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INSPECTION CITATIONS

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.

Timaru, Liaise Loddon

Rating: Good
Date: September 2017

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‘The provider had robust systems in place for maintaining accurate records. Staff used a hand held device to record people’s daily care and activities and this was then uploaded onto an electronic system. This enabled the registered manager and senior staff to monitor people’s progress or any concerns and produce detailed reports as and when they needed them. We viewed a number of reports during the inspection and found the information to be detailed and up to date. A relative told us “The documentation is very good. The attention to detail, the depth and volume of the paperwork they keep for [my family member]‚Ķit’s so important, especially with challenging behaviour. I’m delighted with the way they are looking after him.”‘

‘The registered manager told us relatives could access the ‘Relative’s Gateway’ (an online system), with a unique password which gave them access to family member’s records if they wished to do so. This included activities, achievements and photos. Relatives confirmed they had access to this and felt involved and kept informed of their loved one’s progress. One relative told us “We always attend reviews and are involved in care planning. They keep us informed of what’s happening.”‘

 

Coghlan Lodges Limited

Rating: Good
Date: September 2017

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‘Details were recorded on an electronic care plan system so that if any staff were unable to be present or wanted to check details, this was available throughout the shift.’

‘Staff knew how to keep people’s information confidential. The electronic systems used were all password protected.’

‘There was a hospital section which could be downloaded so that it could be taken to hospital with the person. People’s care plans were held on an electronic care system. This was accessed by staff through a hand held device and or a laptop. Staff told us they regularly used care plans to understand people’s needs and that these care plans were regularly updated. One staff member commented on the system, “The system is really good, is easy to get up to date information about a person”. We saw regular reviews of care plans were in place to ensure people’s needs were still being met. Particular needs were recorded on the electronic care system. The system would automatically ‘flag’ up when a particular activity had not been completed. For example, medicine administration or when a care plan review was due. This system was reviewed by the registered manager and senior staff to enable them to monitor people’s care. If any anomalies arose, the registered manager or senior staff would investigate.’

Barton Court

Rating: Good
Date: August 2017

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The provider had recently invested in a bespoke computerised care planning system. Each member of care staff carried a smart device which gave them access to the care plans from anywhere in the home. The system also tracked when care was due, when it had had been delivered, what care had taken place and enabled staff complete their log of care directly into the smart technology. This enabled management to monitor care delivery in real time and respond to any deficiencies.

 

Bowburn Care Centre

Rating: Good
Date: August 2017

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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.

Brierfield Residential Home

Rating: Good
Date: August 2017

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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.

Keychange Charity Romans Care Home

Rating: Good
Date: August 2017

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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.

Sefton Hall

Rating: Outstanding
Date: August 2017

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‘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.’

The Old Rectory Nursing Home

Rating: Outstanding
Date: August 2017

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‘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.’

WCS Care Westlands

Rating: Good
Date: August 2017

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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.

Abbey Lodge Residential Home

Rating: Good
Date: July 2016

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‘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.’

How it works

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