Cheshire House

1. To ensure staff respond appropriately to adult support and protection concerns the provider should: a) review their "Safeguarding adult procedures Scotland 2017." in line with current guidance and good practice; and b) where concerns are raised about customers, there should be a clear and recently reviewed process in place that staff follow. This is to ensure that care and support is consistent with the Health and Social Care Standards (HSCS) which state that:

'I am protected from harm, neglect, abuse, bullying and exploitation by people who have a clear understanding of their responsibilities.' (HSCS 3.20); 'I am listened to and taken seriously if I have a concern about the protection and safety of myself or others, with appropriate assessments and referrals made.' (HSCS 3.22); and 'I experience high quality care and support based on relevant evidence, guidance and best practice.' (HSCS 4.11).

2. So as people receive their medication in line with their assessed support, the provider should ensure protocols are in place for the administration of PRN ('as required') medication. These should clearly identify when medication should be given, the desired effect, impact evaluation and next steps if medication is not effective. This is to ensure that care and support is consistent with the Health and Social Care Standards (HSCS) which states that: 'Any treatment or intervention that I experience is safe and effective.' (HSCS 1.24); and 'I experience high quality care and support because people have the necessary information and resources.' (HSCS 4.27).

3. In order to ensure people receive safe care and support which reduces the risk of spread of infection, staff should be confident and following good practice guidance in relation to infection control. Particular attention should be paid to hand hygiene. There should also be a system in place to regularly refresh and assess staffs' knowledge and understanding on how to keep people safe from infection. This is to ensure care and support is consistent with the Health and Social Care Standards which state - '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) and ‘I experience high quality care and support based on relevant evidence, guidance and best practice.' (HSCS 4.11).

1. To allow the evaluation of planned improvements there should be a dynamic and responsive service improvement plan in place. This should be reviewed and evaluated regularly. Priority should be given to improvements that will have the most significant impact on customers well being. This is to ensure that care and support is consistent with the Health and Social Care Standards (HSCS)'I benefit from a culture of continuous improvement, with the organisation having robust and transparent quality assurance processes.' (HSCS 4.19); and 'I experience high quality care and support based on relevant evidence, guidance and best practice.' (HSCS 4.11).

2. So as leaders have the capacity to drive service improvements forward, the provider should review their current administration arrangements. This is to ensure that care and support is consistent with the Health and Social Care Standards (HSCS) which state that: 'I use a service and organisation that are well led and managed.' (HSCS 4.23)