Clinical risk meeting- weekly

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location
  Address

New Residents / Re-admissions (If yes is answered, please provide details in the relevant sections)

• Current home occupancy

• WCR1-1<br>Have all risk assessments been completed, and 72-hour documentation audit has addressed any gaps in support plan for any new residents or re-admissions?

  Yes

  No

  N/A

• WCR1-2<br>Have new residents or re-admissions had all medications prescribed and is it now in stock?

  Yes

  No

  N/A

• WCR1-3<br>Have all required referrals been made and any registrations with the GP been completed?

  Yes

  No

  N/A

• WCR1-4<br>Are we meeting the needs of new residents and re-admissions? (e.g. is all required equipment in place, have staff completed any specialist training / skills update)

  Yes

  No

  N/A

• WCR1-5<br>Have we received each new admissions discharge letter and has the support plan been updated with any changed needs?

  Yes

  No

  N/A

• WCR1-6<br>Has the staff dependency tool been updated (Minimum monthly or where there has been a change on the occupancy?)

  Yes

  No

  N/A

Tissue Viability (If yes is answered, please provide details in the relevant sections)

• WCR2-1<br>Have any newly identified wounds been incident reported and identified in current skin plan with additional short term plan for evaluation and actions needed?

  Yes

  No

  N/A

• WCR2-2<br>Upload an up-to-date wound wednesday tracker, that will confirm all appropriate action has been taken (e.g. 7-day review, weekly photograph, short term plan has been reviewed)

  Yes

  No

  N/A

• WCR2-3<br>Have all appropriate TVN / DN / GP referrals been made, followed up and are evidenced via the health visits log?

  Yes

  No

  N/A

• WCR2-4<br>Are positional change charts in place and completed accurately to reflect the management plan?

  Yes

  No

  N/A

• WCR2-5<br>Have all wounds with signs of infection been swabbed by a district nurse and referred to the GP? (if applicable)

  Yes

  No

  N/A

• WCR2-6<br>Does the home have a sufficient supply of dressings for all wounds?

  Yes

  No

  N/A

• WCR2-7 Is there any air flow mattresses in place? If so are these to the correct setting and have these been documented as checked?

  Yes

  No

  N/A

Safety (If yes is answered, please provide details in the relevant sections)

• WCR3-1<br>Have all accidents / incidents this week been reported and entered into the incident log? (UPLOAD LOG MY CARE INCIDENTS)

  Yes

  No

  N/A

• WCR3-2<br>Have these been reviewed by management for any trends, such as unexplained bruising, that require further investigation? (Ensure families, where appropriate, are informed of all incidents.)

  Yes

  No

  N/A

• WCR3-3 Have any incident cases been opened via LOG MY CARE, actioned and closed. (Please list any open cases that require review.)

  Yes

  No

  N/A

• WCR3-4 Have all relevant support plans been updated to reflect newly identified risks such as changes in mobility / swallowing / behaviour?

  Yes

  No

  N/A

• WCR3-5<br>Have all safeguarding referrals been made in a timely manner (within 24 hours)?

  Yes

  No

  N/A

• WCR3-6<br>Have all CQC notifications been made in a timely manner (within 24 hours)?

  Yes

  No

  N/A

• WCR3-7<br>Are current restrictions in place still the least restrictive option (i.e. sensor alarms)?

  Yes

  No

  N/A

• WCR3-8<br>If we have doubts about a resident's capacity around a newly implemented intervention, has a mental capacity assessment (MCA) been completed? If applicable, is a best interest decision in place? Have any applications needed to be submitted to DoLS team?

  Yes

  No

  N/A

• WCR3-9 Where any DoLS applications have been authorised, has the plan of care been updated, along with the DoLS tracker, and any conditions and actions where applicable? (CQC notification will also be required.)

  Yes

  No

  N/A

Falls analysis (If yes is answered, please provide details in the relevant sections)

• WCR4-1<br>Have all falls in the last week been reported, falls risk assessments updated, falls diary completed and where appropriate referral to Falls Clinic made and followed up?

  Yes

  No

  N/A

• WCR4-2<br>Has a top-to-toe assessment and 48 hour post-monitoring fall document been completed and placed in grab files for all falls?

  Yes

  No

  N/A

• WCR4-3 Has the TUMBLES checklist' been utilised to review potential causes of the fall and mitigate further risk?

  Yes

  No

  N/A

Nutrition and Hydration, Swallowing / Choking / Aspiration (If yes is answered, please provide details in the relevant sections)

• WCR5-1<br>Have any incidents of choking, swallowing difficulties, coughing on eating and drinking etc been followed up? (Review notes and support plans / SLT referrals)

  Yes

  No

  N/A

• WCR5-2<br>Have referrals been made to the dietician, GP / SLT when a concern has been identified and followed up in an appropriate timeframe?

