FEATURE Best-Laid Plans
Rising numbers of care homes are struggling with poor care planning, says Helen Fuller, Managing Director at Care 4 Quality.
Despite The Health and Social Care Act 2008 introducing the five Key Lines of Enquiry (KLOE) back in 2014, care services across England are still failing to meet the standards of this framework and legislation, which essentially protects residents from avoidable harm, abuse and anything that breaches their human rights.
Recent collation and in-depth analysis of the current
inspection reports (undertaken by Care 4 Quality), focusing on inadequate-rated care homes across England, has identified that the impact of poor care planning is one of the key areas that is impacting providers’ ability to achieve a positive rating from regulatory bodies. Of course, the need for more robust and stringent care planning is further exacerbated, by the current pandemic that care homes now face.
The spread of coronavirus within the elderly and vulnerable is a significant risk to care providers and accurate, detailed care planning has never been more vital. For many, this means making positive and necessary changes for now and also for the long term as we stand to learn some lifelong lessons in providing the best care especially during a crisis or threat. Educating care home managers and providers on the common areas of poor performance regarding care planning, may help to raise awareness, shiſt mindset and help providers focus towards improving care services and preparing more proactively.
Development of complex care plans alongside regular monitoring and review is extremely time-intensive for care home staff to manage at the best of times, but that task is magnified ten-fold when faced alongside a global pandemic. It may be surprising to hear that prior to the virus outbreak, 90% of inadequate care providers were down-rated during inspection due to their poor care planning. Taking into account everything that is happening in the care home sector right now, this has not got any easier to manage.
The main care planning issues identified were: a lack of input received from those in care and their families; wishes, preferences, likes and dislikes were missing; a lack of staff guidance and triggers identified; missing or incorrect information; failure to monitor plans and out-of-date planning.
Despite its complexity, effective care planning can be achieved via a paper-based system or by using specialist soſtware. Electronic care planning is becoming increasingly popular within care and nursing homes as well as domiciliary services. Using technology can be an effective step in formulating a detailed care plan that is robust, relevant and consistently kept up to date. However, choosing the right care planning product that suits the service, the staff and its residents,
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is vital. Even during a crisis good care planning must be consistent and even though the transition period can be disruptive and time consuming the outcome will undoubtedly improve care and could potentially save lives.
Implementations like this should always be planned carefully with contingencies in place, to ensure that staff have access to relevant information and guidance on their resident’s care needs during this period. For those using paper-based systems, they must be consistent, comprehensive, easy to navigate with a people-centred approach at the core while being easy to review and maintain. It is oſten discovered during our audits that paper-based systems have been added to repeatedly or haphazardly, which can lead to a disjointed, and potentially ineffective care planning system.
“Prior to the virus outbreak, 90% of inadequate care providers were down-rated
during inspection due to their poor care planning.”
The development of complex care plans alongside regular monitoring and review is extremely time-intensive and disruptive for care home staff to manage, especially during a pandemic that is all consuming. Yet it is becoming ever more important for providers to plan more efficiently and put the correct contingencies in place to ensure staff have immediate access to information and care needs during this period.
Some services are choosing to adopt short term or acute care plans for residents during this unprecedented time, which allows key information to be gathered and accessed in a more timely way, via a centralised booklet that is ready for instant review by medical teams when required. In this respect, it is also important to determine, based on each individual, the required level of information and monitoring, to ensure that people remain safe and supported throughout this troubling time.
www.care4quality.co.uk www.tomorrowscare.co.uk
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