Mardale Group’s care ethos is rooted in three C’s, competence, choice and compassion. Or, as Ollie Smith, Mardale’s Head of IT, put it. “We work in our residents’ home. They don’t live in our work environment.”
This focus guides the decision making throughout their homes. ‘How can we bring information, options and understanding to the people utilising our service?’ A question they answer every day in Ardale, their family run group of bespoke homes. As well as The Marbrook Centre, a specialist neurological, dementia and stroke care services provider.
It is no mean feat to meet the personal and varying needs of the people they support, let alone support their ambitions for tomorrow! The teams at Mardale are committed, experienced and engaged with their guiding values of competence, choice and compassion. They are also skilled at using technology to support their community. With a decade of digital experience under their belts, Mardale are adept at harnessing technology to achieve human goals. They have used Nourish Better Care to support their services for over 3 years.
Never one to rest on their laurels, Mardale sought to improve the quality of their service, by improving the oversight of and insights into their services with technology. This led them to implementing Nourish Confidence. Our new functionality that brings audits, actions, and AI powered care plan improvement opportunities together and smoothly integrates them into care workflows on our Better Care platform.
We sat down with Mardale’s Head of IT Ollie Smith to discuss how Nourish Confidence supports their care values, improves their approach to audits and helps them utilise AI in a responsible, impactful way for their community.
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Why Confidence
Using technology to build understanding and champion lived experience
Beyond Dip Testing
How Nourish Confidence moved their monthly care plan audits from a fifth of their service to the full residence
Key Categories
The way Mardale focused findings from Confidence to their unique needs
Risk Reduction
Confidence’s significant impact on risk management at Mardale
Richer Care Plans
Improving personalisation and detail in care plans with Confidence
Flipping the Script
How Mardale utilised Confidence to change their focus from what peope can’t do, to what they can!
On the Ground
We discuss Mardale’s teams experience with Confidence
Digital Partnership
What it’s like working with Nourish
Why did you choose to implement Nourish Confidence?
“One of the main motivations for our adoption of digital tools is to give our care teams the tools to be able to support our residents. Especially when it comes to oversight. We want our teams to be able to identify any changes in the people we support. Whether they may not be their normal selves or how they are on a regular basis. Digital tools help us factor in everyone’s history so we can better understand their present.
“A lot of people can remember a time when it was on paper and you just wouldn’t have that oversight. You’re never going to be able to summarise a decade of paper records like that. Whereas now with electronic systems, it’s bringing all that data together and giving a true representation of how someone lives their life and how they want to live their life. In a way that is much more accessible and implementable.
“Nourish Confidence is the next step in us championing competence, choice and compassion for the people utilising our services.”
How have you found using Nourish Confidence?
“We’re really happy with Nourish Confidence. The main tool in Confidence that caught our eye was the AI care plan audit. The reason being, a care plan is a key piece of information for how our support team can support the resident and enable them to live the way they want to live.
“Now, let’s say you have 300 residents and you have 20 care plan categories per each resident. That’s quite a lot, and quite standard. We would love to check them every day or even every week. But in reality, that doesn’t happen and it can’t happen. With manual care plan audits we would select a handful of residents a month and we would audit those residents and those care plans. But that still leaves, in and around, 250 other residents that potentially aren’t being checked every month. Which means they’ll fall into the next month. Over time this caused gaps to appear. You can see how this is not conducive to quality care and support.
“Nourish Confidence has just been so powerful for our audits. The insights that we’ve been able to see, purely by the monthly run, have been game changing. What’s even better is it will scan everything all at once so you can see an overview of all residents monthly.”
How has this process impacted your oversight of your services at Mardale Group?
“We’re able to audit every care plan in the same amount of time we would have spent dip testing care plans previously.
“When we were dip testing we’d be able to review about 20% of the people in a service a month. Care plans are incredibly detailed, and they take time to review and audit properly. For example, say one of our buildings is 82 resident capacity. We would be looking at roughly 15 residents or 20 residents a month. Which means there are 60 residents that aren’t being audited that month for their care plans. Now, thanks to Nourish Confidence, we can review them all with the level of depth and insight that they need.
“We’ve been testing Confidence for this exact purpose since we first implemented it and I’m 100% confident in the AI Care Plan Audit.”
How do you specify Nourish Confidence to your services’ needs?
“We’ve selected some key categories that we want to focus on ourselves in the Confidence reports. We started with contradictory information. That’s the first thing that we go for.
“Because at a glance, something in the care plan has been changed and updated, which is great because it needed to. The person’s care need had changed, that happens a lot. But, outside of the care plan section, there’s critical information which hasn’t changed. So, someone may have updated the care plan but not updated the critical information. Confidence’s automatic audit tells us straight away that there’s something conflicting here. That’s such a powerful piece of information for us to easily and routinely see, it can be genuinely life changing!
