We carried out this unannounced inspection on 19 and 21 January 2016. Leawood Manor is run and managed by Runwood Homes Ltd. The service provides accommodation and personal care for up to 70 people in four units. Two units accommodated people living with varying stages of dementia and two units provided residential accommodation for people. On the day of our inspection 69 people were using the service.

The service had a registered manager in place at the time of our inspection. 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 and associated Regulations about how the service is run.

When we last inspected the service in June 2013 People’s care and treatment was not always planned and delivered in a way that was intended to ensure people's safety and welfare. During this inspection we found people who lived at the home were supported by staff who understood their needs. The information required to assist staff with people’s care was available in care plans. The risks people who lived in care homes faced were highlighted in their individual care plans and staff were aware of their responsibilities in protecting people from abuse.

The risks to people’s safety were thoroughly assessed and reviewed on a regular basis. These risks were managed in such a way as to both protect people and allow them to retain their independence.

Staffing levels in the home were sufficient and the registered manager regularly reviewed and maintained safe staff levels dependant on the needs of the service. People received their medicines safely from suitably trained staff. Staff had a full understanding of people’s care needs and received regular training and support to give them the skills and knowledge to meet these needs.

People were encouraged to make independent decisions and staff were aware of legislation to protect people who lacked capacity when decisions were made in their best interests. We also found staff were aware of the principles within the Mental Capacity Act 2005 (MCA) and had not deprived people of their liberty without applying for the required authorisation. The service was proactive in ensuring people’s rights were respected.

People received the support they required to meet their nutritional needs. Staff showed an excellent knowledge of the specialist diets people required and gave appropriate support to people who required it. Referrals to and support from a range of health care professionals were managed in a timely way. The relationships with the health professionals were positive and led to improved outcomes for people.

People had positive relationships with the staff in the home and were treated in a caring and respectful manner. The staff delivered their support in a relaxed and considerate manner. People and their relatives were actively encouraged to participate in the planning of their care. Staff were empathic when dealing with people’s privacy and dignity.

People who used the service, or their relatives were able to express their opinions and views and felt they mattered to the staff. They were encouraged to maintain their independence and follow their interests. People and their relatives were activity encouraged to give feedback about the service they received and there systems were in place to monitor the quality of service provision. People also felt they could report any concerns to the management team and felt they would be taken seriously and acted upon promptly.

We spoke with seven people who were using the service. The people we spoke with were generally complimentary about the care and support they received. We were told, “It’s lovely here, this is my home. I am quite independent but when I need any help I just have to ask and it is given.” Another person told us, “I am very happy, I get a bit of support sometimes washing and dressing. I just have to press the buzzer and someone comes very quickly.”

We looked at the care plans of four people who were using the service. A care plan should provide information about a person’s needs and how staff can meet those needs. The care plans we looked at had not always been signed by the staff member completing it or the person using the service. We saw that care plans did not always provide staff with detailed information about people’s needs, likes and dislikes.

We saw staff carrying and wearing disposable gloves which they wore when providing care and support to people. Staff also had and were wearing disposable aprons.

We spoke with seven people who were using the service. The people we spoke with felt that there were generally enough staff to meet their needs. One person said, “If I need something I’ll press the buzzer or call for someone. They’re usually pretty quick.” Another person said, “On the odd occasion I may have to wait but generally they are pretty quick to come and help out.”

People who used the service told us their dignity and privacy was respected by staff. One person said, "They've been really good." They told us that staff provided care that met their needs. One person said, "They'll do as much as they can to help you."

We spoke with two relatives. They told us their relative was well cared for and their needs were met.

When we looked at records we saw there was evidence of an assessment and a care plan. We saw that some records had not been reviewed as often as they should and some had not been updated to include the level of risk that existed. This increased the risk that people's changing needs may not be appropriately met in the agreed way.

People using the service who we spoke with told us they with told us they felt safe, they were happy with the standard of accommodation and their belongings were protected.

We found some evidence that people’s needs were not always being met by the appropriate number of staff.

A person using the service commented on the cleanliness of the home. They said, "The home is very clean and that's important to me." People using the service who we spoke with said they could comment on how the home was run and how their care was organised and they felt listened to.