This inspection took place on 9 August 2017 and was unannounced. This meant the registered provider and staff did not know we would be visiting the service. A second day of inspection took place on 15 August 2017 and this was announced.

The Outwood is registered to provide accommodation for adults under 65 years of age who require nursing or personal care and have a diagnosis of Learning disabilities and or Mental health conditions. On the day of our inspection 10 people were using the service.

The Outwood is a large home based in Horsforth, in a rural area of Leeds. The main entrance to the home had pictures and the names of staff members so people knew who worked in the service.

This was a Victorian style home with large rooms and ceilings. There were two large lounges in the home, one lounge was often used as a sensory room and they had a box with sensory equipment for people to use. These included lights, different textured items, sensory jigsaw and a foam connect four game. The garden was large with swings, trampolines and a designated planting area for people who enjoyed gardening. There was also a smoking shelter.

There were eight bedrooms in the main house and attached were two flats which included kitchenettes and were used for people that were more independent. Rooms were very individual and people decorated these as they wished to make it their own.

The regional manager told us, most people were supported by two staff in the community and sometimes in the home dependent upon peoples changing behaviours.

There were door activation systems in place which meant people using the service could only access the kitchen with staff. This helped maintain people's safety.

During the inspection the registered manager told us they were due to change job role. The deputy manager had been acting as the manager and planned to apply to become the registered manager once an appropriate hand over of the service had taken place. 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. For the purpose of this report, we refer to the deputy manager as ‘The manager’ as they are currently acting as the manager.

People told us they felt safe. We found people were protected from the risk of avoidable harm or abuse because the provider had effective systems in place to manage any safeguarding concerns. Staff received training on safeguarding adults from abuse and understood their responsibilities in respect of protecting people from the risk of harm.

Risk assessments had been developed and contained relevant information. We found that these were in place and had been regularly reviewed. Accidents and incidents were recorded and appropriate action taken to reduce the risk of reoccurrence.

Medicines were stored securely and assessments had been completed on staff to ensure they were competent completing this activity. Medicines were administered correctly and ‘As required’ medicines were managed appropriately with guidance in place for staff to follow.

Safe recruitment processes were in place and had been followed. Pre-employment checks on employees were completed that helped to minimise the risk of unsuitable staff from working with adults at risk. Records confirmed staff received induction training when they were new in post.

Training records confirmed staff had received training on an annual basis and staff told us they felt the training was sufficient to meet people’s needs.

We checked and found the provider was working within the principles of the MCA and all people using the service had a DOLs in place. Best interest decisions also took place and were documented in care plans.

People living at The Outwood were supported to maintain a balanced diet and were re