Archived: Argyle House

Updated 14 June 2019

The inspection:

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 (the Act) as part of our regulatory functions. This inspection was planned to check whether the provider was meeting the legal requirements and regulations associated with the Act, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

Inspection team:

The inspection was carried out by two inspectors, a specialist advisor, and an expert by experience. A specialist advisor is a person with professional expertise in care and nursing. An expert by experience is a person who has personal experience of using or caring for someone who uses this type of care service. The expert by experience for this inspection had experience of co-ordinating care services for relatives.

Service and service type:

Argyle House is a care home. People in care homes receive accommodation and nursing or personal care. CQC regulates both the premises and the care provided, and both were looked at during this inspection.

The service had a manager registered with the Care Quality Commission. This means that they and the provider are legally responsible for how the service is run and for the quality and safety of the care provided.

Notice of inspection:

The first day of the inspection was unannounced. We carried out an announced visit on the second day.

What we did:

On this occasion, we had not asked the provider to send us a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and

improvements they plan to make. However, we offered the provider the opportunity to share information they felt relevant with us.

We contacted the health and social care commissioners who monitor the care and support the people receive. We also contacted Healthwatch England, the national consumer champion in health and social care, to identify if they had any information which may support our inspection.

During the inspection process we spoke with 11 people who lived in the home and four people’s relatives. We also spoke with 15 members of staff, including care staff, senior care staff, nursing staff, kitchen staff, housekeeping staff, the registered manager, the regional quality compliance inspector and regional director. We looked at 12 records relating to people’s care needs and six staff recruitment records. We looked at other information related to the running of and the quality of the service. This included quality assurance audits, quality surveys, training information for staff and arrangements in place for managing complaints.

We observed support being provided in communal areas of the service and used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us.

Following the inspection we were made aware of allegations of neglect regarding one person who lived in the home. This is currently under investigation by the local safeguarding authority.

Updated 14 June 2019

About the service: Argyle House is registered to provide accommodation for people who require nursing or personal care for up to 87 older people, some of whom are living with dementia. The home is set out over four floors, with each floor set up as a separate unit providing a particular type of care; these are residential dementia care, nursing care, dementia-nursing care and residential care. At the time of the inspection the provider had closed the dementia nursing floor; people who had previously lived on this floor had moved to other areas of the home. There were 41 people living in the home at the time of inspection.

People’s experience of using this service:

People and relatives told us the service had improved since the new registered manager started in January 2019. Most people were satisfied with the service they received and felt previous concerns had been listened to and acted upon.

The provider, registered manager and staff were clear about improvements that had to be made at the service. They were proud of what they had achieved but understood that further improvement was needed in some areas, for example record keeping and staff deployment. Improvements already achieved needed to be sustained and embedded.

Everyone praised the registered manager who was approachable, resourceful and provided strong leadership. All staff told us they were motivated to work with the registered manager to make the improvements needed at the service.

Staffing levels had been increased and there were now sufficient staff to ensure people’s care needs were safely met. The registered manager was aware that improvements were required to ensure that staff were consistently deployed and were able to spend time with people. Staff were appropriately recruited and there were enough staff to provide care and support to people to meet their needs.

People were provided with a variety of nutritious meals, based on people’s choices and including special diets for those who needed them. Improvements continued to be required to the mealtime experience for people living in one area of the home.

Most people were happy living at Argyle House. They felt safe and liked the staff who looked after them. People received safe care and they were protected against avoidable harm, abuse, neglect and discrimination.

Improvements had been made to ensure that people’s medicines were safely managed. People’s safety was maintained because staff followed the risk management plans in place to mitigate risks to people.

The arrangements in place for food safety and infection control had improved. The environment was clean and well maintained.

External healthcare professionals supported staff to help people maintain or improve their health.

People were supported to have maximum choice and control of their lives and staff supported them in the least restrictive way possible.

Staff had access to the support, supervision and training they required to work effectively in their roles.

Staff were friendly and caring; they treated people with respect and maintained their dignity. Staff encouraged people to maintain their independence.

People had personalised plans of care in place to enable staff to provide consistent care and support in line with people’s preferences.

Information could be provided to people in an accessible format to enable them to make decisions about their care and support.

People knew how to raise a concern or make a complaint and the provider had implemented effective systems to manage any complaints received.

The service provided appropriate end of life care to people.

The service met the characteristics for a rating of "requires improvement" in all five key questions. Therefore, our overall rating for the service after this inspection was "requires improvement".

Rating at last inspection:

Inadequate (report published 17 January 2019).

Why we inspected:

This was a planned inspection based on the rating at the last inspection.

At the last comprehensive inspection, the provider was in breach of regulations 10, 12, 14, 17 and 18 of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We placed positive conditions on the provider’s registration to restrict admissions to the service and to provide monthly reports to the Care Quality Commission (CQC).

This service has been in Special Measures. Services that are in Special Measures are kept under review and inspected again within six months. We expect services to make significant improvements within this timeframe. During this inspection the service demonstrated to us that improvements have been made and is no longer rated as inadequate overall or in any of the key questions. Therefore, this service is now out of Special Measures.

Follow up:

We will continue to monitor the service through the information we receive until we return to visit as per our re-inspection programme. If any concerning information is received we may inspect sooner.

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