INTRODUCTION:The report is a reflection on a residential care home. In this reflective account I will describe and share my experience regarding my resident and in this scenario will also show the profound importance of Communication and Inter-Personal skills amongst Professionals, Service Users, their families, care staff and more in a care home settings. (The Open University 1999-2018) A resident who was diagnosed of Dementia of Alzheimer’s Type middle stage decline. (Alzheimers Association 2019) and with the medical condition of diabetes type 1insulin dependent. (NHS 14 May 2018) Using Driscoll ( 2007 ), according to Driscoll template there are three cycles process of frame work using WHAT, So WHAT and Now WHAT. (Driscoll 2007),p.44. Using Driscoll’s cycle will help me reflect and improve my practice as a Nursing Associate. For confidentiality I’m using different name for my Work Place, resident and persons in this reflective account. NHS says “Confidential information about service users or patients should be treated confidentially and respectfully”. (NHS 2018)WHAT:During my first day as a Team Leader role at Loving Care Residential Home, I had the responsibility of checking my new admission resident in my unit. I came across a 79 year old emergency admission resident, I also found as I was going through her pre assessment, I have read that Mrs Grace has a diagnosis of Dementia of Alzheimer’s Type middle stage decline. Dementia is a life threatening condition that causes memory loss, communication problems, (NHS 2017) Due to her mental condition impairment, Grace was hesitant to communicate with me because she’s confused and she can’t get the right words. (Alzheimers Association 2019) I made her feel comfortable and showed that I was interested in what she was saying. I used my listening skills and encouraged and giving her time to respond. “being able to listen to others is imperative in the communication process”.(TUW 2008-2019)Mrs Grace also has a diagnosis of Diabetes Type 1 in which she has Insulin Injection and as per her pre assessment Mrs Grace has to administer Insulin 3 times a day which is before each meal. “You need daily injections of insulin to keep your blood glucose levels under control”. (NHS 14/05/2018)Due to Mrs Grace’s diagnosis of diabetes type1 – related insulin injection my first responsibility is to communicate with the Doctor. I made a phone call to our Doctor and District Nurses to seek advice regarding her insulin. The Doctor advised me to monitor her blood glucose three times a day before each meal before administering her insulin injection. I speak to Grace clearly with eye contact, moderate tone of my voice and slowly and asked her permission that district nurse will show me how to monitor her blood glucose and procedures on how to inject insulin and she made sure I was competent. (Skillsforcare 2016-2018) Since taking Grace’s blood sugar for monitoring purposes is an invasive procedure. I have raised this concern to Grace Families and to my Manager. She then advised that I ask for District Nurses support and she will also communicate to the Social Services that Grace’s needs are more of Nursing Home . I called the District Nurses team in which after an hour or two, Nurse Maureen came and showed and assessed me in taking Grace’s blood sugar using the Blood glucose monitoring machine and the procedures on how to inject insulin, RCN site says “ The blood sugar is important in diagnosing and monitoring the ongoing treatment of diabetes”. “ Regular monitoring enables the patients/client and the health care team to ensure the blood glucose levels remains with in safe limits.” (RCN 2016) the nurse was happy and signed me off to be able to monitor blood sugar without a qualified nurse present. My Manager has also been informed and was happy about it. SO WHATThough in the scenario that the district nurse showed me how to monitor Grace blood glucose and procedures on how to inject insulin and made sure I was competent and signed me off. But now I think that was not in a Residential Care Home policy for me to inject insulin to carry out the nurse responsibilities. I would like to give with high quality care and maintain my obligations as a Team Leader in a residential care home. Though I followed the Doctors advised and instructions from District Nurses due to this action The Care Home Policies was violated which means I had the duty to take positive action for Grace and to avoid any harm to her. I was disappointed in my decision and action to allow myself to perform task which is not in my line of role. Like what I have mentioned that glucose monitoring purposes is an invasive procedure. There’s why, when and how and need to know your target range and record of your results. (Mayo Clinic 1998-2019) It’s really show that Grace’s needs are more of Nursing Home. I felt bad as my colleague did not pick-up and communicate in her pre-assessment that Grace’s needs are more of nursing home as she needs insulin injections 3 times a day. I do understand that Grace has been admitted as emergency, however my concerns is to provide medical assistance from professionals which were not Nursing Home. I noticed that the Senior Staff who made the assessment in Grace’s medical condition did not communicate well to Team leaders and to our Manager to inform us that Grace’s needs are more of Nursing Home. I think in this scenario my decision was not good enough though I done my part to communicate with the professionals and to my manager. I should stand firm and be reminded regarding the care home policy and I should understand the best care for Grace and not to perform unsafe practices. I need to be accountable in all my actions and responsibilities as a Nurse associates by promoting health care and well being of residents or patients by providing to attain highest possible level of care. NMC says “ This makes sure that everyone entering the profession has the skills they need to care for people safely, with integrity, expertise, respect and compassion from the moment they step into their first job.” (NMC 2019) “ Like nurses and other health professionals, nursing associates can expand their knowledge and skills with the right training and clinical governance”. (NMC 2019) NOW WHAT:This experience has made me more aware of importance of effective communication in one sector. Grace’s mental and medical condition gave me a lot of learning experience. Awareness of my present role and in accordance to my skills. I will try to be proactive and watchful to identify unacceptable and unprofessional action that will cause harm to residents. To attend full trainings and follow the nursing associates guidelines to prevent unnecessary action or unacceptable practice. (NMC 10 October 2018) Nursing Associates has skills and responsibilities needs full trainings My goal will be to understand the role of a Nursing Associates and be aware of new and updated research to identify new rules and practice to achieved the high standard of care.Conclusion :In conclusion it can be seen that promoting effective communication has a very important role in all health care sector in communicating with patients and residents through their care service and treatment. When a residents admitted to a Residential Care Home, Nursing Home or Hospitals, assessments should be made and done based on medical, mental condition or depending on their daily activities ability. Grace’s assessment should have identified the level of medical care needed. Grace’s needs professional nurses on a daily basis to provide proper medical assistance. In General, through this reflection I have learnt that communication is necessary and important skill that needs as much practice and consideration as any other aspect of nursing.