Blandford Grange Care Home is purpose built to accommodate up to 63 people. 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 accommodation is spread over three floors. At the time of our inspection there were 54 people living at the home.

This inspection took place on 21 and 23 February 2018 and was unannounced.

There was a registered manager in post. 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.

This was the first inspection of this service since it was registered with Healthcare Homes (LSC) Limited.

Risks associated with some people’s behaviour were not effectively managed. Care plans lacked detail to support staff to meet people's needs.

There were not enough staff to support people that presented a risk to themselves and others. There were not enough staff to provide meaningful activities for people and to be supported to pursue individual interests. We have made a recommendation about the review of staffing levels in the home.

Staff knew how to identify and respond to abuse. Concerns had been shared with the local authority by the registered manager.

Medicines were administered safely but improvements were required to how ‘as and when’ (PRN) medicines were monitored for their effectiveness.

Improvements were required to improve the cleanliness the home.

Staff’s employment history and suitability were checked before they started working at the home.

Premises and equipment were managed to keep people safe.

Staff required more training and support to meet the needs of people living with dementia including supporting people with behaviours that may challenge others.

People received support from staff to eat and drink where required.

The provider did not act in accordance with the Mental Capacity Act 2005 Deprivation of Liberty Safeguards at this service. Care homes must follow the Deprivation of Liberty Safeguards otherwise this is unlawful.

Relatives and people gave us mixed feedback about how the home had ensured that staff got to know people and treat people with compassion and as individuals.

Staff did not always communicate with people in accessible ways that took into account any sensory impairment which affected their communication.

People did not always receive care that was responsive to their needs and improvements were required to the home’s approach to person centred care.

People’s preferences and choices for their end of life care were discussed with them and recorded in their care plans.

The service did not have a clear strategy for how it supported people living with dementia.

There were systems in place to track incidents and accidents in the service but this was not always effective to identify action required and review care provided.

Arrangements for oversight of the service required improvement to identify and respond to concerns and risks.

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can read at the back of the full report what action we have told the provider to take.