Care Quality Commission (CQC), the Care Inspectorate in Scotland and Care Inspectorate Wales (CIW) regularly cite us in their inspection reports of our customers. The following are all extracts from CQC, the Care Inspectorate and CIW reports as a result of inspections performed at care homes where Mobile Care Monitoring is being used.
Date: August 2018
‘An electronic support plan was used in the home and staff carried small electronic tablets which recorded the care and support people needed and when this was given. This system ensured people received care and support in the way they preferred and we saw their support needs had been discussed and agreed with them. People knew they had a support plan and where people’s needs had changed, the support plan was updated to reflect this.’
‘One person told us, “The staff explained the system. I think it’s marvellous and it makes it clearer for everyone. I can see what’s written down on there or the staff show me on a computer. It’s the way things are now and I’d rather spend time with them than have them scribbling in books about me all the time.” Another person told us, “I know I have a support plan and they do it all on the tablet. You can click on the photo and it gives you all the information. I know this is how they report everything.”‘
‘With people’s consent, family members could have access to the electronic care records throughout the day. One member of staff told us, “We always make sure we use appropriate language when we are recording anything in our reports. We don’t do anything different because family are seeing our notes. We need to be open and transparent with what we are doing and as our system is refreshed each hour, family can see what is happening and how their family member is being supported throughout the day.” The information recorded was used during the handover between each shift team.’
‘People were confident that personal information was kept secure and staff understood the importance of confidentiality and respecting people’s private information. Information stored electronically was password protected and each person, relative and member of staff had an individual account. […] Where information was recorded, this was date stamped electronically so there was a record of who and when the record was completed.’
Rating: 6 for Care & Support
Date: June 2018
“The home implemented an electronic care planning system, which enabled staff to log their work with residents directly on to a handheld device and gave all staff the information they needed to know about the residents at the point of care. Staff told us that this had greatly reduced the time spent on paperwork, which allowed them to spend more time with the residents. The system also enabled the manager to have an immediate overview of activities, audits and communications at any one time within the home.”
Date: May 2018
“The provider had invested in an electronic care planning system which helped to ensure that detailed care plans were available. These were well organised and easy to read. Plans included clear instructions for staff about how to provide personalised care and support for each person. It considered the risks, their needs and wishes and how best to support them with the right equipment. This might include pressure relieving equipment or walking aids. Staff said they had taken a little time to get used to the new electronic care plan system but were now seeing the benefits of being able to update what care they had completed for each person as they completed the task.”
Date: May 2018
“Since our last inspection, the service had implemented an electronic care record system. Staff used hand held electronic devices to keep people’s records up to date, which they said freed them up to spend more time with people. The new care plans were comprehensive, personalised, and were regularly reviewed and updated. Further improvements were underway to allow relatives with appropriate consent or legal power of attorney to access part of the electronic record. This was so they could see how the person was day to day, including accessing their photographs.”
Date: May 2018
“Since our last inspection the provider had implemented a new electronic care records system – Person Centred Software (PCS). This meant people’s risk assessments and life plans were stored electronically. We looked at the electronic care records in detail and found all the information contained was reflective of people’s needs. All expected risk assessments were in place and reviewed promptly in line with people’s life plans. Life plans clearly identified measures taken to mitigate any risks to people.
Each staff member had a handheld mobile device and had continued access to people’s risk assessments and life plans. The PCS provided a visual ‘snap shot’ of people’s risks that continued to go across the top of the screen; this included people’s mobility needs or specialist requirements in regards to their eating and drinking. Examples of this included: if the person was diabetic, or had an ‘unsafe swallow’ and required a modified diet to manage these risks.
We looked at food and fluid records for six people across three different households and found there was no ambiguity regarding what people had been given. Records were clear, concise and consistently reflected people were being provided with care and support that was reflective of their required need.”
“We looked at accident and incident information and found these had been documented as necessary. PCS enabled the quick identification of accidents/incidents and alerted the management team. Where people had experienced a fall, risk assessments had been updated and action taken to reduce the likelihood of further falls.”
“Through the electronic PCS system, staff at the care village were able to generate a ‘hospital pack’ that could be printed off in an emergency to go with a person to hospital. Records clearly specified where people’s views were known in relation to their wishes in case of a sudden deterioration in their health. This included copies of life plan assessments and details of the resident’s life plan. Where possible, staff that knew the person well accompanied them to hospital, in order to provide advice and support.”
“The PCS system was integral in developing and providing opportunities for people to engage in meaningful activities. The activity available on a daily basis was inputted into PCS and the system flagged the people on each household that had expressed an interest in that activity. The staff then received an alert from PCS to encourage the persons to attend. For the remaining people that were not interested in attending the activity, or were nursed in bed, two of the part-time activity staff approached these people and offered one to one activities which could include; reading to the person, doing manicures, brushing their hair, reading poetry, looking at photographs with them, playing them some music, watching a film, or just having a conversation.”
