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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.

The Top 10 Essential Care Planning Tips

  1. Care plans must be specific and measurable
    For example ‘Make sure Mrs Smith is comfortable when sitting’ is not sufficient. The care note should read ‘Mrs Smith should be made comfortable when sitting by providing a cushion for her back and a footstool to rest her feet’. This provides a specific task and a measurable outcome.
  2. A care plan is a legal document treat it as such
    This means that it shows accountability and identifies the care to be given. It should guide the work of others and be a basis for continuity of care
  3. Use a positive care recording style instead of negative
    Instead of recording “Mrs Smith can’t reach the toilet and is frequently incontinent”; you should endeavour to record your notes in a positive style. “Mrs Smith is continent when supported by staff to use the toilet frequently and regularly. Give Mrs Smith the opportunity to be supported to use the toilet before and after all meals, after mid-morning and mid afternoon tea, and before going to bed” this demonstrates more respectful approach and brings us onto the next point.
  4. Record person-centred approaches showing respect, value and appreciation
    Using a person’s life history to help enabling control, choice and participation; promoting an enabling environment; maintaining and developing relationships, knowing what is important to someone and why it’s important helps to promote effective care provision.
  5. Focus on a person’s abilities and strengths
    Rather than concentrating on what someone cannot do, you should record what the person can do and what support they need to enable them. For example you should record that ‘Mrs Smith is able to wash her face, hands and front but needs help to wash her back and lower half of body’ rather than ‘Mrs Smith is unable to fully wash herself’.
  6. Focus on the person’s perspective
    Rather than focusing on the staff’s perspective; you should accept and enter into the person in care’s world. Don’t force them into your perceptions, which can cause distress to the person.
  7. Record any preferences the person has
    A great example of this is when the person in care has a preference as to how you as a carer, should assist to provide personal care and in what order. Never forget that their preferences have priority over yours as to how you deliver care.
  8. Do not use labels
    Examples we come across regularly include ‘wanderer’ and ‘difficult’, these do little to explain and understand behaviours. You should focus on understanding behaviours and contextualise their ‘To be aware that Mrs Smith starting to pace up and down the corridor is a strong indicator that she needs to use the toilet’ or ‘ Mrs Smith expresses her lack of understanding of what is happening by trying to hit out at care staff if they do not approach her in a way which suits her’. ‘Therefore you should always approach Mrs Smith directly in front of her, do not approach from behind or from the side’.
  9. Demonstrate the involvement of the person
    Written evidence of their involvement in the activity is always preferable, “Gerard had a great time this morning playing bridge” rather than “played cards”.
  10. Show compliance with the Mental Capacity Act
    Record clearly if you have involved other people in the assessment and care planning and why, according to the requirements of the Act.

Want to know more about how our care plan software can work for you? Get in touch with our team today and book a personalised demo.

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THE BIG INTERVIEW: Our founder Nuno Almeida in Care Home Professional

Positive and person-centred care – what the experts say

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.

Are your care services safe?

  1. Have you checked your safeguarding systems?

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.

  1. Do you have the right resources in place to foster a safe environment?

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.

  1. Have you considered your infection prevention and control strategies properly?

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.

  1. How do you manage medication?

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.

  1. Do you have the correct levels and abilities of staff in place?

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.

How can you demonstrate that you provide a caring service?

  1. Do you adhere to the 10 Dignity Dos and Don’ts?

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?

  1. Are your care plans person-centred?

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.

  1. Did you use values based interviewing?

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

  1. Ensure people’s wishes and preferences are clear

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

  1. Ensure that you have a robust training and development programme in place.

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.

Can you demonstrate that your care services are responsive?

  1. Do those in your care contribute to their care plans?

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.

  1. How clear are your feedback procedures?

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

  1. How do you get involved with the local community?

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

  1. Do you promote access to meaningful activities to those in your care?

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

  1. How well do you ensure staff communicate between one another?

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

Are the care services you provide effective in catering for people’s needs?

  1. How do you make sure you promote a balanced diet?

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.

  1. Do you support the people using your care services to have proper access to healthcare?

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.

  1. Do you ask for consent to care?

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

  1. Do you have a robust training program in place?

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

  1. How do you review your staff performance?

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

Can you demonstrate that your care services are well led?

  1. Do you promote a person-centred culture?

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.

  1. Is there a quality assurance system in place?

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.

  1. How do you foster good practice within the organisation?

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.

  1. Are you compliant with all relevant legislation?

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.

  1. Does your organisation have staff champions?

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.

Find out more about how Nourish can help to improve your care services

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.