Technology in care has become increasingly important, transforming the way in which care is delivered and the use of digital care systems has resulted in many people experiencing better and safer care, says John Rowley, senior sales manager at Cura Systems.
The Care Quality Commission (CQC) annual assessment of the state of health and social care in England shows how providers are working together more effectively - often using technology – to help ensure people get the care they need, when they need it.1 The report has highlighted how the innovative use of technology can help address the five key lines of enquiry (KLOE) and supports the use of technology to improve the delivery of quality care. Every care home wants to be validated with an outstanding certification for all the effort put in to creating and consistently delivering person-centred care, but what makes an outstanding care home? This article will consider ways to achieve an outstanding rating for each line of investigation.
Five Key Lines of Enquiry
Is your service safe?
An outstanding care home must be safe. The CQC defines ‘safe’ as meaning that people are protected from abuse and avoidable harm. When the time comes for a loved one to move into a care home, it is only natural that the first and overriding concern will be for their safety. Entrusting a mum, dad, husband or wife to the care of strangers pushes against natural instincts to do all that we can to protect and provide for them ourselves.
Choosing the right care home is one of the biggest and most difficult decisions to make and safety will figure very prominently in selecting one. Care homes need to have appropriate tools to demonstrate to relatives of prospective residents their ability to monitor safety. Recognising these concerns, the first question asked by the CQC is always about safety.
In this instance, safe means taking every possible step to ensure that residents are protected from abuse and avoidable harm. Abuse can be physical, sexual, mental or psychological or financial, involving neglect or institutional or discriminatory abuse.
Avoidable harm will consider everything from medicines management to the safe use of facilities and equipment. CQC scrutiny is robust to ensure that all these conditions are met and inspection reports provide families and loved ones with the information they need regarding the ability of a home to meet these conditions consistently.
Aspects of ‘safe’ that directly relate to the use of technology include:
- staff are skilled and well equipped with all the information and tools required to provide outstanding care and protection from any safeguarding and compliance issues
- detailed records of incident reports to protect from being bullied, harassed, harmed, neglected or abused
- incident report trigger to deal with quickly and openly monitor incidents and accidents and a care app that instantly sends reminders and reports incidents to ensure everyone is aware and corrective action is taken
- assessment forms to monitor medical conditions providing peace of mind with customised assessments and care plans, medication reminders and tracking
- monitoring drug rounds throughout the home, including reminders for those administering medicines and alerts for when rounds have not been completed; drug rounds can be tracked as they happen, with automated mishap prevention mechanisms
- timely preparation and review of health and safety checklist specific to each resident as well as for general facilities; the home should be kept clean and hygienic to prevent any risk of infection to residents and visitors.
Electronic care plans and mobile monitoring care apps can play a significant role in supporting care home managers to meet and exceed CQC standards.
Cura recognises the critical importance of safety in care. Cura’s suite of applications supports care staff by giving them the information they need to ensure that they meet CQC’s criteria, including the safe delivery of care.
Is your service effective?
An outstanding care home must be effective. The CQC defines ‘effective’ as that an individual’s care, treatment and support achieves good outcomes, promotes a good quality of life and is based on the best available evidence. Finding out what a good care home looks like helps families make choices about the care of their loved ones. It can also help them to understand what they should expect from a service provider.
Finding out what a good care home looks like helps families make choices about the care of their loved ones. It can also help them understand what they should expect from a service provider.
The Care Quality Commission (CQC) is the body responsible making sure that residential care homes meet the highest standards of care. One of the questions the CQC asks is how effective a home is. What does this mean in practice?
A critical concern is that staff must have the right knowledge, qualifications and skills to carry out their roles, enabling residents to have a good quality of life. They should always ask for a resident’s permission to give care, treatment and support in a way that is easy to understand. Family and friends should also be involved in decisions about care, where appropriate.
Staff should know about each resident’s health care needs and personal preferences, and give them as much choice and control as possible. Staff should also work with health and social care professionals, such as GPs, and take the right action at the right time to maintain good health.
Aspects of “Effective” that directly talk to the use of technology, include:
- Meal planner to monitor the choice of food and enable calorie counting. Choosing meals based on dietary requirements and restrictions. Variations are alerted to the manager.
- Set individual’s daily food intake and targets per service user. Automatic calculations of the total fluid intake and output within a defined 24-hour period and shown through easily understood graphical features.