Since our last inspection, the care village had introduced a new ‘paperless’ system of personalised care planning. This was known as PCS. Belong Atherton care village staff had piloted the system and had influenced changes to the terminology used in the computer programme to align the system with the Belong Limited values. Staff each had a handheld electronic device and in addition to this there was a larger android device (tablet) and a laptop on each household. The system reduced the time staff spent recording the care and provided a more accurate and contemporaneous record as it was completed at the time the care was provided.
Staff consistently emphasised how much the implementation of the electronic system had on ensuring people received the optimum level of care. Each person’s life plan was tailored to their needs, including their emotional, behaviour, health care needs, goals and aspirations. There was step by step guidance for staff to follow with people’s daily activities such as personal care, how they preferred to wash their hair, and what support they may need if they became anxious or upset. The system alerted staff if a person hadn’t been seen for fifteen minutes and alerted them if a care intervention hadn’t been completed.”
“Belong Atherton Care Village had piloted the PCS electronic care records system. The registered manager discussed the benefits of the system as it kept managers up to date with incidents/concerns which enabled them to promptly discuss with heath care professionals if further guidance was required. This ensured people’s care was reviewed promptly and measures were put in place to review strategies to improve the care people received.”
Date: May 2018
‘The computerised care planning system ensured that information about people’s risks was shared efficiently and promptly across the staff team. This meant staff had detailed knowledge of people’s individual risks and the measures necessary to minimise them. The registered manager had an oversight of the support being provided at all times. This system could also be accessed by relatives with the persons consent.’
‘Information about people’s individual risks was accessible to all staff, using hand held computers to access the computerised care planning system. Risk assessments had been completed related to a range of areas including falls, nutrition, pressure area care and cognitive difficulties. They were reviewed monthly or more frequently if required. The system prompted staff to undertake the tasks required to minimise the risks and ensure people’s needs were met, for example supporting people with fluids or repositioning them to prevent skin breakdown. Any immediate changes to people’s level of risk were discussed at the staff handover and the information added promptly to care records. A member of staff told us, “Any new information is shared in handover and put straight into the care plans. Everything is recorded as the day goes on”. This meant staff had clear and up to date information showing how they should support people to manage the risks while ensuring they had as much control and independence as possible.For example, one person’s care plan advised staff to “take the time to sit down and chat with me”; if they observed that the person was feeling low in mood or anxious.’
‘Any accidents or incidents that took place were recorded by the staff on the computerised care planning system. The system prompted staff to describe the incident and explain what they had done to resolve the issue. This information was reviewed and analysed by the management team, and action taken where required, to prevent reoccurrence.’
‘People at risk of dehydration and malnutrition were on ‘food and fluid watch’ which meant the registered manager had additional oversight of people’s food and fluid intake using the computerised care planning system.’
‘The information gathered during the initial assessment was put onto the computerised care planning system prior to the person moving in. This enabled staff to familiarise themselves with it and provide care tailored specifically to the persons individual needs. People’s care records were reviewed three days after admission and then at least monthly to ensure they remained up to date, with the involvement of people and their representatives every three months. Representatives were also able to access the computerised care planning system, with the consent of their family member, which gave them continuous oversight of the support being provided by the service.’
‘The computerised planning system gave the registered manager oversight of the support being provided to people. They told us, “All the information is there. I can look at any given time day or night and see what care is being provided at that time”.’
Date: April 2018
‘The provider had implemented an electronic care recording system. The system was accessible to relatives and enabled them to monitor care recordings in real time. One person used this secure system as a personal media facility and regularly shared photos of their activities and achievements. The provider created monthly newsletters about each individual which families consistently told us they looked forward to reading.’
Date: March 2018
‘Each member of staff had their own mobile device where they were able to access all records and information for each person using the service. When care was given the details were uploaded to the device so all staff, managers and even relatives, with permission, could see what care and support had taken place. We saw that hourly checks at night were in place and staff used the software to scan a barcode to confirm that a check on a person had been made. A member of staff said, “We do it to make sure that people are safe.”‘
Date: March 2018
‘Care plans were available to staff via mobile devices, up to date, regularly reviewed and audited by the management to ensure they reflected people’s individual needs, preferences and outcomes. The system alerted staff to changes and when checks needed to be completed. A staff said, “The devices alert us if people are on time specific checks or turns. We can also monitor food and fluid intake on them”.’
Date: December 2017
Records showed that care plans were comprehensive and consisted of information that was person centred and reflected care needs and preferences of people who used the service. The information in various care documents, such as, pre-assessment forms, care plans and risk assessments was consistent, regularly reviewed and up to date. At the time of our inspection, the home was also at the final stage of implementing a new, progressive, person centred Mobile Care Monitoring system. The system was designed to create comprehensive care plans that were easy to keep updated when people’s needs changed and to record daily care with a few taps on designated pictorial care icons on an iPad device. The system was easy to use and gave staff instant access to current information on care needs of each individual. Its interactive nature allowed staff to record care as they provided it and with people present. This innovation effected in staff having more time to spend with people on social and fun interactions.
Since the last inspection, the home had introduced an electronic portable care planning and recording system that allowed quicker record keeping and gave the staff more time to spend with people on social and fun activities.