responsibilities effectively. Staff had an excellent understanding of managing risks and supported people to reach their full potential through consistent, personalised care.

There were enough staff to meet people's needs and staff were able to support people in a relaxed and unhurried way. Appropriate recruitment procedures were in place to help ensure only suitable staff were employed. People were supported by staff who were highly skilled, and knowledgeable in caring for people with additional needs. Staff were skilled in helping people to express their views and

This inspection took place on 9 and 10 June 2016 and was unannounced. The home provides accommodation for up to eight people with a learning disability. There were eight people living at the home when we visited. The home is a converted house and is based on two floors. There was a choice of communal rooms where people were able to socialise and most bedrooms had en-suite facilities.

There was a registered manager in place. 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.

Most people felt safe living at the home and were protected from the risk of abuse. Individual risks were managed in a way that protected people from harm while promoting their independence.

Staff worked in a flexible way to support people and enable them to undertake activities. Recruitment practices were safe, people’s medicines were managed safely and there were plans in place to deal with foreseeable emergencies.

Staff were suitably trained and supported in their work and knew how to care for people effectively. They received appropriate induction and supervision.

People received enough to eat and drink and received appropriate supported when needed. Staff sought consent from people before providing support and followed legislation designed to protect people’s rights and freedom. They had appropriate access to healthcare services when needed.

People were cared for with kindness and compassion. All interactions we observed between people and staff were positive and it was clear that staff knew people very well. Staff supported people to build and maintain relationships and protected their privacy at all times.

The provider operated an innovative outdoor project which people enjoyed, together with a wide range of other meaningful activities to help people lead happy, fulfilled lives. These helped them build friendships and retain links with the community.

People were involved in developing and reviewing the care and support they received. Staff were responsive when people’s needs changed or when people requested changes to the way they were supported. The provider sought and acted on feedback from people.

The home was well-led. There was an open, transparent culture. Staff were happy in their work and worked well together. There was a suitable quality assurance system in place.

People’s care was planned and records showed people were cared for according to their care plan. People we spoke with said they were happy living in the home and we saw a range of activities was available to people.

Staff were aware of safeguarding principles and demonstrated knowledge of how to report any potential signs of abuse. The provider acted appropriately to any allegation of abuse.

The home was clean and procedures were in place to ensure the home was kept clean. Staff were aware of their duties and records were kept which showed the procedures were followed.

The home has a new manager, however, in this report the names of the managers are those that were on our records at the time of our inspection.

People were treated with dignity and respect. In communal areas we heard staff speaking to people warmly and referring to them with respect. We looked at three care plans and a DVD version of one care plan. We saw they were personalised and contained details of how people wished to be cared for.

We spoke with four people who used the service. They told us they felt safe and were well cared for. We spoke with a family member who said, “Staff are excellent, the relationship is good”. The service had developed a wide range of activities to promote community involvement, including a garden project at a local abbey. One person said, “I love it there”. Another person told us, “It’s good because you meet people”.

We spoke with the managers and three members of staff. All demonstrated a good knowledge of the people they cared for and how they liked to be supported. They had received recent training in safeguarding and knew how to report allegations of abuse.

The environment was suitably designed and adequately maintained. Adaptations had been made to the environment to meet the needs of users, including a height adjustable hob and sink in the kitchen.

Staffing levels were appropriate and staff were suitably trained. The provider assessed and monitored the quality of service provided through a series of surveys and audits. These showed that people were satisfied with the care they received. We saw one comment which said, “I cannot find any fault with the level of care.