- Consent to electronic care plans including DNAR status to give permission to care, treatment and support. Where appropriate, your family and friends are also involved in decisions about their loved ones.
- Staff know about health, needs and record personal preferences and wishes using a voice note functionality. These can be taken into account when care plans are drawn up and updated.
- Access individual’s personal and medical records using digital care plans at the point of care to allow the most efficient and personalised care to be delivered.
CQC gives the highest priority to nutritional needs, and one crucial measure of an effective care home is that staff make sure residents get the right food and drink they need. Residents should also expect to be asked their likes and needs when the home is adapted or decorated. Any changes to the home should be made to help residents to be as independent as possible.
CQC also looks at how technology is used to make the service more effective and our suite of applications supports care staff by giving them the information they need to ensure that they meet CQC’s criteria for the effective running of their care home.
Is your service caring?
An outstanding care home must be caring. The CQC defines ‘caring’ as staff involving and treating people with compassion, kindness, dignity and respect. In the best care homes, all staff are involved in treating residents with compassion, kindness, dignity and respect. It should not need saying, but these qualities should be at the heart of care in all residential and nursing homes. Another of the five KLOEs is ‘Are staff caring?’.
All homes set out to do the best for residents and to create a caring environment. Sometimes, in a busy environment, maintaining the highest standards of care at all times can be a challenge. The adoption of technology can bring sharp focus to CQC’s line of enquiry and help to ensure these standards are maintained or exceeded.
Aspects of “Caring” that directly talk to the use of technology, include:
- Staff are armed with appropriate knowledge of individualised care plans to reduce the amount of time required on paperwork and administration so that more time is spent on caring.
- Real-time access to daily tasks and up to date shift handover notes
- Detailed records of the individual’s final wishes enable timely and appropriate action is taken to meet the service user’s preferences, dislikes and DNR wishes.
- Instant access and real-time updates with the individual’s most recent information, including details of contact addresses of relatives, medical professionals, etc.
- Assessment forms to monitor the resident’s medical condition with customised assessments and care plans, medication reminders and tracking, individualised health and safety checklists
- Adherence to data protection regulations based on security processes and procedures. Data of individual’s information is encrypted for security.
- A mobile care app that allows getting in touch with family and friends, remind their loved one of important aspects of their life. Ideal support for those suffering from dementia.
CQC expects staff to treat people with kindness and compassion in their day-to-day care and support. Evidencing of care is critical. CQC will look for evidence that people, and those close to them, feel they matter. This means staff listen to them and talk to them appropriately, in a way they can understand. To do this, staff need to know the people they are caring for, including their preferences and personal histories. In a good home, staff show concern for people’s wellbeing in a caring and meaningful way, and respond to their needs promptly. Compassionate, respectful and empathetic behaviour is understood and promoted within the staff team.
The service should support residents to express their views and be actively involved in making decisions about their care, support and treatment as far as possible. Staff recognise when residents need and want support from their carers, advocates or representatives to help them understand and be involved in their care, treatment and support.
Staff give information to residents, their families and other carers about external bodies, community organisations and advocacy services that can provide independent support and advice, answer questions about their care, treatment and support, and, where necessary, advocate for them. Relatives and friends should feel welcome and able to visit without being unnecessarily restricted.
Respecting and promoting people’s privacy, dignity and independence is essential, including during physical and intimate care. Staff should respond in a compassionate and timely way when residents experience physical pain, discomfort or emotional distress. Information about them should be treated confidentially in a way that complies with the Data Protection Act.
The service must ensure that young adults have choice and flexibility about their privacy and the amount of parental involvement in managing their care and support after moving into adult services.
Our care planning system delivers real benefits to everyone connected to the home. When it comes to caring, whilst supporting staff with the information they need about residents and help managers foster a positive, caring environment.
Is your service responsive to people’s needs?
An outstanding care home must be responsive. The CQC defines ‘responsive’ as being when staff and services are organised so that they meet the needs of residents. An outstanding rating for responsiveness requires services to ‘meet people’s needs’.
This is the fourth KLOE and we look at how care home owners and registered managers can ensure service users personalised needs are met through the use of smart technology. Indeed, one of the new KLOE prompts specifically asks: How is technology used to support timely access to care and treatment? Is technology (including telephone systems and online/digital services) easy to use?
