If you work in care you will probably spend a great deal of time carefully planning and organising your care plans and pathways. So how do you know if your care plans are comprehensive enough to not only pass a regulatory inspection, but actively help those in your care receive effective support?
In order to help care providers avoid the many pitfalls that come with poor care plans, we’ve compiled a list of the top 12 mistakes poor care plans make and a subsequent list of methods you can use to avoid making them and ensure you always use effective care plans.
Each of the points we’ve made above has its own set of risks and requirements which all lead to a lower quality of care, but with the right approach, technology and techniques, care plans can be designed to avoid all of these pitfalls entirely.
Below we’ve detailed the best ways we’ve found to overcome these care plan pitfalls and how you can navigate through them yourself:
If you’d like to find out more about how Nourish can help you improve your care planning and avoid some of the pitfalls we’ve discussed above, then give us a call on 02380 002 288, get in touch with the team or book a demo.
Let’s face it, when you work in care there can seem to be an overwhelming number of different buzzwords, jargon and acronyms involved in the information you get given. This is especially true when you look at the practices involved with providing people with good quality care. Today we’re going to be looking into integrated person-centred care planning – we’ll help you to demystify the term and try to encourage you to adopt the practices it involves into your care provision.
To begin with we’ll be looking at what “person-centred” actually means in regards to care. Simply put, it’s a shortened way of expressing the creation of a series of activities aligned to specifically cater for a person and their requirements. In a way it’s how you choose to culminate your care pathways & activities in a bespoke manner to provide someone with actions, activities and results that are focused totally on the individual.
Person-centred, applies to care planning, when you take into account the clinical, holistic, desires, needs and wants of person when creating their care plans. It doesn’t stop there, however and in order to be truly person-centred, care plans must be created collaboratively with the person in control of the care interventions they want to accept, how they wish to receive them and designed to enable the person at every opportunity.
Here’s where things get a bit trickier. In order to provide integrated person-centred care planning, care professionals from all areas need to work together in order to ensure that the person in care has a seamless provision of their care, no matter the setting. When you have a person whose care requires the interventions from a variety of different social care and healthcare organisations, this can become fairly complex and has only realistically been achievable with the introduction of electronic health records and electronic care planning systems.
Here at Nourish we focus firmly on empowering person-centred care for those who provide and are in care. You can read more about our vision in our recent article on “framing personhood to manage frailty, needs and wants” from our founder Nuno Almeida. It’s why we’ve designed the Nourish system from the ground up to help enable people to receive tailored care and empower carers to do just that.
Nourish’s care planning system helps care workers, care teams, care managers and senior care providers with person-centred care planning by:
Our team of experts are always happy to help talk through how the Nourish system empowers care teams and care providers – talk to us today to find out more.
At Nourish we’ve always been about developing better ways to care and empowering people who care, so they can provide the best outcomes possible. We believe that one of the fundamental ways that care providers can improve the way that they provide care is by adopting an electronic care planning system. We know that this can sometimes be a huge shift in established behaviours and ways of working, so we’ve put together our top ten reasons why we believe adopting an electronic system will help in your care setting.
What this means is that whenever you enter information, care records or notes into an electronic care management system its securely backed up to servers on the cloud. Although this does require an active internet connection to achieve, this can be done easily through most handheld devices or computers, automatically – without you having to worry.
By entering your care notes digitally, you’ll be able to make use of a whole host of different methods to speed your recording, such as voice to text and automatic time stamps – always helpful in evidencing the care you’ve provided.
Because all care notes and records are able to be accessed by those who need them, you are able to provide more effective handovers between staff & shifts. Gone are the days where the night shift would be unaware of every aspect of a person’s daily care notes. Care planning systems like Nourish give your staff access to the right information, no matter their shift pattern.
Because you’re entering information in an electronic format, some care management platforms are able to automatically calculate a person’s MUST score as soon as they have the required data saving you time and enabling more one-to-one care for the people in your charge.
Most electronic care planning systems don’t automatically empower person-centred care; however, Nourish is unique as its built from the ground up to put the person in care at the heart of their care management.
When you’re managing care provision you need to immediately be aware of what is happening in your care settings as a whole. By offering a suite of different reports and overviews electronic care management systems like Nourish are able to help care managers and senior care staff instantly gain an overview of the care provided and help identify changes, which need to be made.
