Nourish’s Head of Customer Experience, Daniel Hollingworth, talks about the importance of a good night’s sleep, and what can be done to improve your quality of sleep as well as the people you care for. 

What keeps you up at night? Perhaps it’s a weak bladder, or the traffic from the street outside. For me it’s more than one cup of coffee a day and a young child who doesn’t seem to need sleep at all.

While the odd bad night’s sleep is normal for many of us, regular disruption to sleep can affect our immune systems, making us more susceptible to illness. Other side effects of poor-quality sleep include sluggishness and slower brain function. This is why monitoring sleep patterns and trends is essential within a care environment, it can help us pinpoint areas for improvement and understand what it is that could be affecting sleep. But how to get better sleep?

Quality sleep is a combination of Rapid Eye Movement (REM sleep) and Non-REM (deep sleep), that allows for rest, rejuvenation and even solidifying memories. REM sleep is also essential for emotional and mental health. Sleep cycles take around 90 minutes, and you ideally want to have at least four of five cycles per night. The average person needs a recommended 7-9 hours of sleep, with the ideal amount sitting around the 8-hour mark.

In a typical care environment, night checks are the norm, and waking state is recorded, and anyone else who appears to be sleeping is recorded as asleep. Although this gives an ok understanding of how much the person has slept or remained awake, it doesn’t actually look at the quality of their sleep.

With a wealth of technology available such as wearables and monitors, we are now able to track sleep quality with great accuracy. When you think of sleep tracking, people tend to think of fitness bands for the wrist, but there are a lot of affordable trackers available, from bedside table noise sensors, under mattress sensors and even wearable rings, these devices can all assess and manage sleep with convenience and comfort.

Everything gets better with a good night’s sleep!

It has been shown that the regularity of your sleep is just as important as the amount of sleep you get at night. It is always better for your health to get regular sleep than to binge on sleep at the weekends, for example. We all feel more alert after a good night’s sleep, but when sleep deprived, the brain has a 40% reduction in capacity to learn.

Research being conducted by Jonathon Cedernaes from Uppsala University in Sweden suggests that sleepless nights can create an increase in an Alzheimer’s related protein called ‘tau’, suggesting a link between poor sleep patterns and more complicated health issues.

Good quality sleep is what boosts our immune system to help fight off disease, so when our sleep is compromised, so is our health. One of the most important factors in ensuring flu vaccines work is to ensure you’re looking after your immune system. Lack of sleep means your body may not be able to create enough antibodies to fight off the virus, therefore resulting in a higher probability of getting flu.

Fortunately, there are many ways we can improve our sleep quality. Many care environments now encourage caffeine free hot drinks, and for good reason. In one study it was found that consuming caffeine six hours prior to bedtime reduces sleep time by one hour. So whether you’re looking to boost your own sleep patterns or wanting to improve sleep in elderly residents you support,  a simple change such as switching to decaf can make a difference.

This doesn’t sound that significant until you compare it to further research which found that heart attacks increase by 24% when the clocks go forward in spring at daylight saving time. However, when they go back in autumn, heart attack cases decrease by 21%. This really shows what a difference an hour of sleep can make.

So that swap to decaffeinated drinks really could be a life saver.

Drinking enough fluid is very important and many of the people we support have fluid targets in place for this very reason. Try to drink consistently throughout the day rather than trying to hit your fluid intake in the latter half of the day. The more fluid you drink at the end of the day the more likely you are to make that bathroom trip, breaking your sleep cycle. This also correlates with falls during the night.

Finally, one of the best ways to encourage quality sleep is to increase physical activity. Not only does exercise reduce stress, it has been shown to reset sleep/wake cycles by increasing then decreasing body temperature which triggers tiredness a few hours later.

Better sleep habits and getting good quality sleep is essential in ensuring the body and mind rest, repair and prepare for the next day. Do you monitor your sleep or carry out sleep assessments on those you support to help get better quality sleep in care? Let us know by leaving a comment below

As you may have already seen, we’ve developed a close working relationship with former CQC inspector Anne Weston. Anne is now part of RHW Care Consults, a specialist team designed to help care providers with their regulatory commitments, which helps to provide Nourish with critical guidance when it comes to regulatory updates and compliance. Her direct experience of how the regulatory bodies operate, along with her vast knowledge of the care industry, make her perfectly placed to help guide care providers on a range of different technical topics they may need advice on. This week, we spoke to Anne regarding one aspect of care recording that is often overlooked when working in a busy care environment – “positive person-centred care”.