  Yes

  No

  N/A

• WCR5-3<br>Has the kitchen been informed, and is involved with residents requiring additional nutritional support and / or texture modified diets?

  Yes

  No

  N/A

• WCR5-4<br>Are there any residents who require fluid monitoring and fluid totals reviewed for people at risk, with interventions and outcomes documented?

  Yes

  No

  N/A

• WCR5-5<br>Have the weekly and/or monthly weights tracker been reviewed this week for losses or gains and appropriate support plans in place to manage them?

  Yes

  No

  N/A

Positive Behaviour Support (If yes is answered, please provide details in the relevant sections)

• WCR6-1<br>Have any new, or changes in, behaviour been seen this week, and if so, have triggers been identified and person-centred strategies developed to support the resident and staff? Have underlying causes such as pain / infection / delirium / loss / change in environment been assessed, or medication review requested? (If yes-please describe below)

  Yes

  No

  N/A

• WCR6-2<br>If a resident has displayed new or changed behaviour this week and they are prescribed medication for their stress and distress, has the PRN / as required medication protocol been updated to reflect the changes? (e.g. behaviour is clearly described, there is no judgemental language used, such as aggressive / abusive, assessment of triggers, linked to health & medication plan)

  Yes

  No

  N/A

• WCR6-3<br>Have referrals been made and followed up to GP / CPN social workers etc? With Family/Advocates/POA notified and involved as appropriate?

  Yes

  No

  N/A

• WCR6-4<br>Have all medications to support residents who are displaying signs of stress or distress been reviewed within the last 3 months and evidenced in support plan (antipsychotics/sedatives tracker) in place?

  Yes

  No

  N/A

Medical Conditions that Impact on Care (If yes is answered, please provide details in the relevant sections)

• WCR7-1<br>If a resident has experienced unstable blood glucose levels this week, is this being well-managed? (e.g. advice been sought from GP / Diabetic Nurse, review invidual diabetes management plan to check it is updated)

  Yes

  No

  N/A

• WCR7-2<br>For any residents who have deteriorated or you are concerned for their welfare, has relevant medical intervention been sought and appropriate measures put in place to meet their needs? (e.g. support plan thoroughly captures new support needs and these are communicated clearly to the team, all relevant referrals made and followed-up)

  Yes

  No

  N/A

• WCR7-3<br>Upload weekly infection tracker. (For all new infections this week, ensure short term generic assessments been implemented into health and medication support plans.)

  Yes

  No

  N/A

• WCR7-4<br>For any residents who have been newly assessed as End of Life in the last week, have relevant actions been taken? (e.g. support plan around end of life wishes which respects the wishes of the resident and / or family, end of life medication (if appropriate), GP review, DN referral, documentation updated, DNACPR in place, statement of intent)

  Yes

  No

  N/A

Medication (If yes is answered, please provide details in the relevant sections)

• WCR8-1<br>Have any issues with prescribing or delivery of medication been resolved? (particular focus on issues which have potential to impact resident care)

  Yes

  No

  N/A

• WCR8-2<br>Have all medication errors been incident reported, investigated and action taken to ensure resident safety?

  Yes

  No

  N/A

• WCR8-3<br>If there have been any concerns that a resident(s) have been negatively affected by side effect / risk factors with medication (e.g. bleeding / over-sedation / mobility concerns), has appropriate action been taken? (e.g. GP / Pharmacy input sought, support plans reviewed)

  Yes

  No

  N/A

• WCR8-4<br>Identify any residents who have been refusing medication. Has appropriate action been taken to support them? (e.g. GP review, support plan review, capacity assessments, refer to covert medication procedure)

  Yes

  No

  N/A

• WCR8-5<br>For any resident who has commenced on a covert medication pathway in the last week, is all relevant documentation completed? (e.g. GP and pharmacy involvement, MCA / best interest decision, clear instructions from prescriber on how to administer each covert medication safely)

  Yes

  No

  N/A

Shared Learning (If yes is answered, please provide details in the relevant sections)

• WRC9-1 LESSONS LEARNT: Following review of incidents or any investigations completed, are there any lessons learnt. If so, have these been cascaded to the team and how?

  Yes

  No

  N/A

• WRC9-2<br>Is there evidence that any alerts (e.g. MHRA) or shared learning has been cascaded to the team?

  Yes

  No

  N/A

• WRC9-3 Has the call bell been checked randomly. Please identify location and how long. Are there any issues to report?

  Yes

  No

  N/A

• WRC9-4 Has the 24 hour handover been reviewed and signed off for the week to ensure that any resident risks are identified, along with daily notes reviewed and action taken where needed?

  Yes

  No

  N/A

• WRC9-5 Are weekly audits up-to-date and completed and any actions documented onto the homes Service Improvement Plan.

  Yes

  No

  N/A

• WRC9-6 What monthly, quarterly, or ad hoc audits have been completed this week?

  Yes

  No

  N/A