Nourish provides an instant messaging function to users of the system, this allows care team members to immediately communicate as long as they’re with their handheld device.
Overall the features that are available from electronic care planning systems like Nourish are there to help empower your care team to provide more effective care. All of the designs, inputs and reporting are structured in such a way to provide your care teams with the information they need, when they need it.
My care team are always aware of the issues that are currently at hand. By having all devices setup to receive warnings when certain tasks aren’t completed we are able to prioritise actions and work more effectively.
We’ve designed Nourish from the ground up to support those who provide and receive care. At the touch of a button you can bring up a person’s full care record enabling carers to provide truly person-centred and positive care, with the most minimal amount of administration.
If you would like to find out more about adopting the benefits of an electronic care planning system into your care setting, then please don’t hesitate to book a demonstration or give us a call on 02380 00 22 33. It really is very simple and as our previous post, “how quickly can a care provider go online with Nourish?” can help give you an idea.
At first glance mental capacity assessments and the Mental Capacity Act can seem fairly daunting concepts to get to grips with. However, the subject really isn’t as complicated as it might seem on the surface and most of the content covers actions and activities you’d recognise from your own best practice as a care provider.
This article will help you to understand what mental capacity is, what the Mental Capacity Act is, work out when you should perform an assessment, why they need to be performed, how you do them and who in a care setting is best placed to get involved.
Mental capacity isn’t a state which is all-or-nothing. Commonly people feel that diagnoses such as Alzheimer’s, dementia or learning disabilities – even heightened levels of frailty, automatically mean someone lacks the capacity to make their own decisions. This is not always the case!
Mental capacity is defined as the “ability to make your own decisions” and can be broken down down into four main questions:
The Mental Capacity Act 2005 (also known as the MCA) is an act designed to help protect and empower people who might lack the mental capacity to make their own decisions about their care and treatment.
It’s not easy to ensure that someone isn’t wrongly stopped from making decisions that are rightfully theirs to make. Nevertheless, a person needs to be protected from making decisions when they don’t have the capacity.
Before you decide that an individual lacks capacity to make a decision for themselves, you need to ensure that you’ve:
Someone’s mental capacity needs to be assessed when they are:
The Mental Capacity Act puts forth a two-stage test you can perform in order to ascertain a person’s capacity. This is called the, “2 stage test” and consists of:
Remember someone’s mental capacity can fluctuate, therefore you need to make sure you allow the person time to make a decision themselves. The best way to do this practically is to start a conversation. Ask that person how they got to that particular decision. Remember that they might need more information and so you need to be ready to provide that if at all possible.
In a care setting this will typically be carers who are directly concerned with the person at the time. This means that multiple care team members and even teams can become involved in the assessment. However, this isn’t a negative factor, as this will allow a broader time spectrum to be taken into account and how a person’s capacity varies over time. If a care worker feels that they’re following the care plan and have a, “reasonable belief” that the person lacks capacity to make specific decisions they need to make the assessment – this could be anything from accepting food to personal care. This means that their care plans need to be created collaboratively with the person, who agrees to them or an assessment must be made of their capacity to decide if they refuse specific care interventions.
Nourish empowers care workers by providing them with an easy way to plan, record and manage care. This means that carers can easily work with people on their care plans and identify whether they have the capacity to make choices about their particular set of care interventions.
For more information on Nourish, then please get in touch – our team of experts are always happy to help.
Recently Nourish was approached by a journalist from The Guardian and asked to comment about several key issues currently impacting the world of care, both for those that provide it and to those who are being care for. The following is a full response breakdown from Nourish’s MD – Nuno Almeida and contributing to the Guardian’s article “The tech making a difference to social care“.
How big an issue is effective resource management for care providers and what are the type of tools Nourish is providing to help them streamline their operations?
The need to recruit and maintain good care teams and pay them appropriately whilst the sector is under the constant pressure of negative news and budget cuts means that managing a care provider operation is far from straightforward, now more than ever.
On top of these pressures, care homes are having to align with two competing trends: on one hand there is a race to luxury, with the wealthy ‘baby boomer’ generation setting higher expectations of quality and transparency. But on the other hand there is a trend for people who require financial assistance to avoid admission into a care home until very late in life, in circumstances that determine high degrees of dependency, which is at odds with the trends for councils to slash spending on adult social care.
