Inspection-Ready, Every Day — in the U.S., U.K., Ireland, and Canada

What All Regulators Expect

Even though inspection bodies differ from country to country, they all look for the same core principles in dementia care:

 

1. Non-drug approaches first

Staff should look for the reason behind a behaviour — pain, boredom, confusion, overstimulation, hunger, loneliness — and support the resident without relying on medication.

2. Regular medication review

If an antipsychotic is used, there must be a clear reason, documentation, and regular attempts to reduce or stop it safely.

3. Safe, well-managed systems

Every PRN dose must be justified, reviewed, and clearly recorded. Medication is never the first response.

4. Trained and confident staff

Inspectors want to see that staff understand dementia, recognise unmet needs, and respond in a calm, person-centred way.

5. Ongoing review and improvement

Care plans, team meetings, audits, and notes should show continuous learning and better resident outcomes.

The ICE Framework builds all of these into daily routines — and your Evidence Binder shows this clearly to inspectors.

 

How ICE Aligns With Your Country’s Standards

Below are quick summaries showing how ICE maps directly to major inspection bodies.

 

United States — CMS (F-Tags & OBRA ’87)

U.S. surveyors look closely at:

F758: Unnecessary Psychotropic Medications

• Gradual Dose Reductions (GDR)
• Behaviour monitoring
• Non-drug interventions
• Consent and clear documentation

How ICE helps:

Identify → shows the unmet need behind the behaviour

Connect → documents non-drug approaches used

Evaluate → provides GDR notes, outcome monitoring, and interdisciplinary review

The ICE Binder gives surveyors a clear, step-by-step record that meets CMS expectations.

 

United Kingdom — CQC & NICE (NG97)

CQC inspections focus on whether care is:
Safe, Effective, Caring, Responsive, Well-Led.

NICE dementia guidance emphasises:

• Non-drug approaches first
• Regular review of antipsychotics
• Person-centred planning

How ICE helps:

Identify → unmet needs and life history documented

Connect → clearly documents alternatives attempted before considering antipsychotic medication”

Evaluate → PRN reviews, medication reviews, audits

ICE makes Regulation 12: Safe Care and Treatment easy to demonstrate.

 

Ireland — Relevant Regulatory & Clinical Guidelines

Irish dementia care guidelines emphasise:
• Person-centred care
• Clear rationale for antipsychotic use
• Evidence that non-drug options have been considered
• Regular review and updating of care approaches

How ICE helps:

Identify → behaviours assessed with clear rationale

Connect → non-drug supports shown in care plans

Evaluate → regular medication reviews and reductions

An ICE Binder helps providers demonstrate a clear, structured approach to safe, thoughtful dementia care.

 

Canada — HSO Standards & AUA Initiative

Canadian inspectors and quality bodies focus on:

• Reducing potentially inappropriate antipsychotic use
• Person-centred dementia care
• Medication review and tracking
• Staff education

How ICE helps:

Identify → supports the National AUA strategy

Connect → structured non-drug interventions

Evaluate → tracking, dashboards, and review cycles

The ICE Dashboard supports CIHI reporting and AUA monitoring.

The Evidence Binder (Your Proof During Inspection)

 

The Evidence Binder is where everything comes together.
It shows inspectors — in one organised place — that your home:

• Reviews every resident on antipsychotics
• Uses non-drug strategies before medication
• Trains staff in person-centred dementia care
• Places resident well-being at the centre of decisions

When inspectors arrive, you simply open the binder and walk them through it.

 

How the Binder Works

• Staff complete ICE training
  They learn to identify unmet needs, connect with supports, and evaluate outcomes.
• Evidence is created naturally
  Care plans, logs, audits, STAR exercises, PRN notes, quarterly reviews.
• Evidence is filed under simple tabs
  Everything has a place. Inspectors can find what they need, instantly.
• The binder stays current
  Daily, weekly, and quarterly updates ensure you are always inspection-ready.

In short:
The binder turns good practice into visible proof.

What’s in Each Binder Section

1. Traffic-Light Dashboard

A quick way to prioritise residents on antipsychotic medication by identifying who are presenting with behaviours of concern, who are improving and who may be ready for medication reduction.

Red = behaviour concerns present and resident in distress, requires a review to identify unmet needs that are driving the behaviour change

Amber = improvement, next step is a review is planned

Green = behaviour is settled, may be ready for reduction/stop of antipsychotic medication when resident well-being plan is completed and in place

Shows every resident is regularly reviewed.

 

2. Pre & Post Training Audits

A quick check before training begins — and again after.

Shows real, measurable progress.

 

3. Resident Well-Being Packs

One folder per resident on antipsychotics, including:

Behaviour description

Reason for medication

Unmet needs identified

Non-drug strategies attempted

GDR attempts

Current well-being plan

Proves care is personalised and safe.

 

4. PRN Log

Records every PRN dose, what was tried first, and the prevention plan added afterwards.

Shows medication is never the first response.

 

5. Training Evidence

Staff completion list

STAR and Stone-in-Shoe exercises

Team meeting notes

Shows staff are trained and supported.

 

6. Quarterly Review Notes

Every three months:

Reviews completed

GDRs attempted

Non-drug strategies that worked

Feeds directly into quality improvement.

 

7. Policies & Crosswalk

Non-drug-first policy

GDR protocol

One-page summary demonstrating how your nursing home is meeting standards

Makes compliance easy for inspectors to see.

 

8. Small Wins & Culture Change

Records improvements across the home:

Routines

Activities

Communication

Environment

Staff approach

Shows real culture change, not just paperwork.

Download Sample Evidence Binder

Always Inspection-Ready

With ICE, you’re not just meeting standards — you're building a confident, compassionate system of dementia care that inspectors can trust.

Managers feel organised.
Staff feel supported.
Inspectors see the evidence.
Residents feel the benefit.

One framework. One binder. Full confidence.

 

Get in touch with Cathal