Person-centred care is a way of providing care so that those receiving and giving it are on equal footing when it comes to developing, monitoring and undertaking care, ensuring it always meets a person’s individual needs. This doesn’t mean that you give people whatever they want, nor does it involve mindlessly providing information, it’s about considering a person’s individual and personal wishes, family, values and circumstances, then working with them to create the best possible solution for care that’s tailored to their individual needs.

When recording care, being positive means communicating in a manner that reflects the positive aspects of the care and support being described, and not just the negatives. It’s the difference between – “Gladys is unable to get to the toilet herself and frequently wets the bed” which is a negative way to record care. Instead you should record in a style that highlights what she is able to do, such as “Gladys is able to use the toilet when aided by one of the care team” and “This means that she needs to be helped to go to the toilet before she goes to bed and first thing in the morning”.

Here are my top areas for ensuring your care planning is both positive and person-centred:

The Nourish care management system allows you to style your recording in a way which is completely customised to the individual receiving care. With person-centred timelines at the heart of the system your care teams are helped to record care that is bespoke to the individual.

If you’d like to find out more about how Nourish’s care plan software can help you deliver person-centred care planning and management, then give us a call on 02380 002288 or email the team at caring@Nourishcare.co.uk and one of our experts will get in touch. To find out more about how Nourish can benefit your care service, book your personalised demo today.

We spoke to Anne Weston from RHW and asked her what she would say the, “Top 10 essential care planning tips care providers need to consider when considering care plans and their management” would be. This article covers the areas she feels care providers can really make positive gains and improve the care they are able to provide.

The care planning process needs to follow an organised, systematic and deliberate format, which supports and guides care delivery. This means there should be a logical and systematic flow of the information, right through from the initial assessment to the final evaluation.

Last week, we attended yet another fantastic Dorset Care Conference, hosted by Care Management Matters at the Lighthouse in Poole. This time, we were invited to present on the role of digital in modern care delivery.

The fact that so many people joined us in the discussion was testament to the event organisers, but also showed that more and more care providers are considering how technology can help them improve the way they plan, record and report care.

Our care consultant, Luis Rela, shared some useful tips on how to approach the digital transformation process and how change management is key; while Juliana Jeffery from Luxury Care Group talked about her experience of using the Nourish system in her care home and how to overcome challenges.

The floor was obviously open for questions at the end, of which there were many. Here, we’ve shared a few of them.

Understandably, a banker in the audience wanted to know about the return on investment of going digital in care. Luis explained that there are both tangible and intangible benefits, and that care providers should think about the bigger picture when considering investing in a digital care management system:

“The tangible benefits are easier to define, of course. You only need to think about the paper you will no longer need to print, store, archive and shred to understand how those costs can be reduced over time.

“There are then intangible benefits such as time saved by recording notes digitally. Many of our care providers say they save at least one hour per carer each day because they don’t have to spend that time at the end of a shift writing notes and instead, record as they go. For some care organisations, this leads to a cut in the number of staff needed on each shift. However, what we find is that care providers instead maintain staff levels to increase the available one-on-one care for residents.

“In fact, one provider said that this decision led to them achieving an outstanding rating with CQC across three of the homes in the group.”

Juliana added: “There is also less time needed to get new or agency staff up to date with individual care plans and they have the time to get to know and spend time with that resident instead.”

So digital transformation is not primarily about driving costs down but improving the amount and quality of care that can be provided.

We were joined in the room by care providers of varying sizes, and many of them wanted to know how much time it takes to go from paper notes and care plans to digital ones.

Luis said: “Typically, it takes two months and we break down the transfer into stages; starting with daily notes and then care plans. However, this really depends on the size of the care home and whether it’s part of a group. If you take Luxury Care for example, they are still going through the process but that’s because they are doing one care home at a time. It also depends on whether we are developing unique features that work with their service. In one instance, a provider wanted to amend the digital care plan template to mirror that of the paper one, so we would do that first.”

Another member of the audience, who is already using Nourish in their care service, commented: “You could argue that there is never an end date once you are using an electronic care management system because you are always evolving and innovating. Every day we are learning something new and get more confident with the system, so every time we have a new idea, we integrate that into our process.”

Going digital obviously involves the use of physical handsets and electronic devices and some members of the audience were concerned that the responsibility of purchasing such equipment would be left to them.