Navigating these trends, managing change and resources, while ensuring compliance with CQC or CSSIW, NHS and local authority auditing teams makes for a perfect storm, and one that exposes clients and providers to clinical and business risks. Most care providers use paper based systems as the main support to plan and manage care and support. Beyond the high costs of archiving, and all the stationery, carers, who tend to be recruited for their empathy, are expected to write daily notes of all their services provided and observations. And care managers are expected to interpret these notes, and update care plans accordingly. This is known to take carers time away from face to face care.
By empowering carers and care managers to manage all care planning and daily care information through digital platforms with smartphones and tablets, Nourish helps care teams in improving their care information while reducing the time carers spend recording their notes, and ensures care plans are continuously updated. Most providers using the platform report a substantial savings, but the main impact is the increased reassurance of the quality of care provided. Care managers say they “sleep better at night” with “an increase of 40% in the time spend face to face with residents”, owners say that “it feels as if we have an extra carer per shift”. Financially, using a well-designed digital care management system means that carers don’t require as much training, meaning that turning a home into a paper free environment is done in hours rather than weeks or months. Most of our clients are reporting savings that exceed the cost of our product.
Is smart, mobile technology better at putting the person being cared for first?
The real potential of digital systems is by creating views of data and user journeys that bring the right information to the right person at the right time. At Nourish we designed the entire system and design based on the person receiving care. It is by most measures a counter-intuitive decision. Usually systems are designed for the client, the person or organisation who is paying for the solution. But we made the call to make the person in care the focal point of all design decisions. This required a significant investment as we had to develop a whole framework of data management that allows Nourish to serve carefully selected information to carers and care managers. A care provider can manage all aspects of care for an individual effortlessly. Things such as nutrition, mobility, tissue viability or continence are easily managed, while taking into account the cross interactions between all those areas for an individual. Because the information for an individual is laid out in a way that is naturally centred on them, it becomes possible to create algorithms that check for missed support or clinical interventions, or trends that may indicate reasons for concern.
We have several examples of people who used to skip services, e.g. refusing a breakfast, and because all of the information about them and their services is now structured in person-centred way, the reasons for those services being skipped became immediately obvious. This allowed care providers to make changes to their service that resulted in clear improvements of the care they provided.
Good care providers also know that good care involves acknowledging the abilities that the person has, not just their frailty. Recognising this, Nourish is developing a self-management app that allows a person to engage with recording their daily routines, to self-manage their long term conditions, report their wellbeing and the care they receive. This will allow providers, families and individuals to become an integral part of a coherent circle of care in giving people the support they need, when they need it.
At Nourish we don’t take the typical path when it comes to care plans. Rather than telling care providers how they ‘should’ go about their care planning, we prefer to learn how they like their own care plans built. We know that care plans are not a one-size-fits-all exercise. There are a whole host of good reasons for care providers to adopt different styles in the care plans they choose to use.
How is a robust care planning template created?
Much has been written about how care plans should be put together. But ultimately, the structure of the care plan template needs to be decided by the senior team of the care provider (including its owners) who will set how the service should be led and by the care managers who will conduct service delivery day to day.
Care planning isn’t just about documents, its about shared journeys with each person
Although it is tempting to shrink the care planning exercise to a structure of needs assessments, a list of support services and the risks involved; good care providers are increasingly recognising that a good care plan covers a representation of a person as a whole. This means they need to cover their wants as well as their needs, their abilities as well as their frailties.
Getting this information goes well beyond an admission interview, or a comprehensive assessment; getting to know a person takes time, and people change their preferences and habits. Care planning is part of all interactions with the person and their close circle of support, family and close friends, not just at discrete times.
Care providers are different and so is their care planning
Some care providers may prefer to tackle recovering mobility with garden activities, others will focus on dancing, this will allow different care providers to resonate with different clients. This is why care plans cannot be the same for all care providers. Because care providers decide, which services to provide and together with their team decide how they are provided, how they are adapted to each individual’s wants and needs, the care planning framework must support the team in this journey.
