This inspection took place on 20 and 24 April 2018 and was unannounced. This is the first inspection for the location under this new provider.

Dimensions Somerset The Old Vicarage is a ‘care home’. 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.

Dimensions Somerset The Old Vicarage accommodates up to seven people in one adapted building. At the time of the inspection four people with learning disabilities and other complex needs were living at the home. None of the people were able to verbally communicate with us. Their opinions were captured through observations, interactions they had with staff and their reactions. Each person has a personalised bedroom and there were communal spaces including a kitchen dining room, lounge and sensory space. There was a garden and people were free to move around the home if they were able to.

“The care service has been developed and designed in line with the values that underpin the Registering the Right Support and other best practice guidance. These values include choice, promotion of independence and inclusion. People with learning disabilities and autism using the service can live as ordinary a life as any citizen”. Registering the Right Support CQC policy

At the time of the inspection there was a registered manager in place. 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.

People were happy and appeared comfortable in the presence of staff. Their relatives thought people were kept safe. Improvements could be made with the management of medicines because practice was not always in line with current national guidance to keep people safe. Risk assessments were carried out to enable people to retain their independence and receive care with minimum risk to themselves or others. Not all health and safety checks were being completed due to staff changes.

The management had developed positive relationships with people, their families and other professionals. There were enough staff to keep people safe and due to recent changes sometimes activities had to be adapted to the number of staff. Recruitment systems were in place to reduce the risk of inappropriate staff working at the home.

People were protected from potential abuse because staff understood how to recognise signs of abuse and knew who to report it to. When there had been accidents or incidents systems were in place to demonstrate lessons learnt and how improvements were made. Staff had been trained in areas to have skills and knowledge required to effectively support people. People had their healthcare needs met and staff supported them to see other health and social care professionals

People were supported to have choice and control over their lives and staff supported them in the least restrictive way possible. When people lacked capacity decisions had been made on their behalf following current legislation. People were supported to eat a healthy, balanced diet and had choices about what they ate.

Care and support was personalised to each person which ensured they were able to make choices about their day to day lives. Care plans had a wealth of information about people’s needs and wishes which occasionally could become confusing. People were listened to when they were upset and their relatives knew how to complain. There was a system in place to manage complaints.

Relatives told us, and we observed, that staff were kind and patient. People’s privacy and dignity was respected by staff. Their cultural or religious needs were valued. People, or their representativ