Ernie Graham, owner of Graham Care Homes, speaks about how they are utilising the latest technologies like electronic care planning and eMAR to improve outcomes for their residents.
In October 2019, Rodwell House, one of Graham Care Homes’ sites in Surrey, was the first care home to integrate ATLAS eMAR with Person Centred Software’s electronic care planning system.
Graham Care Homes is a family-owned group of seven nursing and residential care homes in Kent, Surrey and London. The service is owned and run by Ernie Graham whose aim is to provide long-term sustainable care for people, including people living with dementia. Graham Care Homes is constantly thinking of how to improve the care they provide and is not afraid of changing to new and specialist technologies.
Adopting technology in care homes
“At Graham Care we recognised that the latest technology would help us strive to mitigate risk, demonstrate resident care outcomes, demonstrate compliance with regulations and standards to our end users and stakeholders in their care, such as commissioners, CQC and relatives.
Moving forward in care and given the pressures to demonstrate outcomes and tackle risk, there is no other way but to first collect data and then have analytics to highlight and mitigate the risk. Care records used for recording historical events can be audited if something goes wrong, but as a sector we need to be cleverer and, for that, we need data from all the different technologies that we use for care. There are now many companies creating specialist technologies with open infrastructures to combine data from all sources.”
“Person Centred Software’s system is widely used, it is very visual and easy to record notes and it saves a lot of time and is relatively low cost. The inspectors were very happy and familiar with it. In fact, 94% of their care homes have a good or outstanding rating with CQC.”
Ernie Graham, Owner of Graham Care Homes
Specialist technology for every aspect of care
“Providing care is complex and multi-faceted, and at Graham Care Homes we have learnt that the best technology is provided by companies who are specialists on a specific aspect of care. Their focus means their product helps us to achieve our aims from the technology.
We chose ATLAS eMAR for medicine management, from Invatech Health. The company is run by experts who are pharmacists and doctors. We also switched to using Person Centred Software’s Mobile Care Monitoring software for evidencing care in real-time and electronic care planning. The company has expertise through many years of developing for care administration and care planning software.
We also have a specialist staff rostering system and a different call bell system. We don’t want one system as a ‘one stop solution’ for everything for care as it will limit what we can do with the technology. We want to work with real in-depth specialists, to have the ‘best in class’ in each specialism of care, and then apply analytics from each specialism to combine outcomes and mitigate risk.”
Considerations for an electronic care planning system
“As we had initially developed our own electronic care planning system as there was nothing on the market that suited us at the time, it was a big decision to move to a software provider’s system. One of the main reasons we chose Person Centred Software’s system was because of the technical and open architecture. Our system operated on desktop computers and ran locally from a server, but we switched to Person Centred Software which uses more modern mobile handheld devices so staff can evidence care on-the-go. The care planning uses mobile devices to prompt care and record its events. It is very visual and easy to record notes and it saves a lot of time and is relatively low cost. Person Centred Software’s system is widely used, and the inspectors were very happy and familiar with it. In fact, 94% of their care homes have a good or outstanding rating with CQC.”
Relatives Gateway for openness and transparency
“In the last eight years with our own in-house care planning, we gave relatives online access to all care records. Relatives really valued this openness and transparency. We were one of the first care providers to do this. Contrary to the fear of some care providers that showing all the care notes would create additional legal cases, we found that being more open with our relatives actually defuses things.
The Relatives Gateway included in Person Centred Software’s solution gives a summary of care notes to family members, along with a social network for sending photos and messages to keep in touch. We are really pleased that Person Centred Software has configured the Relatives Gateway further for Graham Care Homes so that relatives have permissions to be able to see all the notes and not just the summary.”
“With the integration between our eMAR and electronic care planning providers, Invatech Health and Person Centred Software, we can analyse the combined data well and predict where risks are and amend care plans to keep people well.”
Ernie Graham, Owner of Graham Care Homes
Considerations for safe eMar
“A fundamental requirement of an eMar system was barcode scanning for safety. It also had to have full stock control and tackle the issues of communication around changes to therapy and prescriptions with the pharmacy and GP surgeries. The ATLAS eMAR system was the only one that had all of these. Evidence-based research with Cardiff University showed that ATLAS eMar was safe and gave time savings to providers.
We also worked with Cardiff University on a project that delegated medicines administration from nurses to carers, using the ATLAS eMAR and Scorecard for safety, monitoring and auditing. Before the project, nurses spent two hours giving medicines out, leaving no time to manage the shift. Now, we have ‘med carers’, trained and competency assessed, to do the meds. The shifts are now nurse led and they delegate medicines tasks to the med carers. We have got rid of the senior carer role who traditionally took more responsibility for the shift.
The ATLAS Scorecard uses the data from important medicines management tasks and aggregates the results to give each of my homes a score. This allows me and compliance managers to have an overview of medicines management in all homes at any given time. This means we can manage by exception and tackle under-performance and mitigate risk. Now we want this type of scorecard in all aspects of our care so that we can bring the running of the homes to the standards of the built environment.
In a care home environment, there is a mass of data and the challenge is to combine the data together to make sense of and predict where errors and risks are. With the integration between our eMAR and electronic care planning providers, Invatech Health and Person Centred Software, we can analyse the combined data well and predict where risks are and amend care plans to keep people well.”
Vision for future use of data in care homes
“We want to share the data we have with relatives and other stakeholders in the care of residents. This will help to create closer relationships and even more openness with relatives and improve the quality of care that our residents receive in their health and social care journeys.
There is a case for integration and inter-operability to give the ability to share data, for example with care planning, medication management and call bell events. Using in-depth specialist systems, we have analytics and insights that on care that we did not have before. I think in future there will be a need for a data analyst in every care provider.”