Leverburgh Care Home

1. To support continued improvements and to keep people safe following best practice, the provider should ensure that people at risk of choking have all interventions documented appropriately in line with the International Dysphagia Diet Standardisation Initiative (IDDSI). This is to ensure that care and support is consistent with the Health and Social Care Standards (HSCS) which state that: 'Any treatment or intervention that I experience is safe and effective' (HSCS 1.24).

1. To ensure that staff and people using the service benefit from a culture of reflective practice, supervisions and appraisals should be carried out regularly to support continued improvement. This is to ensure that care and support is consistent with the Health and Social Care Standards (HSCS) which state that: 'I have confidence in people because they are trained, competent and skilled, are able to reflect on their practice, and follow their professional and organisational codes' (HSCS 3.14).

1. To support necessary improvements being introduced properly, the manager should assess and evaluate actions taken to gain reassurance that this has been done correctly. They should use a process of quality assurance audits to establish this. This is to ensure that care and support is consistent with the Health and Social Care Standards (HSCS) which state that: 'I benefit from a culture of continuous improvement, with the organisation having robust and transparent quality assurance processes.' (HSCS 4.19).

1. To support reassurance that staff are following best practice guidance, the manager should introduce ways to establish competency checks on staff who administer medication, and other ways to carry out practical observations on staff practice. This is to ensure that care and support is consistent with the Health and Social Care Standards (HSCS) which state that: 'I have confidence in people because they are trained, competent and skilled, are able to reflect on their practice and follow their professional and organisational code.' (HSCS 3.14).

2. To improve how the service evidences people's needs are met by the right number of people, the manager should add more detail that describes their decisions around the levels of staff. This is to ensure that care and support is consistent with the Health and Social Care Standards (HSCS) which state that: 'My needs are met by the right number of people.' (HSCS 3.15).