Care quality
written summary of findings. A day is chosen randomly and then a total of 30 minutes of footage is viewed spanning different times of the day and night in different areas of the home. These are discussed at manager’s briefings and action taken if required. These are predominantly very positive. We can also audit the behaviour of staff and residents in the event of a fire drill and use this footage as learning material for staff on duty.
l Reflective learning. Following some incidents, it is sometimes considered that the best course of action is reflective learning. In this instance, a group of staff will observe a practice via CCTV footage and consider improved ways of working.
We record many incidents and accidents during the course of a year and on average, 20 per cent are the subject of CCTV review. The examples in the table below show three of our documented case studies where CCTV has influenced the action we have taken.
From this small sample of incidents, it is clear that our action with and without CCTV footage would be different. We believe that the information we are producing, which we collate and use as intelligence for the purpose of service improvement, is significantly more accurate with the use of CCTV footage.
CCTV in care planning We have used CCTV information to inform care plans many times. Two such examples are given below. (1) ‘Mrs. A’ was thought to have many unwitnessed falls as staff kept finding her
In our view, CCTV is one of the best investments we have made and we would strongly advocate for it being more widely used
on the floor. For her safety, this could end up with details in her care plan to the effect that she must be highly supervised, or that she should not be allowed to walk unaided or possibly be encouraged to sit for long periods of time.
However, CCTV revealed that this was not a matter of unwitnessed falls, but ‘Mrs. A’ had carefully lowered herself on to the floor to sit down, as is clearly her preference. Therefore, compromise of her independence is completely unnecessary. Without CCTV, her care plan could be unnecessarily restrictive. (2) ‘Mrs. B’ was described as not sleeping at night at all. That may have resulted in a consultation with her GP and
possibly the introduction of medication to assist sleep patterns, as is sometimes completely appropriate for the resident’s overall wellbeing.
However, a careful review of CCTV footage showed multiple short naps throughout the day, every day, equating to six to seven hours. That, together with our knowledge that ‘Mrs. B’ used to work night duties, confirms that this pattern of sleep is one of her choosing and that she is getting adequate sleep in her own way. There was no need for any medication assistance in this case. Without this knowledge, we could have made the wrong clinical decisions.
Legal and ethical considerations Being legally compliant and open and transparent about the use of CCTV involves being registered with the Information Commissioner’s Office and being fully GDPR compliant. The Care Quality Commission recognises that some care providers may wish to use CCTV. They consider it appropriate subject to correct management and use and state their position clearly on their website.
We aim for complete transparency and choice where CCTV recording is concerned. Residents and their families choosing Marbrook do so with full advanced knowledge that CCTV is operational.
Our funders - predominantly NHS - are also fully informed that we operate CCTV in all areas. We then have notices at every entrance door and on our reception desk next to the visitors signing
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www.thecarehomeenvironment.com • November 2020
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