Platform 4: Providing and Evaluating Care
Through participating in Solomon's care under appropriate supervision, Alex gained experience of how evidence-based interventions are delivered, monitored and evaluated. He recognised that effective care involves not only meeting physical health needs but also promoting communication, wellbeing, inclusion and quality of life.
Alex learned that providing care extends beyond meeting physical health needs. Through spending time with Solomon and those involved in his care, he observed how communication, relationships, meaningful activity and social inclusion are integral components of person-centred nursing care. He also recognised the importance of continually evaluating interventions to ensure they remain effective, safe and responsive to changing needs.
Demonstrating Platform 4 Proficiencies
Proficiency 4.1: Safely provide and evaluate person-centred care
What Alex did
Alex observed how Solomon's care was delivered in accordance with his individual preferences, communication needs and health requirements. He spent time observing daily routines and discussing with support staff how care was adapted to meet Solomon's needs while promoting dignity, choice and independence wherever possible.
What this demonstrated
An understanding of person-centred care and the importance of evaluating whether care continues to meet the individual's needs and preferences.
Proficiency 4.2: Deliver evidence-based interventions and evaluate outcomes
What Alex did
Alex participated, under appropriate supervision, in supporting Solomon's nutrition, hydration and medication administration through his Percutaneous Endoscopic Gastrostomy (PEG) tube. He observed the assessment of the stoma site, infection prevention measures and the monitoring of potential complications associated with enteral feeding. Alex also discussed how interventions were reviewed and adapted to ensure they remained safe, effective and person-centred (Bischoff et al., 2020; Malhi and Thompson, 2014).
What this demonstrated
An value of evidence-based practice and the importance of evaluating the effectiveness of care interventions.
Proficiency 4.3: Support people to maintain comfort, wellbeing and quality of life
What Alex did
Alex observed how staff supported Solomon's comfort through appropriate positioning, postural care, communication approaches and engagement in meaningful activities. He recognised that maintaining quality of life is a central aspect of care for people with PMLD (Public Health England, 2018).
What this demonstrated
The need for holistic care and the importance of promoting wellbeing alongside physical health.
Proficiency 4.4: Provide care that is responsive to individual needs and changing circumstances
What Alex did
Alex learned how staff monitored Solomon's health and wellbeing and adapted care when required. He discussed how changes in respiratory health, nutritional status, seizure activity or comfort would trigger reassessment and review by the multidisciplinary team. He observed how care was adapted in response to changes in Solomon's respiratory health, seizure activity, nutritional status and overall wellbeing.
What this demonstrated
An understanding of responsive care and the importance of adapting interventions to changing needs.
Proficiency 4.5: Demonstrate knowledge of how care is evaluated and reviewed
What Alex did
Alex reviewed examples of care documentation, risk assessments and care plans and observed how staff evaluated outcomes through regular review and communication with family members, support staff and healthcare professionals.
What this demonstrated
Recognition that the role of evaluation in ensuring care remains safe, effective and person-centred.
Proficiency 4.6: Recognise and respond to signs of deterioration or distress
What Alex did
Alex learned about common health concerns experienced by people with PMLD, including aspiration, respiratory infections, pain, epilepsy-related complications and changes in wellbeing. He participated in monitoring Solomon's respiratory status and discussed how signs of deterioration, aspiration, increased seizure activity or discomfort would be recognised, documented and escalated appropriately (Hull et al., 2012; Codling and MacDonald, 2009; LeDeR, 2025).
What this demonstrated
An understanding of the importance of ongoing observation, clinical vigilance and timely escalation.
Proficiency 4.7: Use therapeutic approaches to support health and wellbeing
What Alex did
Alex observed how staff used Intensive Interaction and other person-centred communication approaches to build relationships and support Solomon's engagement with those around him (Nind, 2009). Alex used Intensive Interaction techniques and other person-centred communication approaches when engaging with Solomon, helping to build rapport and support participation in everyday activities (Nind, 2009).
What this demonstrated
The importance of therapeutic communication and relationship-centred practice.
Proficiency 4.8: Contribute to reviewing and improving care
What Alex did
Alex participated in discussions with members of the multidisciplinary team regarding Solomon's care and reflected on how care plans, interventions and support arrangements were reviewed to ensure they continued to meet his needs. Through discussions with the multidisciplinary team, Alex explored how care plans relating to PEG feeding, epilepsy management, communication and social participation were regularly reviewed and updated to reflect Solomon's changing needs.
What this demonstrated
The value of continuous review and quality improvement in nursing practice.
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