Going Paperless in Care & the CQC
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Transcript of Going Paperless in Care & the CQC
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. 3. 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. 4. 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 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 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. 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 was when we recently employed a new staff member and had to print out the 350 page Care Certificate for him to complete. He recently left and we then had to re-‐print out another 350 pages for his replacement. Keeping track of all the staff 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 online training they were 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. Staff 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 time 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.