All Service Providers set out to do the best for Service Users and to create a responsive environment, however, without the support of technology, it makes the task so much harder to deliver. Clearly, technology is not the only answer but it goes a long way to help deliver the desired outcome.
Aspects of “Responsive” that directly talk to the use of technology, include:
- Up to date care, treatment and support plans are set out in a document that is shared by all through a Tablet that describes what staff need to do to make sure that service users receive personalised care.
- Reminders and alerts that encourage timely delivery of care and treatment
- A record of incidents, comments and feedback that allows automatic escalation which then lead to online manuals for continuous learning and improvement.
- Personalised care plans for end of life situations to make informed choices about care are easily documented without the need to type. All on-line and available to others who may need to know.
- Instant availability of deep level information about people supported that allow caregivers to follow their interests and take part in activities that are socially and culturally relevant and appropriate to them.
- Detailed assessment, care plans and services recorded, delivered and coordinated through automated hand-over notes, to-do lists and a task manager accessible and responsive to people with complex needs.
- Family and friends, where appropriate, are actively involved through a mobile care monitoring app that enables sending messages directly to carers and updates the family about their loved ones.
To achieve outstanding for RESPONSIVE: The service must have an innovative approach to using technology. People are involved in decisions about how it is or could be used. There is a rapid response to people’s changing care needs and advice on care and support for people and carers at the times they need. Staff use innovative and individual ways of involving people and their family, friends and other carers in their care and support plans, so that they feel consulted, empowered, listened to and valued.
Service Providers are always expected to set and maintain the highest standards of care. CQC now actively looks at how technology is used to make the service more responsive and a suite of applications supports care staff by giving them the information they need to ensure they meet CQC’s criteria.
Cura helps service providers to achieving an outstanding rating for responsiveness with a feature rich system designed from the ground up for caregivers and care homes.
Is your service well-led?
An outstanding care home must be well-led. The CQC defines ‘well led’ as the leadership, management and governance of the organisation to ensure it provides high quality care based around the individual’s needs and that it encourages learning and innovation and promotes an open and fair culture. The fifth question is extremely important: Is the home well-led?
Achieving an outstanding rating for well-led means owners and registered managers can effectively monitor and improve the quality of care in the home. Caregivers are now expected to have not only the right attitude but also latest information to hand to deliver sustainable care.
Service Users have changing care needs and there should be in place a strong framework of accountability to monitor performance and risk, leading to the delivery of demonstrable quality improvements to the service. This is where technology comes into the fore.
Aspects of “Well-Led” that directly talk to the use of technology, include:
- Management of all assigned tasks including ad hoc tasks to staff from a tablet device and receive alerts in real time
- Digital to-do lists with notifications to allow for the prioritisation of key tasks related either to the resident or to the care staff.
- Flexible staff planner that caters to ad-hoc changes.
- Discussion boards and interactive messaging that enables colleagues, carers and other care professionals to communicate, escalate and share information quickly, easily and effectively.
The use of technology is no longer an option. The best homes are going digital and clearly pushing the boundary towards better care and Cura Systems is proud to be at the forefront of this change.
Cura leads the way to achieving a well-led rating with features that alert and track critical actions. Evidence of training, improving communication through our discussion module, audit trail and other features greatly improve leadership capability and service delivery.
References: Care Quality Commission. State of Care. [www.cqc.org.uk/publications/majorreport/state-care].
About Cura Systems
Cura is at the forefront of technology innovation and transforms caregiving. We support care homes of all types and sizes, with focus on service users with complex care needs: person-centred dementia, learning difficulty or learning disability, and long-term chronic illnesses.
Cura means care, and we are committed to supporting owners and care home managers to deliver outstanding care. We help care homes with the most demanding needs to deliver better quality outcomes by automating more daily tasks for management and caregivers than any other care home software.
We work closely with care-home owners and managers to deliver a full digital care system at a low cost. Cura helps to save caregiver time (from tedious paperwork) and makes more time available for care. We think Cura does this better than any other care home management system.
CQC has continually urged health and care services to embrace innovative digital technologies. We have the right tools and support to improve CQC ratings. If you have not yet used technology within your care setting, it’s time to go paperless and reap significant benefits.
About John Rowley
John Rowley is senior sales manager at Cura Systems. He has worked in care technology for over 35 years and is credited with the design of the first ‘computerised’ assessment based care plan in the 1980s.
Phone: 020 3621 9111