Answers to CQC s five key questions The Care Act 2014 came into place on 1 st April 2015, which includes the changes CQC have made to the regulation and inspection of adult social care services. They have identified five key questions that they will now ask of services: are they safe; are they effective; are they caring; are they responsive; and are they well-led? These questions are designed to assess the quality and safety of adult social care providers. This article outlines the five key questions in bold font, a summary for how Mobile Care Monitoring gives providers the tools to demonstrate evidence of care, together with bullet point specific ways the system enables providers to automatically answer the five key questions. Is the service safe? Are service users protected from physical, psychological and emotional harm? The media loves to latch on to care providers who don t protect service users from harm, which unfortunately colours the view of the general public. It is therefore in every care provider s best interest to ensure the industry focuses on keeping service users safe. Whilst there are environmental aspects necessary to ensure safety, it is interesting that CQC seem to be focusing more on protection from harm that people could instigate. Where we can help is to reduce stress for everyone by creating visibility of potential problems and monitoring of incidents. One of the major features of our system is that is reduces the time spent on admin, particularly for shift leaders and managers. Because the system can be used anywhere, there is no need for senior people to be stuck in offices or nursing stations away from the service users for many hours each week. Simply having more time, and being free to be in the same place as the services users provides the opportunity to spot potential problems before they occur. 1
Carers can see if care actions have been missed for service users, or if they are potentially going to be missed, due to the flags against every service user on the carer s device. Shift leaders also have important care that has been missed highlighted on their dashboard and as part of the shift handover process. The system tracks who was on duty in each community, which enables trends for carers who might be responsible for higher levels of missed care to be spotted. Accidents and incidents that occur are easy to log by carers, which is automatically communicated to managers and other care staff so no one is unaware of what has happened. The device will prompt staff to record what they did to resolve the situation, encouraging care staff to take responsibility for the safety of the service user directly as the situation occurs. These events are added to a queue which the manager or shift leader can look at and can be used to identify trends in people involved or other aspects that could have led to the problems. Care staff have a summary of each service user s care plan in their hands at all times when delivering care, with information relevant to the action they are undertaking presented when they evidence it. This means that all care staff have the necessary information to ensure the service users individual needs are correctly dealt with. In addition, any critical care needs scroll across the top of the device whenever a service user is selected, so no one is left uninformed. Is the service effective? Are service users needs met, and is their care in line with nationallyrecognised guidelines and relevant NICE quality standards, or are effective new techniques used which gives them the best chance of getting better or living independently? There has been a lot of focus in the past on outcomes, and these can be used to measure the effectiveness of care, but in some situations it is difficult to provide appropriate care that leads to the defined outcome. Another way to measure effectiveness is the quality of life the service user is enjoying, and this can be measured very simply by how happy they are. 2
Service users happiness is recorded for every care interaction, so if patterns emerge due to certain care activities or staff members care it is easy to spot and make changes. The system records care delivered relative to what is planned, so anything that is missed, or not needed, or was done but not planned, is highlighted. This enables care planners to see how effective the care plan is and make adjustments accordingly. If there is a risk assessment that identifies a support need that is not addressed on the care plan then this is highlighted to the care planner, enabling them to very easily ensure that all needs have planned care against them. Is the service caring? Are service users treated with compassion, respect, dignity and is care tailored to their needs? An obstacle to treating service users with compassion, respect and dignity is lack of time. Having care tailored to their needs involves both periodic analytical assessments and regular updates from everyone involved in their care. Carers are able to update every service user s personal preferences for every aspect of their care at the point of evidencing care interventions. These preferences are then automatically communicated to all carers thereby ensuring that the care delivered meets each service user s current needs. The system saves all care staff time that they would usually spend on paperwork, which can instead be used to spend time caring for service users. We cannot make care staff do their job in a caring fashion, but we can give them the tools to free them up to care, and give managers the tools to spot who isn t taking a caring approach. 3
Is the service responsive to service users needs? Do service users get the care at the right time, without excessive delay, and are they listened to in a way that responds to their needs and concerns? There is an old saying: if you fail to plan, you plan to fail, and ensuring service users receive care at the right time starts with a care plan identifying the times of day that care interventions are most appropriate. It is common for care planning to be reviewed on a periodic basis, often with limited knowledge of service users particular needs. We believe that allowing carers to update the service users preferences at the point of care helps to ensure that everyone is aware of all service users current needs. Planned care that is done late, or is marked as not needed, is automatically highlighted against each care plan element when reviewing the care plan. This gives managers the tools to know that care is being delivered at the appropriate time. Carers can update service users preferences, and these updated preferences are communicated to everyone, ensuring that care delivered is responsive to changing needs. Whenever a carer delivers care that is unplanned the system identifies if this is a common occurrence, and if so, will automatically update the list of frequently used unplanned care actions, which helps the next carer know what intervention the service user commonly needs. Is the service well-led? Does the organisation have effective leadership, governance (clinical and corporate) and clinical involvement at all levels of the organisation, and an open, fair and transparent culture that listens and learns from people s views and experiences to make improvements? 4
Effective leadership is difficult for a system to facilitate, but we can help to ensure that information is open and transparent, and provides everyone in the organisation with the opportunity to express improvements in service user care. Through transparency, managers and senior people are given the opportunity to spot potential problems, and we provide the tools that enable them to make leadership decisions. We provide alerts for important items, such as care that is missed when it must be done, or care that does not meet the requirements (such as hoists used with only person), or service users having an episode of challenging behaviour. These alerts are highly visible to care managers to give them the tools to identify weaknesses or lack of resources in the care delivery team, so that they can make the necessary improvements. Every carer has the ability to highlight information relating to any service user for the shift leader to address. This information is visible to everyone involved in the shift handover process, and can readily be included in the shift handover notes for the next shift. Any care action that is planned as being necessary, such as medication or fluid checks, if missed, the system will identify all the carers that could have provided the care. By making everyone aware of this, carers are more inclined to help each other when they are on duty to ensure that all service users needs are met, which promotes team working. Each carer has the opportunity to make updates to a service user s preferences, so that they can ensure that improvements in care are communicated to all other carers automatically. Mobile Care Monitoring and Integrated Care Planning are Person Centred Software products. Contact Person Centred Software on 01483 604108, care@personcentredsoftware.com or @PersonCentredSW on Twitter. 5