CQC inspection reports that cite us. CQC regularly cite us in their inspection reports of our customers and we’re also cited by the Scottish Care Inspectorate. The following are all extracts from CQC and Scottish Care Inspectorate reports as a result of inspections performed at care homes where Mobile Care Monitoring is being used.
Date: August 2017
The provider had an electronic quality monitoring system in place. The registered manager entered information on the system including accidents and incidents, details of the people who used the service including monitoring of their weights, and a range of monthly audits. The provider used this system to generate reports, request updates and results of investigations from the registered manager, and as a monitoring tool for quality monitoring visits to the home by the provider.
Date: August 2017
There were systems in place which showed that the service continued to improve. This included the recent installation of a computerised care recording system. These were hand held devices used by staff to input the care and support people had been provided with and their wellbeing. These allowed information to be recorded immediately and allowed the staff to spend more time with people.
Date: August 2017
Care staff recorded when they attended to people through the use of an electronic system where staff recorded any care interventions that took place throughout the day and night. For example, interventions such as when people required turning to protect their skin integrity, fluid intake and output, hygiene, blood pressure, blood sugar and night checks, without having to fill in any additional paperwork.
Relatives would be able to view their family member’s care plans within the new format as soon as the new system had bedded in.
Date: August 2017
‘Care plans contained specialist assessments, for example, a tool to assess possible pain in people who would not be able to communicate this verbally. The care planning system was also able to generate a ‘hospital pack’ that could be printed off in an emergency to go with a person to hospital. Records clearly specified people’s views where known in relation to their wishes in case of a sudden deteriorating in their health.’
‘We saw recorded assessments which demonstrated that a thorough process had taken place. The assessment gathered information about people’s immediate and longer term health needs. The assessment identified what equipment and involvement would be needed to support them, the person’s social needs and degree of family involvement, the person’s likes, dislikes, preferences, wishes and aspirations. All of this information helped to formulate extensive and very relevant care plans. These continued to evolve as some people got more involved in their care planning or staff got to know the person better. The care planning was centred on what the person thought and wanted making them very personalised. Care plans were constantly reviewed and updated and where possible they involved the person themselves. Staff and visiting professionals, therefore, had access to fully up to date information on people’s care and their needs which helped people receive safe and appropriate care.’
Date: August 2017
‘Catering staff told us, “We have a special diet and allergies list plus people’s likes and dislikes. All food that is eaten is documented on the care plan electronic tablet, that applies to food and fluids. We also have a list of food and fluids that can interact with certain drugs. If someone’s diet changes we are informed, we have very good communications.’
‘The computer system allowed alerts to notify staff if someone needed to be ready for an activity they liked or were going out.’
‘People’s records showed contemporaneous records of the care provided by staff and staff were observed throughout the day updating records. Staff used a comprehensive computer care planning programme and updated care records using electronic tablets… Care plans included routines and preferences and there were separate care plans for day and night routines. An example of preferences include what the person’s usual routine was, any likes or dislikes and what was important to them.’
‘There was excellent communication about people’s needs with staff signing electronic shift handovers covering the previous 72 hours.’
‘It was important to the service to promote a ‘family feel’. This meant that people and their relatives and friends were very involved in the running of the home. For example, as well as regular newsletters and residents, family and friends meetings, promotion of the use of IT for communication with distant relatives.’
Date: August 2017
The provider was innovative and creative and strived to improve the quality of people’s lives. They had researched and reflected on how an internationally recognised provider of excellence in dementia care provided care. They had implemented an electronic care planning system that ensured staff and management had access to the most up-to-date information at the press of a button and enabled relatives to be fully informed and involved in their relations’ care.
