We Change Lives are amongst the most eponymous care providers in the UK. A charity based in Cheshire, England, they support people with dementia, elderly people, people with learning disabilities, mental health issues and brain injuries, to live their lives to the fullest. They have been using Nourish Care for over two and a half years. The success of their people focused service has seen them grow considerably during this time. Including adding three new services at the end of last year. We sat down with their Head of Care Sarah Gardner and their Quality and Safeguarding Manager Sarah Battersby. To discuss how Nourish has supported them to change so many lives through their variety of services.
Can you share why you first joined Nourish?
“Initially, we were trying to get away from paper and the complications of storing our data in office filing cabinets,” said Sarah Gardner. “That was the driving force, trying to come into the 21st century. As time has passed, our focus has changed, particularly for Sarah and myself. Now we are focused more on controlling quality, recording information and keeping that data in a single, central place.
“It means that when Sarah, in her role as Quality and Safeguarding Manager, conducts site visits they are centred on feedback and interactions with people. She has so much more time to interact with people directly. Because she can access all the relevant assessments from her home office. The freedom to give that much attention to people and really be present with them when visiting our services is incredibly important to us.
“As for me in my oversight role. I find having the insights and the ability to reference all the information we have available quickly is incredible. At the click of a button, I can see what people are telling me. What they have recorded, what is the wider context and so on. Having that data readily and easily accessible is really, really effective.
“The crucial thing is the working relationship. We’ve used electronic systems in other areas of the organisation and the support function has not been the same. With Nourish it has felt more like a relationship. Where we’re working together to produce a really good system that can benefit the wider social care system. Whereas that’s not been our experience with some of the other introductions of software. With Nourish, it’s been actually ‘let’s work together to find something that really, really works.’”
How was onboarding your recently acquired services to Nourish?
“We did that in a very different way to the initial rollout,” explained Sarah Gardner. “In both instances we were digitising a paper-based organisation. However, because we had more experience the second time around we were able to move much quicker. We now how we want to adapt the Nourish system to best wrap around our services. All our learnings from the first time around helped us shape the system to our needs.”
“The staff were very eager to get Nourish up and running in the new services,” added Sarah Battersby. “Honestly, they got a bit fed up with rolling it out slowly and just wanted to go with the one digital system. The love Nourish that much.”
So the rollout was really driven by your staff?
“Absolutely,” continued Sarah Battersby. “We had the initial training with everyone, the managers, deputy managers and Nourish. We started off with weekly meetings. Then they went to monthly and that continued for a long time as we sorted everything out. Once we finished building out the system to match our new services, we were a lot quicker. Our information was much more up to date and accurate. Like Sarah said earlier, we really wanted to get away from paper and centralise all our information. Nobody wants to be tracking back through cabinets of paper records.”
“We had a deputy manager in one of our residential services who does not like change. She does not like technology,” said Sarah Gardner. “She is now one of our champions. So, she goes out to our new services and supports them to engage in the system and helps them develop bespoke support plans. It’s brilliant because she can go out with that point of view of ‘I didn’t want this I didn’t want to do it,’ and now she’s a real advocate for it. That voice from that sort of personality is much stronger than ours, and it’s because of how easy Nourish is to use and how clear the benefits and positive outcomes are.”
Once you were up and running on the digital system what were the main benefits and outcomes you noticed?
“The most obvious outcome is the quality of information we are recording is so much better now, because we’re recording it in real time,” detailed Sarah Gardner. “We have a lot of supported living properties, so when one of our carers goes out, they might be out all day. Thanks to Nourish, they can easily use their phone to take notes throughout the day. You can take photos and record notes as it’s happening. So it’s not just everything’s in one place, accessible and easy to share. The information we’re recording is better because it’s being recorded at the time it’s happening.”
And the immediacy of the data recording improves its accuracy?
“Not just the accuracy, we get more detailed information now as well,” said Sarah Battersby. “People used to write their notes at the end of their shift. So, they’re at the end of a 12-hour shift and they get the care file out, they’d write up the notes, and you’d see ‘oh, yeah, had a good day, everything’s fine’. There’s no real data or information as to what the person’s been doing or involved in that day. Whereas now, they’re imputing that data straight after every event, straight after a meal, straight after their personal care. This means there’s much more data, and it’s much more detailed.”
“Writing can be difficult for some of our colleagues,” added Sarah Gardner. “It wasn’t something that came naturally to them. They struggled with the spelling and putting the words together but they’re brilliant at supporting people in the right way. Nourish takes that stress away, it’s such an enabler for our staff. Nourish even has a translate function which is incredible for our team members whose first language isn’t English.”
“It’s an opportunity for staff to sit with that person and look back at what they’ve done in the day as well,” continued Sarah Battersby.” So if they’re awake in the night, and they’re upset and distressed, they can look back at what they’ve done and have a chat about it. Some people we support might forget those things, but then they see a photo and it’ll take them back and they can have that important conversation.”
