Braemount Nursing Home

1. To keep people safe and promote their health and wellbeing, the provider should ensure recording in relation to health and wellbeing is consistent across the service. This should include, but not be restricted to, monitoring charts being fully completed and detailing why monitoring is in place, review dates, thresholds of when actions are required and evidence of action taken when needed. This is to ensure care and support is consistent with the Health and Social Care Standards (HSCS) which state that: "I experience high quality care and support because people have the necessary information and resources." (HSCS 4.27).

2. To promote choice and ensure people's nutritional requirements are met, the provider should ensure people are supported with food choices that meet their dietary needs and preferences. This is to ensure care and support is consistent with the Health and Social Care Standards (HSCS) which state that: "My meals and snacks meet my cultural and dietary needs, beliefs and preferences" (HSC 1.37), and "I can choose suitably presented and healthy meals and snacks, including fresh fruit and vegetables, and participate in menu planning." (HSC 1.33).

3. To keep people safe and improve consistency of support, the provider should develop clear guidance for each person supported, where medication is administered covertly, prescribed as required, or in soluble forms. This is to ensure 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." (HSC 1.24).

4. To respect people's choices and support health and wellbeing, the provider should ensure support is carried out in line with peoples wishes. This should include the frequency of personal care activities. This is to ensure care and support is consistent with the Health and Social Care Standards (HSCS) which state that: "My needs, as agreed in my personal plan, are fully met, and my wishes and choices are respected." (HSC 1.23).

5. The provider should enhance the provision of activities throughout the home, to ensure these are designed around people's choices and preferences, aimed to support better outcomes. This should include but not be limited to: a) Regular planned activities linked to individuals’ preferences that provide stimulation and meaningful engagement. b) Creating opportunities for all people who live in the service to have access to meaningful activities. c) Improved availability of one-to-one support where people are unable, or do not wish to be involved in group activities. d) Developing methods to evaluate activities that have been facilitated to inform future plans. This is to ensure care and support is consistent with the Health and Social Care Standards (HSCS) which state that: "I can maintain and develop my interests, activities and what matters to me in the way that I like." (HSCS 2.22).

1. To continue the improvement journey, the provider should ensure that quality assurance is well led, to ensure people experience consistently good outcomes. This should include at a minimum: a. the registered manager having complete oversight of the service and ongoing key activities b. the registered manager ensuring audits are effective in improving outcomes for people. Quality audits and action plans should be accurate, up-to-date and lead to the necessary action to achieve improvements without delay c. utilising evidence-based information to review and update quality assurance tools, to ensure they are effective and driving forward improvement. This is to ensure that care and support is consistent with the Health and Social Care Standards (HSCS) which states that: "I benefit from a culture of continuous improvement, with the organisation having robust and transparent quality assurance processes." (HSCS 4.19).

1. To ensure the safety of people and that support is provided in line with people's preferences, the provider should ensure effective staff deployment. This should include sufficient staffing hours being allocated appropriately over the course of the day, with the right skills mix of staff to meet people's assessed needs and preferences. This is to ensure that care and support is consistent with the Health and Social Care Standards (HSCS) which states that: "My needs are met by the right number of people." (HSCS 3.15).