The provider had recently implemented an electronic care planning tool, which was designed to facilitate staff’s record keeping and monitoring of the quality of the service people received. All staff had hand-held mobile devices so they had instant access to people’s care plans and individual risks at the touch of a screen. Staff told us they liked the new system. An electronic alert sent directly to staff’s handheld devices ensured staff were reminded to take time-critical actions related to people’s health. For example, actions by staff to minimise risks related to specific-time medicines administration, poor food or fluid intake and risks of skin becoming sore or damaged.
The system prompted staff to make sure checks had been carried out for people who stayed in their rooms, as identified in their care plan. Duty managers monitored the quality of the service through the same electronic care planning system, which showed a red flag if specified, planned care interventions were ‘late’. A service manager told us, “Any omissions, ‘late or asleep’ records are red flagged. At our three daily handover meetings, staff check the red flagged ‘hotlist’ and decide on actions needed. There is a footnote facility to explain why items on the hotlist are closed.” The electronic care planning system enable the management team to monitor if people were not weighed regularly, did not eat well, or if their weight or fluid intake dropped out of an appropriate range for their height, age and health condition. The provider was able to demonstrate that people had benefited from the electronic monitoring system. For example, by constantly monitoring how much people drank, staff had been able to encourage people to drink the right amount for their height and weight. Management reports showed that staff at Westlands had successfully encouraged 94% of people to drink at least their target amount during April 2017, which reduced the risk of people becoming dehydrated or of developing infections.
The provider’s operations team monitored management reports across the group of homes three times a day, seven days a week and sent reminders to all the registered managers requesting explanations for any gaps or omissions compared to people’s care plans. All the information staff entered on the system was instantly available to the duty manager, which meant they were able to continuously check that people received the care they needed. We saw the system required staff to record details such as the person’s response to care and support, their moods and appetites and how much they drank. The system supported the registered manager’s monthly audits of people’s medicines, complaints, accident and incident records and housekeeping records. The ultimate goal of the electronic care planning system is the ability to monitor whether staff take the agreed actions that are critical to a person’s health or wellbeing.
The electronic care planning system provided a new opportunity for relatives to stay fully informed and involved in their relations care if they were unable to visit regularly. Relatives had a password protected access to an on-line ‘gateway’ into their relation’s care plan and daily records. Relatives were able to talk to staff through an associated messaging service, so were able to obtain immediate reassurance from staff if they had any concerns about their relation’s care, support or health.
Date: July 2016
‘Since our last inspection a computerised system for storing care records had been introduced to the service. This system was user friendly and helped to ensure that records were accurate. Staff had iPod’s on which they could input information throughout their shift, reducing the risks of information being forgotten. The system also created graphs and charts from the data entered which enabled the manager and senior staff to analyse the information for any changes or anomalies.’
Date: July 2017
People’s care records were held electronically and covered a range of information relating to people’s health and social care needs. For example they contained information to assist staff to provide care in a manner that respected people wishes. Staff held individual electronic monitors to add any information at any time to people’s personal care records. This helped to ensure care records were always updated and staff were able to respond appropriately. All the staff we spoke to were familiar with people’s needs and said information and guidelines were clear and easy to access. Care plans were personalised and included information about how people chose and preferred to be supported.
Date: July 2017
‘The provider had researched national and international best practice measures and adopted innovative technologies to improve how people’s care was delivered, monitored and adapted to meet their changing needs.’
‘The provider was innovative and creative and constantly strived to improve the quality of people’s lives. The provider had researched and reflected on how an internationally recognised provider of excellence in dementia care provided care. They had implemented technological systems that […] ensured staff and management had access to the most up-to-date information at the press of a button and enabled relatives to be fully informed and involved in their relations’ care. People benefited from the technology because staff had more time to care for them.’
‘All the information in the care plans was available to staff electronically in hand-held devices they carried with them. A member of staff told us, “I have all the information I need, the care plan, contact details and medical information.” The management team used the risk assessments, care plans and their knowledge of people’s dependencies, to calculate the number of staff needed to support people according to their individual needs.’
