This inspection took place on 22 May 2018 and was unannounced.

Dimensions Somerset The Saplings 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.

The Saplings is registered to provide care and accommodation to up to seven people. The home specialises in the care of people who have learning disabilities and complex physical disabilities. All accommodation for people is on the ground floor and all areas are accessible to wheelchair users. At the time of the inspection seven people were living at the home.

The care home has been open a number of years and was previously owned and managed by Somerset County Council. This was the first inspection of the home since it was registered with Dimensions Somerset Sev Limited.

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.

There was a registered manager in post, however at the time of this inspection the registered manager had been away from the home for a number of weeks and the home was being managed by the deputy 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.

Improvements were needed to make sure the home was well led. The quality monitoring was not always effective in making sure that improvements to the service people received was implemented in a timely manner. Records relating to the safe running of the home and people’s personal care were not always clear, up to date or correct. Information, such as care plans and the complaints policy was not always available to people in a format which met their individual needs.

Staff were not always following up to date guidance in relation to the safe storage and recording of medicines.

People were comfortable and relaxed with the staff who supported them. The provider had systems to minimise the risks of abuse to people and staff knew how to report concerns. Risk assessments were carried out to enable people to take part in activities and receive care safely.

Staff worked with other professionals to make sure people’s care and support met their needs. Staff followed advice given and monitored people’s well-being, although records relating to people’s individual care were not always clear.

Staff knew how to support people who lacked the capacity to make decisions. 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 cared for by staff who were kind and compassionate. Long term staff had built trusting relationships with people and tried to involve them in day to day activities according to people’s abilities. People’s physical needs were well managed and staff ensured people had opportunities for social stimulation.

The home was situated close to local facilities which enabled people to access community facilities such as shops, cafes and the park. At the time of the inspection people had limited access to transport due to issues with staff training.

We recommend that the provider ensures all staff are familiar with the current national guidelines for managing medicines in care homes.