Thank you - I've not heard of Beacon - I will go and have a look straight away. Amazing these things exist but you have to search so hard for them. The problem that we have really is that mum has had dementia now for 10 years and so is very severely effected. Her communication is non-existent but they keep insisting that this is moderate. She has zero awareness of her behaviour so comes into conflict with other residents - she was attacked and did nothing to defend herself as she didn't understand what was going on. Yet, this wasn't mentioned at all in the assessment. In that domain, I was told that Severe only applies to people in a coma! I asked how you could possibly put systems in place to help someone in a coma to communicate but not surprisingly didn't receive an adequate explanation. Likewise, things like Psychological/Emotional Health and were just put down as moderate as mum doesn't participate in activities - she has no language left and is not able to understand instructions or answer questions so this seems impossible to assess. This weekend I tried asking her all sorts of questions - are you a man? are you a woman? do you prefer meat or fish for dinner? are you hot? are you cold? are you in pain? are you happy? She couldn't answer a single question but still this is moderate. In the assessment, myself, the care home manager and the social worker all said that this should be Severe but in the assessment it was put down as Moderate but noted that we didn't agree. She is in a very good (bloody expensive) home and they do manage her care very well. I think this is why they feel able to downgrade her needs despite the fact that this is specifically mentioned as something you shouldn't do.