We undertook a comprehensive unannounced inspection of Argyll House on 4 January 2018. Argyll House is a ‘care home’ registered to provide accommodation and support for up to five people with learning disabilities. There were five people living at Argyll House on the day of the inspection. 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. The care service 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 service had a 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 receiving support from staff at Argyll House received highly individualised person centred care. Support plans contained detailed and personalised care plans and we saw that many people had been supported to have a full and meaningful life. People benefited from a large range of activities and interests provided, to ensure they were kept occupied, if they chose. There were many excellent opportunities to optimise people's social and stimulation requirements.

There was clear guidance for staff on how to meet people’s individual needs and support them to develop their confidence and have their preferences met. We saw that people were relaxed and staff demonstrated a caring attitude. The service had ensured people’s communication was maximised, which assisted an increased understanding and reduction of distress.

As the values and vision of the organisation and service had been integrated into everyday practice, people living with learning disabilities were able to achieve what they wanted in their lives and overcame obstacles to achieve positive outcomes.

People and their families, where appropriate, were fully involved in the development of their care planning along with health and social care professionals and Argyll House staff.

The service was outstandingly well-led. The service actively promoted a positive, inclusive and open culture. All staff showed a passion and commitment to providing the best support to enable people to have full lives. The registered manager had taken time to look into ways to improve safety and share this practice within the organisation. There were robust quality assurance systems in place, which monitored the service, identifying potential areas for improvement, and actions were taken to improve these.

Staff were highly motivated and worked as a team and shared a common ethos of providing high quality, compassionate care with regard to people's individual wishes and support needs. Staff were valued, well-supported and supervised by the management team.

Staff knew how to keep people safe, and how to report any concerns. There were enough staff to keep people safe. People received their medicines as they had been prescribed.

Risks to people were identified promptly and effective plans were put in place to minimise these risks, involving relevant people, such as relatives and other professionals. Where risks were more complex, comprehensive guidance was in place to guide staff, including the most effective approaches to use, or particular communication methods suited to the individual. Guidance was in place for staff so that they could mitigate risk, and support people to take sensible risks as safely as possible.

People were supported to have maximum choice and control of their

We inspected Argyll House on the 27 October 2015. Argyll House is registered to provide accommodation for five people with learning disabilities who require personal care and support. This home was last inspected in October 2013 and was meeting all the standards inspected at that time.

There was a registered manager in post at the service. 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 benefited for a service that had a strong person centred culture where there was plenty of opportunities to access activities and experience new things. When people’s needs changed the service responded. People views were seen as important and feedback was used to improve the service.

The registered manager was described as outstanding and was supported within a culture where quality was expected. There was a clear vision within the home that inspired staff to want to do well and be part of the service. Clear systems were in place to monitor the quality and safety of the service. People’s relatives felt able to raise concerns and had full confidence they would be heard. The service has an exemplary record in terms of compliance at previous inspections.

People were protected from the risk of harm and abuse by staff that understood their responsibilities in relation to safeguarding. Staffing levels were sufficient to meet people’s needs. People’s needs were assessed and risks associated with their needs were mitigated through clear guidance and staff that understood and followed that guidance. People’s medicines were stored safety and people recived their medicines when required.

Staff felt supported and had access to regular supervision and appraisal. There was also adequate training for staff and opportunities to develop professionally. People benefited from a service that understood and applied the principles of the Mental Capacity Act (MCA) 2005. MCA is the legal framework that protects people’s right to make their own decisions. People had access to appropriate health professionals which was clearly planned and people also received a varied and healthy diet.

Staff were described as caring by people and their relatives. People were supported to maintain friendships with people they lived with and other people who were important to them. People independence was supported and their privacy and dignity were respected. People had access to advocacy as and when required.

We found that the provider had systems to gain and review consent from people and that best interest meetings were held with people who knew and understood them.

People experienced effective, safe and appropriate care that met their needs and protected their rights. Relatives of people living at Argyll House praised the staff for making it a "real home". One person told us that they liked all of the staff because they helped them to achieve their potential. They told us, "They make me happy because we do so much good stuff that I like." A relative of one person told us, "I cannot speak more highly of the staff. They all know what people need and are always so friendly and happy. You can feel the warmth as soon as you walk in."

We observed that people had their medicines administered to them safely, at the time they needed and in a way they preferred. We saw that people knew what medication they were taking and understood the reason why.

The provider had effective recruitment and selection procedures in place to ensure people's needs were met by appropriately qualified staff. Staff we spoke with confirmed they had completed a robust application process and were not allowed to start until all references had been checked.

We found the service had an effective complaints policy. We reviewed one complaint and noted that it had been recorded and considered fully before it was resolved to the satisfaction of the complainant.

We spoke with all the people who lived in the home. Most people were not able to tell us in words about their experience of living in the home. We observed their experience during the day of our visit. We saw three people return from a visit to the swimming pool. Staff talked with them about their experience and two people showed us that they had enjoyed swimming. The other person showed us their room and told us that they had enjoyed swimming. They said that they were going for a walk later and going bowling in the afternoon. They said that they "could not wait until Christmas." Some staff said that they were planning a Christmas menu and decorations.

Each person had their own room, which was individually decorated and furnished, with an ensuite shower and toilet to maintain their privacy. People were supported to make decisions about their care and their day-to-day lives. They were also supported to be independent as possible and to access community facilities.

There were safeguarding procedures and staff had received training so that people were protected from abuse. Staff had also some received a range of training and qualifications and they were supervised and supported so that they could meet people's needs.

People and their representatives were asked their views about the service and these were listened to and acted upon. There was a robust system to monitor the quality of the service that people received and to make improvements when needed.

The people at Argyll House expressed their views in different ways and not everybody had verbal communication. Staff said that they had got to know people’s preferred means of communication. We saw staff talking and using signs while they were supporting people. This engagement was very positive; it encouraged the people to feel involved in what was happening and to communicate in their own ways.

People told us about the different things that they do, such as going on day trips, swimming and being part of a ‘walking club’. There was a vehicle that could be used for trips out. One person told us that they liked to go on the bus into town and they had their own bus pass. Staff told us that they supported people with community involvement and with different activities outside the home.

People were getting ready for their morning activities when we visited the home. Some people went horse riding; another person was due to go, but they chose to stay at home instead and to do cooking with one of the staff.

Staff told us that people needed a lot of support to ensure that they were safe and remained healthy. The people we met looked well supported with their personal care and appearance. Staff helped people to decide what to wear each day, for example by showing people two or three items from which they could choose.

We saw people enjoying their lunch during our visit. Staff had their lunch together with the people who use the service. This helped to create a social setting and meant that the meal arrangements did not solely focus on the support that people needed. Staff responded well to people’s individual needs throughout the meal.

There was a menu board in the hall. Photographs were being used, which helped people to see what was on the menu for lunch. Other information had been well presented and displayed in the home. Pictures and symbols had been used, so that the information was easier for people to understand. This included a complaints procedure and a chart which showed people’s weekly activities. We saw photographs of a recent holiday that people had been on. This reminded people of the things they had done, and the display provided an area of interest in the home.

A person who uses a wheelchair was able to move around the accommodation on the ground floor. Everyone had their own room with an en-suite shower and toilet. People were being well supported with keeping the home looking clean and in a hygienic state.