“Let’s say someone’s continence needs have changed. But something in the critical information which sits outside of the care plan section hasn’t been updated to reflect the care plan change. That’s really important for us to notice and address. The continence care plan has changed, but then actually their nutrition and fluid intake care plan hasn’t been changed.
“Confidence enables us to prioritise the improvement opportunities it highlights to us. Which ensures we are locked in on the right areas of focus for the people we support.”
Do these insights help you manage risk in your service?
“Confidence has had a massive impact on risk reduction for us at Mardale Group.
“Summarised, a lot of the insights come back to risk, especially with contradictory information. If someone is an agency member of staff or not, it depends on where they are going to look for information. If they could look at our system and get contradicting information, it’s dangerous.
“Our application of Nourish Confidence ensures we have uniform information across the system for each resident. Honestly, we didn’t really know the extent of the issue for us before Confidence highlighted it!”
What other information points does Confidence help you address?
“Confidence has a lot of different useful categories which we review. Another one we use is ‘Insufficient Care Guidance’. It’s a great indicator of opportunities to improve personalisation and depth of information.
“It highlights that we explain someone’s situation but potentially doesn’t specifically say how to care for that person. How to help that person and how to support them to be able to be independent. Whatever their goals may be, how we can help them achieve them.
“For example, say in the care plan text we have eating and drinking. The person has a history of poor appetite and reluctance to eat. The plan explains that this person has a long history of poor appetite, low BMI, and relies on fortisips.
“Staff are told to encourage support of oral and fluid intake and to offer food. But it doesn’t necessarily say how often to or how the person would like to be offered the food. Or what worked previously to help this person get the fluid and food that they need.
“What makes Confidence so impactful, is that if we were doing our manual audit, we probably wouldn’t have thought anything wrong about that example. We’ve specified the current situation, we’ve specified the expected outcome, and we have specified to offer a prompt for the intake. It’s not a bad care plan.
“But Confidence highlighted something else where we can be a little bit more specific. An opportunity to get the best outcome effectively by picking up on common times or the best methods to do it. That’s what we want technology to do for our service. Inform decision making and empower our teams to deliver outstanding care.”
What is another key category you’ve used Confidence to review at Mardale Group?
“Another key one we focus on is negative language. We go and have a look at that quite a lot. By negative language I mean our care plans sometimes were not focusing on what a resident can do. It was more focusing on what they can’t do.
“Here’s an example. In one of our care plans, which is mental capacity assessment for decision making, we have mentioned the use of no capacity. Which is saying that the person is incapable of making a decision effectively. That’s focusing on what they can’t do. They can’t make decisions. It’s not focusing on what they can do and who can help them with it.
“We find this negativity ripples out across their lived experience. It just makes people feel bad about themselves. It’s not personal, it’s not person-centered either. In the sense that, yes, this person is living with a condition. But they’re living with dementia, they don’t suffer from dementia. That’s an important distinction at Mardale Group, it comes back to our values, and Nourish Confidence is helping us bring our values to bear across our service.
“The AI is fantastic, can’t fault it. It’s down to how you use it. For us, focusing on a step by step approach of looking at the categories has been really effective. Starting with Contradictory Information, Insignificant Care Guidance, then Negative Language and so on works really well for us.”
How are your teams finding using Nourish?
“We do really love Nourish Confidence. We all consider it a massive support. It highlights how something could be changed. If there’s an area missing or how it could be improved, it doesn’t explicitly tell you how to improve it. That’s not what it’s for, and I think that it’s the right approach.
“We’re professionals, we’re the people who have been trained to be in the role that we’re in. Whether it’s a nurse or creating a support plan. Confidence is the tool to highlight the information that potentially could have been missed. Our teams then address those opportunities through their experience, expertise and personal connections.”
What is it like using an AI that is explicitly insulated within that system and for social care usage?
“Great, we needed it for a long time. I think it’s amazing and powerful and it can only get better. We’re really excited to see where it can go.”
How do you find working with Nourish as a digital partner?
“I can’t sing your praises high enough. We absolutely love working with Nourish. We’ve worked with a number of different care systems before and there’s no comparison. The thing that I love the most about Nourish is you only partner with the best in the space.
“You don’t try and partner with anyone that offers something to do with social care. I use the Nourish partners section if I’m looking for any other solution out there. I know that you guys have vetted them and checked them out.
“As our Head of IT, I have regular account catch ups with your team. They’re always on hand to answer any questions, take feedback and support us. You are a genuinely forward thinking company.”