Fundamental building blocks to a robust care planning framework
The building blocks you need to consider when building each care plan include:
In a modern care planning framework, people receiving care have the ability to continuously give feedback about their care, as well as help to improve and adapt the care they receive. This includes the ability to manage consent, allow a next of kin and other informal carers to record relevant notes, raise warnings and alarms, as well as help to stay involved in the care of the person.
Interactions in someone’s day to day care are typically recorded by carers as daily notes. However increasingly, there is information from connected devices, Telehealth or Telecare equipment, wearables and internet of things (IoT), as well as notes from relatives and volunteers outside of the care provider’s organisation. All of this information, when managed digitally, can be used to automatically update care plans, trigger reviews and enable care managers to have the best possible representation of the context of the person and their care, and feel reassured by the clarity of transparency of the quality of the care being provided.
How can Nourish help with your care planning?
Nourish is designed to support organisations in transforming how care information is managed, with radical improvements to the operation of care services and continuous improvement to care delivery. To find out more please don’t hesitate to get in touch.
At Nourish there are a number of principles that guide our work. Firstly we understand the importance of planning in care, which is why we put care plans at the heart of what we do. Establishing a care plan is key to providing truly personalised care, so we designed Nourish to make that process as smooth as possible.
No two care settings are ever the same, which is why Nourish is flexible and customisable. Our approach is to tailor Nourish to work for care teams, not the other way round. So if a care team has well-established care plans that they are already using, we work with the team to take those care plans online with Nourish – creating the same order that carers are used to. Other settings may prefer to use Nourish care plan templates and then customise them to the care they provide – from nursing care to dementia care to domiciliary care to learning disabilities.
Secondly we use clear, user-friendly design to allow Nourish to fit into carers’ daily work. Care plans can be set up to generate tasks on a daily schedule – for example, if part of a person’s care plan is to monitor a person’s weight loss, daily tasks can be set on the timeline to check nutrition and food intake. Carers have told us time and again that the two hours they used to spend at the end of a shift on paperwork has simply gone, because by the time the shift has finished they have already made all the notes they need to.
Thirdly, care is provided not by a single person, but by a circle of care. Within a residential setting, this may involve the care team, visiting medical staff and family. In home care settings, friends and neighbours may also play a role. With Nourish, notes can easily be made by each person providing care. That information is then stored and organised in the care plan logs in a clear way so that others can access it when they need to.
With all this in place, generating reports no longer involves spending hours retrieving files from the shelves but can be done with just a few clicks, before, after or even during a CQC inspection if required. Care plans can easily be reviewed and audited, which is also vital when it comes to inspection. Reviews may be scheduled, but care teams also have the flexibility to react to changes in a person’s condition which may trigger the need for a care plan review.
Care requires both consistency and flexibility. We designed Nourish to support those needs. Which means care teams can get on with doing what they do best – provide the real, human, compassionate care that enables the people they care for to enjoy the best quality of life possible.
When we first went into a care home with Nourish, it took a couple of days to get users online. But time has moved on. We listened to feedback, we watched how users interacted with Nourish, and we adapted design and functionality for the very real world of care. Now when we go into a care home, we expect to see the entire care team up and running by lunchtime. This includes those people who say “oh I don’t like technology”, and those who say “I’ll never get to grips with a mobile device”, and the 76-year-old carer who recently told us that she would never use Facebook but she uses Nourish every day. Because we use design to make Nourish intuitive and fit into the way people care, not work against them.
The speed at which the care setting feels the effects is palpable. We recently introduced Nourish to a care setting which was fully online with over 200 records created on Nourish by the end of day one. We work with a care home that only has a small team but on average they create over 600 records a day – that’s a lot of information to capture, and could only happen with a system that is quick, efficient, and makes sense in the very real world of care with all its challenges. And because of the way Nourish is structured, that information is easily retrievable. With just a few clicks, that same care team can create a report on any category of information captured, with no need to return to the filing cabinet and sift through 600 sheets of paper.
And what about care plans? Will it take hours to change the fit of the care plans used by a team for many years, that work so well, into a new shape? Not at all, because Nourish is fully customisable. We work with care managers to make Nourish fit into the way they work already.
It is people who care that inspire us to do what we do. The best care will always come from teamwork, so talk to us and let’s see what we can do, together, to make care the best it can be.