As part of the Nourish service, we provide tablets for managers; handheld devices similar to Smart Phones for carers; and secure log-ins to our cloud-based system which can also be accessed from desktop. The number of devices needed will usually be the same amount of people you will have on each shift. The user will keep the device for the full duration of a shift, log out and handover to the carer taking over the next shift. Each member of the care team has their own log in with set permissions that have been pre-agreed and there are also log ins for agency workers.

Luis explained why this is the best way forward for everyone: “Care providers do not need the added pressure of having to find and purchase their own compatible devices and set them up. Because our software is completely adaptable to the care you provide, we get these ready for you prior to your training. We also have a dedicated technical support team on hand to help you with any queries.”

During her part of the presentation, Juliana explained how having a digital care management system in place had made communication between members of the care teams much easier and members of the audience wanted her to expand on that.

“Because it’s as easy as using Facebook and the device is with them all the time, it’s great for communicating important messages between members of the care team,” said Juliana. “Everyone can see and send messages through Nourish and handovers are now seamless. It’s been brilliant for ensuring everyone is informed immediately. For example, we also use this system to make sure we notify everyone of quality assurance audit results, which would otherwise have been left for meetings. Now everyone feels involved.”

Juliana also highlighted the added benefits of using these devices when recording notes: “We have carers who are not confident in writing notes or perhaps English isn’t their first language, so they love the speech dictation feature. As you speak, it records what you say.”

If you have any questions about the role of digital in modern care delivery and would like to find out how your care service can benefit, please give our team a call on 02380 002288.

As a whole, the care sector is yet to fully embrace the power of Digital Transformation and all of the benefits that can offer.

Working with Care Management Matters magazine, we shared our views on how to make the most of current digital technology within the care environment; to enhance the depth of notes and care plans, to allow a greater degree of control across the management process and ultimately support care providers and care teams to provide the best possible quality of care.

Gaining knowledge and insight from three care providers who have embraced Digital Transformation, the article answers some important questions. How does the digital system impact at the individual level? What impact will the digital system have on staff? And how will that impact the quality of care you provide?

The full article can be found here:

Below, however, we discuss our Five Top Tips for how you, as a care provider, can make the most of Digital Transformation.

Firstly, for a smooth, quick and efficient transition there will need to be strong board-level support to align all stakeholders. One key tip would be to develop an in-house ‘centre of excellence’ team of skilled staff that can focus on digitising and integration.

“To make the most out of electronic management, a provider must be committed to change, with a fully equipped staff team who believe in it” – Paul Dennis-Andrews, Operations Manager (Encompass)

The most successful organisations will be those that gain feedback direct from the care team. Listen to the everyday challenges your care team face. Evaluate and assess how these challenges can be tackled and overcome before you start the move to digital.

“Ensure the staff that will be using the system are also involved in the decision-making and transition. These are the people who will directly use the system and will raise queries or concerns. It has to be inclusive or it just doesn’t work properly” – Simon Francis, IT Project Manager (Silverline)

The transition to digital can be a lengthy process, but it is also an excellent opportunity to review your paperwork templates and quality of care plans. To allow for a smooth transition, it is crucial that you have your current records in order.

“Ensure that before making the transition to digital, your paper records are in good order. This will make the transition a lot smoother and a lot less stressful for your staff. If you are trying to get your paperwork in order at the same time as transition, you will create extra work for your team. You should also identify any differences between your paperwork and how that translates onto a system. If you can make that as close as possible, the transition will be streamlined and much easier for staff” – Simon Francis, IT Project Manager (Silverline)

The best digital care management system needs to be flexible and enhance your care team. It will support the great work your teams are currently doing, rather than forcing them to work in a different way, and it will offer more than simply a digital representation of your current records. Do your research, understand what it is you want from a system, and find a system that matches your needs.

“I work with a system that is responsive, adaptable, instant, consistent, person-centred and surprisingly cost efficient” – Paul Dennis-Andrews, Operations Manager (Encompass)

“We have been able to work directly with our system providers to give feedback and make direct changes; we very much feel like stakeholders in the system” – Simon Francis, IT Project Manager (Silverline)

Finally, if you’re going to transition to digital care management, you need to commit fully. Having some records digital and other paper causes confusion and extra work for staff members. It also undermines all of the benefits of full integration.

“It’s about having all your information in one place, which you simply can’t do on paper. If you’re going to use an electronic system, maximise it to its full potential and move everything over; certificates, audits, training. I have been able to stop writing my endless to-do lists because my system does that for me” – Megan Read

Have you embraced digital transformation? What did your experience teach you and what top tips would you share?

