Grange Care Home Ltd

1. To support people to have care and support that reflects their future wishes and health needs, the provider should improve anticipatory care planning. This should include, but is not limited to: a) ensuring anticipatory care plans are initiated promptly when people move into the service or when health needs change b) involving people, families and relevant professionals in discussions so plans reflect what matters to the person c) ensuring staff know where plans are stored and how they should guide day to day and future care. This is to ensure that care and support is consistent with the Health and Social Care Standards which state that: 'My future care and support needs are anticipated as part of my assessment' (HSCS 1.14); and ' My personal plan (sometimes referred to as a care plan) is right for me because it sets out how my needs will be met, as well as my wis2. To support people to receive safe, consistent care that is right for them, the provider should improve health related recording so that records are person centred, clearly organised for each individual, and consistently completed. This should include, but is not limited to: a) ensuring each person has individual, clearly filed records b) ensuring daily notes describe what was offered, accepted or declined (for example, personal care, bathing/showering, hydration support) c) ensuring staff record follow up actions when targets are not met (for example, low fluid intake). This is to ensure that care and support is consistent with the Health and Social Care Standards (HSCS) which state that: 'My care and support meets my needs and is right for me' (HSCS 1.19).

1. To support safe and consistent care, the provider should strengthen oversight of staff working hours to ensure they are safe, sustainable and support staff wellbeing. This should include, but is not limited to: a) putting in place routine monitoring systems to identify additional hours b) ensuring supervision is used to explore the impact of working patterns on wellbeing and practice c) reviewing staffing arrangements to reduce reliance staff members consistently covering rota gaps. This is to ensure that care and support is consistent with the Health and Social Care Standards (HSCS) which state that: 'My care and support meets my needs and is right for me' (HSCS 1.19); and ' 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).

2. To support people to have meaningful daily experiences, the provider should review how activity and care staff are deployed to ensure activity provision is reliable and not disrupted by staffing shortfalls. This should include, but is not limited to: a) reviewing staffing arrangements so activity hours are protected b) ensuring staff in activity roles are not routinely redirected to care duties c) monitoring whether the current deployment model enables sustainable delivery of both activities and care. This is to ensure that care and support is consistent with the Health and Social Care Standards (HSCS), which state that: 'I can choose to have an active life and participate in a range of recreational, social, creative, physical and learning activities every day, both indoors and outdoors' (HSCS 1.25); and ' My care and support meets my needs and is right for me' (HSCS 1.19).