How else do you use Nourish to involve the people We Change Lives support and their circles of care in their care provision?
“Nourish is fantastic for involving everyone in the development of care,” said Sarah Battersby. “The microphone system is brilliant. People can use it to easily share their feedback on their care experience just by talking into it. We can also take pictures of their activities and link them to the things that they’ve done and their goals in life. We can then share this information with their families, so they get to see what activities the person is doing, what they’ve had to eat today, and how they are. They have easy access to the information they want without having to constantly ring up and ask someone who may or may not be directly involved in their loved one’s care.”
From a managerial perspective, do you find it easier to review care notes?
“For us, definitely,” said Sarah Battersby. “There’s a lot of information there that we can now check and oversee. It would take me hours to go through somebody’s paperwork in the service to figure out all the accidents and incidents that have happened over the previous month. Whereas now I can just pull up a chart, and it’s all there for me. And it gives me additional data that it didn’t have like, ‘What time do the most accidents happen?’ ‘Whereabouts in the buildings did the most accidents happen?’ There’s so much other data there to provide me with a more complete picture of the care that’s pulled through.”
“It helps a lot of questioning, doesn’t it?” added Sarah Gardner. “When significant accidents and incidents happen, we have to report that to the CQC. So Sarah and myself will look at the submission before it’s sent from a service manager. I’m not involved in the delivery directly, but I have that oversight responsibility, so it’s an invaluable insight for me. I think, ‘Oh, I’m sure I’ve read this before, this seems like a pattern to something that’s happened before.’ Straightaway I can go into Insights and look at the accidents and data and see if there’s a trend that the manager is not picking up on. Whereas before I was going, ‘do you think there’s a trend?’ and it’s very reliant on what the managers are telling me in a conversation. Now I can follow up on my instincts and I can see that trend for myself. From a senior management perspective, Nourish has significantly improved our questioning ability.”
Does this help you notice trends in your care delivery?
“All of the information is on a timeline,” explained Sarah Battersby. “Which is fantastic for safeguarding and management. If there’s anything that’s raised that you find concerning it’s so easy to review. Say for example, you’re worried about malnutrition, you can see everything that happened and when it happened. That’s what they drank, that’s when they drank it, this is how they felt afterwards. It’ll show me all that information. I can have it in a chart, or I can have it as a list showing what they’ve consumed. It surfaces really crucial information to us like whether there’s a deterioration quite quickly, and we can act on that.”
So Nourish is useful for promoting safeguarding as well as person-centred support?
“It’s brilliant for promoting safety in support,” said Sarah Gardner, “because our carers have all the information they need on their phones. Say you’re a new person that’s come in, you’ve got that immediate, shorter profile that lets you know all the immediate risks and how to support somebody straight away. It’s got all the relevant interactions you need, and everything is up to date. You know exactly when somebody needs their medication, or a catheter changed, whatever it is. In terms of keeping people safe and supporting them in a safe way, it’s brilliant. We previously never had something that you could layer so effectively either. Where it’s got an interaction, and we can embed another action or follow-up behind it, and it all flows together. I’m looking at this from an assurance point of view and I can be confident that people know what they’re doing, and that it’s really accessible and all the information is up to date. It’s brilliant.”
“Nourish makes such a difference with agency staff too,” added Sarah Battersby. “You’re never going to have an agency staff member come in and read a whole file filled with pharmacy plans and care plan information, it just isn’t going to happen. So now they can just access the part of the plan that they need at the time, and we can be confident they have everything they need to provide care to our standards.”
Does Nourish support your service at an organisational level in any other ways?
“It makes a big difference on the commercial side of things as well,” said Sarah Gardner “We have to prove what we’re doing in order to get funding, particularly in supported living where funding can be based on one-to-one engagement and activities. We need to evidence the fact that we’re delivering against these requirements. There’s nothing better than a picture to achieve that. You can write what you want, but when somebody’s looking at the pictures it’s so much easier to understand the impact of our support.”
Were you surprised by any of the benefits Nourish brought to We Change Lives?
“Lots of different things really,” said Sarah Battersby. “We’ve mentioned some of them already, like the microphone, which never occurred to us at all. The fact that you can set alerts and warnings. That is that was a really useful part of the system that we’ve applied in lots of different ways. The insights we’re getting from the information is brilliant. We were expecting some of that, but we’ve actually got a lot more than we anticipated!”
What are your plans for the future?
“We do have quite an ambitious growth strategy,” said Sarah Gardner. “We’re expecting in the next sort of five years that we will be a couple of times bigger than we are. Something we love about our partnership with Nourish is it feels like we’re constantly evolving with you at the same time. Nourish has been such a success story for us so far and we are eager to continue to develop our use of technology to benefit our teams and the people who utilise their support.”
