The inspection took place on 24 July 2018 and was unannounced. The inspection continued on 25 July 2018 and was announced.

Pine Martin Grange 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.

Pine Martin Grange is a large detached property in Wareham. The home provides long term and respite accommodation for up to 64 older people with personal care and nursing care needs. At the time of our inspection 22 people were living at the home.

The service did not have 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. The registered manager had handed in their notice four days prior to our inspection. The regional director explained that the current deputy home manager was acting up and had started the registration process with us.

People, staff and relatives told us they felt there weren’t enough staff which left people at potential risk of harm. At times where people requiring two staff are receiving personal care and the team leaders or seniors are completing paperwork or administering medicines there is no staff member on the floor supporting others. The regional director and deputy home manager acknowledged our concerns and by the end of day two told us that they had agreed with the provider to increase staffing levels by 12 hours per day over the next three months when it would be reviewed again.

People, relatives, health professionals and staff told us that Pine Martin Grange was a safe home. Safeguarding alerts were being managed and lessons learnt by the home. Staff were able to tell us how they would report and recognise signs of abuse and had received training in safeguarding. Medicines were managed safely, securely stored, correctly recorded and only administered by staff that were trained and assessed as competent to give medicines.

People were supported by staff who understood the risks they faced and valued their right to live full lives. Risk assessments in relation to people’s care and treatment were completed, regularly reviewed and up to date.

Care plans were in place which detailed the care and support people needed to remain safe whilst having control and making choices about their lives. Each person had a care plan and associated files which included guidelines to make sure staff supported people in a way they preferred. Staff were able to access care plans and guidance on the go via their hand held devices.

Staff had a good knowledge of people’s support needs and received regular local mandatory training as well as training in response to people’s changing needs. Staff told us they received regular supervisions which were carried out by the management team. Staff told us that they found these useful. We reviewed records which confirmed this.

Staff were aware of the Mental Capacity Act and training records showed that they had received training in this. Capacity assessments and best interest decision paperwork had not always been completed correctly. The management team were reviewing this.

People and relatives told us that the food was good. We reviewed the menu which showed that people were offered a variety of healthy meals. The head chef told us that the menu was reviewed every four weeks with people’s input.

People were supported to access healthcare appointments as and when required and staff followed professional’s advice when supporting people with ongoing care needs. Records we reviewed showed that people had recently seen the GP, district nurses and a chiropodist.

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