‘The electronic care planning system raised a red alert to the management team if people were not weighed regularly, or did not eat well, or if their weight dropped out of an appropriate range for their height, age and health condition.’
‘A member of staff told us that all the information was available to them on a handheld electronic device and they were able to tell us, within seconds of accessing the device, which language one person had spoken as a child. Another member of staff told us, “I learnt about their history and now understand (them).”‘
‘The provider had transferred people’s care plans from paper to electronic records and all staff had handheld mobile devices so they had access to all the information they needed at the touch of a screen. Staff told us they really liked the new system as they no longer needed to spend time writing up daily records by hand. Every time they supported an individual, as agreed in their care plan, they were able to click a button to say ‘completed’. Each person’s electronic care plan included ten ‘must do’s, which were used to make sure time-critical actions were taken by staff. For example, actions by staff to minimise risks related to specific time medicines administration, poor food or fluid intake, risks of skin becoming sore or damaged and checks of people who stayed in their rooms were always relevant to the individual risks identified in their care plan.’
‘The electronic care planning system provided a new opportunity for relatives to stay fully informed and involved in their relations care. Relatives had a password protected access to an on-line ‘gateway’ into their relation’s care plan and daily records. Relatives were able to talk to staff through an associated messaging service, so were able to obtain immediate reassurance from staff if they had any concerns about their relation’s care, support or health. Relatives were able to ask staff to include specific actions into the person’s 10 daily ‘must do’ actions.’
‘Staff told us, “This is better” and “Whenever an intervention happens, we record it – where, how much, happy or unhappy, activities, mobility, in or out of bed” and “I can add ‘must dos’ for the next day, for example, blood sugar and insulin to be checked by district nurse.” We saw the system required staff to record details, such as the person’s response to care and support, their moods and appetites and how much they drank. All the information staff entered was instantly available to the duty manager, which meant they were able to continuously check that people received the care they needed.’
‘The electronic care system sent alerts to staff and managers when specific care actions were due, and showed a red flag if they were ‘late’. A member of staff told us, “The duty manager will come up or phone up very promptly to find out why anything is red.” The duty managers monitored the quality of the service through the same electronic care planning system and through monthly audits of people’s medicines, complaints, accident and incident records and housekeeping records. A service manager told us, “Any omissions, ‘late or asleep’ records are red flagged. At our three daily handover meetings, staff check the red flagged ‘hotlist’ and decide on actions needed. There is a footnote facility to explain why items on the hotlist are closed.”‘
Date: June 2017
The provider utilised an electronic care plan system and each healthcare assistant was issued with a smartphone which they used to clock in and out, and checked off their tasks every time they visited a person to support them. This system allowed the managers to have an overview of when visits were carried out and if healthcare assistants attended visits on time. It also provided them with real-time information about the personal care tasks that had been provided at any particular time.
Healthcare assistants scanned their smartphones when they entered and left a flat to carry out personal care. This uploaded data onto the care plan system so the registered manager was able to view real time information about when people had been supported. The system also allowed for alerts to notify if a visit was late or had been missed.
The system was automated so when clinical staff completed a risk assessment, if the data inputted indicated a high risk there was an associated care plan in place to manage the risk. For example, one person had been identified as being at high risk following a waterlow risk assessment and they had an appropriate skin integrity care plan in place to manage the risk of developing pressure sores.
Observations such as temperature, pulse, blood pressure, blood oxygen, respiration and weight were recorded and could be analysed for any changes easily as they were presented electronically in a graphical format.
The provider used an electronic, paperless care planning system with a mobile application that was used by the healthcare assistants. Care records were created, updated and maintained electronically. The front page of each record had a summary and a checklist and the time of when personal care tasks had last been completed. This provided a visual confirmation of the last time that people had been supported.
The electronic care plan system was able to generate a hospital passport if needed. The aim of the hospital passport is to provide hospital staff with important information about people and their health when they are admitted to hospital. Any relevant notes such as therapy or GP reports were scanned into the system.