This inspection took place on 1 and 2 August 2017 and was unannounced. This meant the registered provider and staff did not know we would be visiting the service. At the time of our inspection 29 people were living in the home.

Meadowbrook Manor is registered to provide accommodation for a maximum of 31 people who require personal care to adults aged 65 and over. It is located in a residential area close to Garforth town centre, near Leeds and is near to local amenities.

The home is an adapted three story building and there is a passenger lift to access all the floors. Externally there is parking for a limited number of cars. There was a large lounge and an open plan dining area on the ground floor. The home also had another lounge on the first floor which included a hair dressing salon and sofa’s to relax. This was a functional room for people to have their hair done or for when family’s had parties.

There was a registered manager at the home and a deputy manager. A registered manager is a person who has registered with the 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.

At the last inspection in August 2016 Meadowbrook Manor were rated as requires improvement due to concerns over medicines management and issues in relation to the operation of the quality assurance systems as accidents and incidents were not being effectively monitored. At this inspection we found that these concerns had been addressed.

Medicines were managed effectively and all medicines stored correctly in line with the providers policy.

Accidents and incidents were managed well with actions taken when required and there was a policy with guidance for staff to follow should an incident occur.

People using the service felt safe and staff had a clear understanding of how to protect people from any harm. Staff were provided with annual safeguarding and whistleblowing training.

The provider completed appropriate checks to ensure the safety of the premises.

Staffing levels were adequate to meet people’s needs and recruitment checks were carried out to ensure people were not placed at risk.

People using the service were met by staff who clearly communicated with them on all aspects of their care.

Mental capacity assessments were completed for people however, we saw on one occasion documents had not been recorded in line with the MCA principles.

We found that one of the DoLS applications had expired on 7 April 2017 but had not been renewed until 21 June 2017. This meant that the person may have been unlawfully restricted as there had been no DoLS in place for a period of 10 weeks and the application process had not been completed.

Maintenance logs were used to identify issues regarding the upkeep of the environment or premises, although dates were not always recorded for completion.

Staff were provided with adequate training to do their job. Supervisions and appraisals were also completed to ensure staff could develop their skills and be managed effectively.

People told us they enjoyed the food, were encouraged to make choices about what they ate and drank. Fridge temperatures were not always completed.

Monthly weight monitoring records were in place. Staff informed us nutritionists and dieticians were contacted should a person require further support. Other health care professional’s visited the home when there was a need.

People using the service and their relatives felt staff were caring and friendly. Staff had built positive relationships with people and involved them in all aspects of their care.

Staff respected people’s privacy and dignity. We saw people’s diverse needs were catered for and care planned for these. People using the service were encouraged to be independent and risk assessments completed to make sure people

This inspection took place on 29 June 2016 and was unannounced. Our last inspection took place on 27 November 2013 and, at that time; we found the service was meeting the regulations.

Meadowbrook Manor is a care home registered to provide personal care and accommodation for up to 31 people. At the time of inspection 29 people were living there. 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.

At this inspection we found people were happy with the care they received. People felt staff were caring. We saw people received good support during the inspection and enjoyed the company of staff.

People told us they felt safe and didn’t have any concerns about the care they received.

We found the provider was meeting the legal requirements relating to Deprivation of Liberty Safeguards (DoLS) and of the Mental Capacity Act 2005 (MCA). Staff understood how to help people make day-to-day decisions and were aware of their responsibilities under the MCA and (DoLS).

We found staff had training throughout their induction and also received refresher training in areas such as dementia care, MCA, DoLS, safeguarding, health and safety, fire safety, first aid and infection control. This meant people living at the home could be assured staff caring for them had up to date skills they required for their role.

Medicines were administered to people by trained staff and people received their prescribed medication when they needed it. Appropriate arrangements were in place for the ordering, storage and disposal of medicines. However, two topical creams were not labelled so we could not determine when these had been opened. Specific times for medication were not on the medication of administration records (MAR). The assistant manager dealt with this straight away by liaising with the doctor on the day of inspection.

People enjoyed some social activities and had good experiences at mealtimes. People’s health needs were met.

People told us the food at the home was good and they had enough to eat and drink. We observed lunch being served to people and saw people were given sufficient amounts of food to meet their nutritional needs.

The assistant manager and registered manager had reviewed staffing numbers to help ensure there were enough staff to keep people safe. Robust recruitment and selection procedures were in place to make sure suitable staff worked with people who used the service. Staff felt supported and had regular supervisions and appraisals.

There were systems in place to monitor accidents and incidents; however, there were no outcomes in relation to these to ensure what the service had learnt from incidents at the time of our inspection.

People told us they would feel comfortable raising concerns or complaints. People provided positive feedback about the assistant manager and registered manager.

We found Meadowbrook Manor was welcoming, well maintained and people who lived there were well cared for. People we spoke with said they were happy living in the home and felt safe. Comments in the quality survey undertaken in November 2013 included, "I am extremely satisfied, the staff are kind and helpful". Another relative had written, "I have peace of mind knowing that my mum is being looked after in your care".

People were treated with respect and dignity by staff and supported to maintain their independence. We found that care planning processes were good and people were involved in decisions about their care. We saw that there was a range of activities tailored to meet people's needs and people were involved in planning these.

We saw from records that there were different health and social care professionals working in partnership with staff and their expertise was called upon appropriately to meet the needs of people living in the home.

We observed that the home was well maintained and there were processes in place to ensure that equipment was maintained and in safe working order.

We looked at records and found that these described peoples needs and were reviewed and updated on a regular basis. Staff records showed that they had access to training and regular supervision to support them to undertake their role. One staff member describing her role as a carer told us, "We're in a privileged position".

Meadowbrook Manor provided accommodation for 23 people who required personal care. The home was in the process of completing an extension to accommodate a further seven people. All people who used the service we spoke with commented they had been consulted and kept up to date about the extra rooms and that there had been minimal disruption whilst the building work was carried out. During the visit we spoke to the registered manager, five staff, two visitors and six people who used the service. People told us they were happy with the care and support they received. People said that the staff were respectful and that they did their job well. Comments included:

“I like living here very much.”

“The staff are very good.”

“I’m very well looked after.”

“[My relative] regards this as home and gets on well with the staff.”

We observed care practices and people who used the service were treated with respect and dignity. We looked at three care plans and found that they were up to date, provided good information about how people's care and support needs were assessed. People said they were happy and felt safe living at the home. We saw evidence that demonstrated the provider had taken appropriate steps to ensure that staff were suitably skilled and experienced to carry out their roles. People told us that they were aware of the complaints process, knew who to speak to and felt confident that complaints would be investigated and responded to.

People told us staff are professional in their approach to providing care.

People said they can generally make decisions and choices about the care they receive. They also told us they were very happy with the care and support provided by staff and staff were kind, considerate and caring and always showed them respect.

People using the service said they would have no hesitation in talking to the manager or staff if they wanted to talk about their and/or a relative’s care.

As part of our review we contacted a number of health and social care agencies who have been involved with Meadowbrook Manor. We received some positive feedbacks which suggest that the service continues to improve and the manager was working well with relevant agencies.