To find out more about how we can support you to make the most of Digital Transformation, please don’t hesitate to give us a call on 023 80 002288.

Over the past few years we’ve formed a close working relationship with former CQC inspector Anne Weston. Anne is now is part of RHW Care Consults, a specialist team designed to help care providers with their regulatory commitments. Her understanding of how the regulatory bodies aim to operate, combined with her vast knowledge of the care industry are really second to none. This week, we spoke to Anne and challenged her to come up with the 5 key areas she felt that care providers’ care services and plans needed to really get to grips with, in order to perform well in their inspections.

Your safeguarding systems need to be reviewed regularly. This will ensure that those using your service are protected from any bullying, harassment, avoidable harm or potential abuse and may include DOLS applications.

Ensuring that you have a safe environment to operate within is critical. This means you need to ensure that you have everything from equipment to risk assessments on premises and specialised equipment in place where required, in order to provide care safely.

You need to make sure that you have robust infection prevention and control. Both of these need to be compliant with the Code of Practice and PPE monitoring.

Safe management of medication including: audits, ensuring behaviour isn’t controlled by inappropriate medicine usage, competency assessments, reconciliation when transferring and monitoring visits from Pharmacies.

Staffing levels reviewed based on those in your care’s needs to ensure enough competent staff are available who have the right skills to provide effective care.

Active Dignity Champions, maintaining a dignity diary which recognising good practice and supporting continuous improvement. Ensure the “10 Dignity Dos” and factors are always promoted. Do you have dignity themed supervisions and meetings? If so do they use the 7 common core principles to underpin their content?

Person-centred care plans need to be regularly reviewed. If they don’t show personal history, expressed preferences and how needs are met they are unlikely to pass muster. Staff also need to understand and respond to people’s diverse needs in a caring and compassionate way.

Use values based interview to recruit staff who are genuinely caring, compassionate and empowering.

People’s preferences in their end of life care are clear in care plans.

Is your training and development programme underpinned by the Care Certificate and the 6 Cs, with training in equality, diversity, inclusion and human rights? If not, then you should consider updating its content to show your adherence to current best practice.

People involved and contribute with assessment and care planning processes. People are listened to and have their diverse circumstances respected. People supported to make choices and have control of their lives. Changes in people’s needs recognised and action swift.

Clear complaints and comments policy and procedure. Respond to complaints and concerns promptly, ensuring that effective resolutions are sought.

Involvement with the local community promoting inclusion. People using your service should be supported to maintain community links.

Staff are creative in fostering support for people to live as full a life as possible, this includes ensuring that those in your care are helped to achieve as meaningful a set of activities as possible

Structured staff handovers to promote effective teamwork so that people receive a consistently responsive care services.

Nutritious meals and snacks supporting a balanced diet, according to people’s preferences. Ensuring a positive mealtime experience with meals appropriate to meet the needs of those in your care.

Ensure those who you care for have access to relevant healthcare services and support. Accompanying people to healthcare appointments, so that they experience consistent, planned co-ordinated care and support.

Do your working practices account for the importance of consent to care, treatment and support and consideration of mental capacity?

Training and development programme which enables all staff to have the relevant qualifications, knowledge, skills, and behaviours to effectively carry out their role.

A staff supervision programme, used to develop and motivate staff and review their practice needs to be implemented and maintained.

Registered Manager actively promoting a supportive and open person-centred culture. Leads with values that include compassion, dignity, independence, equality and safety which staff understand and practice.

Quality assurance systems with the aim of continuous improvement. Learning lessons through any safeguarding and complaint outcomes. Creation of action plans where improvements are needed.

Management links with external organisations to foster good practice. Working practices follow recognised good practice methodologies which are then implemented into the care services you provide.

Legal obligations from CQC or other external organisations are achieved. This includes regular review of policies and procedures; submission of Notifications to CQC; Nurses working in accordance with NMC guidelines and reporting to Health Protection Agency (HPA), Clinical Commissioning Group (CCG) and RIDDOR.

Designated Champions within the service who support staff to ensure people experience good health and social care outcomes leading to quality of life e.g. Dignity Champion; Moving and Handling Champion; Infection Prevention and Control Lead; Dementia Lead; Communication Champion; Medication Lead.

To find out more about how Nourish can help with your care planning and management, then please do feel free to get in touch at caring@nourishcare.co.uk or give us a call. We work closely with a whole range of care providers, from residential and nursing settings to domiciliary care providers right the way through to large national groups. This means we’re expertly placed to offer practical help and services to support the quality of care you provide.