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Going Paperless In Care & The CQC

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An exploration of the care management software and implications with the CQC

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   SMART   STRATEGIES   TO   IMPLEMENT   WHEN  INTRODUCING   CARE   MANAGEMENT   SYSTEMS  INTO  YOUR  SERVICE.    1. Ensure  the  software  you  are  considering  is  practical  for  your  service:  

 Look   carefully   at   what   companies   are   offering   and  think   about   the   key   features   your   service   needs   on   a  daily  basis.    In  this  case  it  really  is  the  quality  and  not  the  quantity  that  counts.    2.   Discuss   the   proposed   changes   with   residents,  families,  and  staff    People   sometimes   take   time   to   adapt   to   change.   The  more   information   you   give   them   the   easier   adoption  will  be.  Talk  about  the  benefits  of  any  new  changes  and  schedule  regular  update  sessions  so  that  any  anxieties  can   be   discussed   and   alleviated.   It   is   important   to  evidence  this  action  e.g.  residents  meeting  minutes.    1. Get  regular  feedback  from  users  Feedback  is  crucial.  Implement  a  strategy  that  makes  it  easy  for  end  users  to  discuss  how  they  are  finding  the  new  product.  Ensure  reports  are  written  which  convey  how   their   feedback   is   being   used   to   improve   the  service.    2. Update   company   policies   to   incorporate   new  procedures  

Introducing   software   into   the   company   may   bring  changes   in  policy.  For  example,  you  may  want  staff   to  carry  photocards  when  out  with  residents  or  you  may  need   to   put   measures   in   place   to   protect   data   on  smartphones.      

   Review  your  policies  and  ensure  they  remain  current.    

 5.  Audit  BYOD  and  company  devises  periodically  It  is  amazing  how  many  times  someone  has  gone  to  use  a   device   only   to   find   that   a   fault   that   had   not   been  reported.        Enhance   safety   by   making   regular   auditing   a   part   of  your  work  culture.      Case  study  1:    Positive   Community   Care   Ltd   is   an   established  provider  of  care  homes,   supported  housing  and  home  care.   They   were   using   the   so-­‐called   ‘market   leading’  software  when  in  2014  they  received  three  crosses  on  their  inspection  report!    Some  problems  highlighted  by  CQC  were:    1. More  person  centered  care  planning  required  2. Evidence  required  as  to  how  client  activities  matched  the  care  plan.  

3. Poor  record  keeping  4. More  robust  risk  assessments      The  management  decided   that   they  needed   to   change  their  care  management  software  and  chose  to  use  Care  Consort,  who  efficiently  migrated  all  appropriate  data.  This  decision  helped  transform  their  service!    Their  next  CQC  report  (April  2015)  was  good  in  every  area.  Here  are  some  excerpts.    

“Care plans were clear and comprehensive…and addressed each personʼs individual needs, detailed what was important to them, how they made decisions and how they wanted their care to be provided” “Arrangements to assess and monitor the quality of the service were in place, so that people benefited from safe quality care, treatment and support.” A providerʼs story:  When  we  first  discussed  the  idea  of  ‘going  paperless’  it  was   not   even   called   that,   it  was   simply   called   IT.  We  had   been   managing   with   paper   for   years   and   had  always  had  a  good  rating  even  back  in  the  CSCI  days.    We  had  developed  a  number  of  different  systems  that  allowed  us   to   assess   important   areas   of   the   business,  using   various   spreadsheets   for   multiple   specific  functions,   and   paper   forms  with   signature   checks   for  monitoring  key  areas.      It   all   seemed   to   work   really   well   until   the   landscape  changed  and  CQC  began  to  request  evidence  of  how  the  activities   of   the   service   users   related   to   their   care  plans?    Now,  this  area  was  one,  which  we  had  always  tried  to  ensure  high  performance,  but  when  the  CQC  requested  evidence   we   encountered   a   few   problems.   Our  information   was   listed   in   various   sources   such   as  handover  books,  daily  records,  and  care  plans  and  took  time  to  collate  into  an  evidence  log.          

   This  made  it  difficult  to  always  prove  not  only  that  the  activities  set  for  Mr  X  had  actually  been  carried  out,  but  also  that  they  were  in  line  with  his  needs  and  reflected  his  care  plan.    Sometimes  daily  reports  had  only  minimal  information  entered,  perhaps  because  staff  were  too  busy,  or  even  because  English  was  not  their  first  language.  The  main  issue   this   highlighted   is   that   inspections   are   based  heavily   on   how   efficiently   you   and   your   team   can  provide   clear,   legible   and   concise   information   in   a  timely  manner.      Because  if  you  are  not  consistent  across  the  key  areas  of  your  organisation,  you  are   liable   to  be  caught  out   -­‐  not  necessarily  because  your  service  is  poor,  but  it  can  be   perceived   as   such   by   the   inspector   due   to   poor  record   keeping   and   communication   workflows   at   all  levels.      Eventually   we   made   the   decision   to   try   one   of   the  market   leading  care  management  systems,  although  it  was   fairly   expensive   because   we   still   needed   other  systems  in  order  to  truly  run  an  excellent  care  setting.      For   example,   we   used   a   separate   online   training  company,   and   that   worked   quite   well   but   it   became  more  of   a   fire-­‐fighting   tool  when   it   became  clear   that  staff   hadn’t   completed   training   that  was   set   for   them  some  time  ago.  We  needed  something  more  proactive  that  informed  us  when  we  were  at  risk  of  not  meeting  CQC  standards.              

   A   defining   moment   for   me   was   when   we   recently  employed  a  new  staff  member  and  had  to  print  out  the  350   page   Care   Certificate   for   him   to   complete.   Six  months  later  he  left  and  I  then  had  to  print  out  another  350  pages  for  his  replacement.    Keeping  track  of  all  the  staff  's  progress  with  their  Care  Certificate  and  other  training  was  a  matter  of  scouring  through   a   ‘training   folder’   which   was   generally   well  stocked  but  had  to  be  matched  with  the  online  training  they   were   also   doing   on   another   website   -­‐   which  required  another  password,  and  so  it  went  on    It  was  clear  that  by  default  Care  Consort  was  ‘set  up  for  success'   from   the   very   architecture/   design   of   the  system.  Using   this   transparent   solution   allowed   us   to  provide  evidence  ‘at  a  glance’  and  when  requested.      The  fact  that  it  was  a  goal  focused,  and  person  centered  system   set   in   real   time,  made   a  massive  difference   to  the   delivery   of   care   in   a   demanding   and   time-­‐short  environment.  Staffing  savings  were  made  immediately  through   the   ‘Time   and   Attendance"   module   which  more   than   covered   the   cost   of   the   whole   system,   so  this,  too  was  a  bonus.      We  could  now  easily  demonstrate  to  placement  teams  exactly   how   we   planned   to   deliver   person-­‐centered  care,   which   contributed   towards   our   quick   return   to  full  occupancy  in  a  tough  environment.    Our  focus  was  back  on  care,  spending  at  least  30%  less  on  administration  duties.    Recording  data  became  more  enjoyable  because    the  system  is  well  designed  and  easy  to  use.        

   Everything  is  legible,  concise,  clear  and    beautifully  designed  just  like  my  smart  phone.    Finally,  when  I  reflect  on  our  journey  since  that  initial  poor   CQC   report   to   our   position   now   as   an  organisation,   I   can   see   that   finding   and   using   a   good  care  management   system  such  as  Care  Consort  was  a  pivotal  part  of  our  success.