OVERVIEW OF FRIENDS OF THE ELDERLY
Friends of the Elderly is a charity that has been supporting and caring for older people since 1905 and aspires to a society where all older people are treated with respect and given the opportunity to live fulfilled lives.
Friends of the Elderly care homes provide quality residential, nursing and specialist dementia care in 10 care homes across the country, while their free-to-access services, including visiting and grant-giving, make a real difference in the lives of older people. Through their subsidiary, Triangle Community Services, they also support older people in their own homes and offer dementia support in their day centres.
Read on to find out how Friends of the Elderly approached the decision to go digital with their care plans and their top tips to help other care providers.
WHAT WERE FOTE HOPING TO ACCOMPLISH?
At the time of our introduction Friends of the Elderly were using a well-structured paper based care planning system across all of their homes and in Triangle Community Services. They had been actively working with SCIE to review the paper based approach with the remit of making the system more person-centred and outcome-focused while also reducing the amount of paperwork involved.
The consideration to use KareInn therefore formed part of a wider process of further developing Friend of the Elderly’s leading role in promoting care planning best practice. Richard Macintyre, Director of Quality and Innovation, recognised that the existing paper process, whilst rigorous at recording information, was limited in its ability to make this information actionable, transferable, or to make the system really person-centred, needs-led and to generate genuine insight from it. He recognised that paper-based care plans were not the future for the sector.
Richard was keen to introduce an electronic care planning and daily record system that would provide Managers and staff teams with greater visibility and assurance to meet CQC regulations under the Care Act (2012/15) and give care staff time back to spend more face-to-face time with service users. In addition, it was important that care staff were quickly able to adapt to the new way of working and that there was evidence of added value for managers, staff and leaders across the charity.
The Regional Director and Manager of the Malvern care home agreed to run a trial on the first floor of Bradbury Court which provides dementia care. The trial provided evidence against a number of agreed outcomes and goals and demonstrated a return on investment using a side-by-side comparison against a control using the current paper based care planning system.
IMPLEMENTING THE KAREINN SYSTEM
The KareInn system was quick and simple to implement, requiring nothing more than good Wi-Fi coverage and a list of staff names and job titles. KareInn set up the rest.
Friends of the Elderly chose to select the optional support for transcribing historical paper care plans onto their system. This relieved any burden on staff for time and helped to deliver greater buy in. It also helped to create an emotional attachment to the new system on the first day of “go live”, as care staff could see life stories of service users at the click of a button.
KareInn supported the Manager of Bradbury Court with posters, power point slides, letter templates and high quality printed briefing materials to help communicate to stakeholders the introduction of a new system. This was well received by residents and families at their residents and relatives quarterly meetings.
All staff were trained on the KareInn system regardless of which floor they worked on, as staff would often alternate between floors in order to cover shifts. This also allowed staff to compare and contrast against the two differing systems in place. Staff were trained at different times throughout the day to accommodate the differing shift patterns. Training took less than 90 minutes, after which all staff were live on the new system.
HOW DO THE RESULTS COMPARE AGAINST AGREED GOALS?
Results were obtained using quantitive data and insights from the KareInn system and from an independent review conduct by Richard Macintyre on site at the end of the trial. This involved one to one and group session feedback, plus ideas for further improvements to the system which KareInn took fully on-board.
Goal 1: Evidence high levels of care staff engagement with the system
From the first day of go live all staff were very engaged with the system and found it easy to use, recording 3,257 care plan updates per resident throughout the trial period, the equivalent of 3 novels!
Staff were also confidently utilising all of the features of the system, with 160 professional visits recorded (this includes GP visits), 80 body maps, over 12000 fluid intakes and 10 abbey pain scales, 50 Waterlow and 50 MUST scores.
Care staff consistently used the system throughout the trial, with all staff still actively engaged on the system at the end of the trial, and new care plan entries stable at 1,879 a week, which is in line with our more established homes.
There were two care staff who had poor writing skills before the introduction of the system, but now have no problem using the KareInn care planning system to document care entries. They were also able to utilise the voice recordings.
GOAL 2. PROVIDE MANAGERS WITH GREATER VISIBIlITY AND ASSURANCE TO MEET CQC REgULATIONS
The manager was really pleased with the ability to monitor service user records in real-time and ensure appropriate actions were being taken and feedback given soon after entries are made.
The Home Health dashboard provides an instant snapshot of entries and areas of care requiring attention. This has helped the unit manager zone in on areas that need improvement.
The task management system, known as “Nudge” helps the unit manager to plan, organise and manage her home more efficiently. The manager is now able to create bespoke tasks for any service user and keep an oversight of when tasks have been completed.
Individual trend graphs for services users allows the manager and senior care staff to spot cases that require early intervention.
As a result of being able to see trended weight graphs over time and compare these to resident MUST scores, the Home Manager was able to move away from uniform weekly weigh-ins for all service users and instead instead set weigh-in periods that were more tailored to the individual. This made the care much more person-centred and outcome-focused.
As a result of the daily fluid trackers the Home Manager was able to counter a claim of dehydration made after a resident was admitted for a short hospital stay.
Goal 3. Give care staff more time back to spend face-to-face with residents
Senior care staff reported gaining over 90 minutes back on each care plan review due to the simplicity of the system, the removal of duplicated effort and the readiness of information to hand in comparison to the service users on the ground floor who remain on the paper care plan documentation.
The management team felt informed, as are care staff, and time has been saved in informing family members etc e.g. has the doctor been to see my Mum today?
The management team are pleased about the time saved by care staff - this is because carers are now recording more information than before.
Goal 4. Improve quality of information recorded, being more person centred and outcome focused
A significant increase in the volume & accuracy of information being recorded using KareInn versus paper as recognised by the Manager. This is as a result of the real-time inputting via a mobile device.
Care Staff explained ‘its easier to get into the habit of recording after helping the service user, I prefer to do it then, and there, rather than in a rush at the end of the shift when I could end up writing a shorter amount or missing things out because I have forgotten’. I also go home on time at the end of my shift – that never happened before”.
The manager reported that ‘posts are now much more person centred whereas before basket terms were often used’. An example given was a service user who had refused a shower but had accepted a bed bath - this was documented before as ‘personal hygiene supported’ - not person centred at all!
There has been an improvement of the legibility of information provided vs paper, and now entries are much more descriptive and detailed.
WHAT ADVICE WOULD THEY GIVE TO OTHER CARE PROVIDERS?
Ensure you engage with both managers and staff and get them involved in early discussions and decisions around the approach to care planning and care management software – the opening meeting was made up of Friends of the Elderly’s Internal Auditor, Health and Safety Manager, Director of Care Homes, Regional Directors and Home Manager for the pilot as well as their external consultant for Safeguarding and Clinical Lead. This helped to create staff engagement which is critical from the outset of any pilot.
Goals were set around what we wanted to get out of the system - this helps demonstrate return on time and investment.
Results of the trial were taken to the Care Home Managers meeting which are held every six weeks - the Malvern home was very enthused about it, which created a nice sense of internal momentum and other Home Managers were keen to be next in line to go next.
Results were also taken to the Board of Trustees which was well received and helped to provide a Board level endorsement for the system.