care quality commission

Our growth news coincides with CQC Inspection update

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Good management of a domiciliary care agency takes more than just ticking boxes

The CQC inspectors have just returned our annual inspection report and we are delighted to announce that a great CQC report coincides with the news that we have just exceeded 400 care hours per week, and now employ 25 people  — a significant milestone we set out to achieve and are now surpassing.

We’d like to share some of the CQC findings with you. It just goes to show once again that boxes can be ticked, but to really come up to scratch you have to see the evidence in the comments behind the boxes. So we are happy to report that not only are we meeting all the standards, but have surpassed expectations in certain areas.

We were found to have met the standard for Respecting and Involving people, Care and Welfare of people, Safeguarding people from abuse, Supporting workers, Assessing and monitoring the quality of service provision — and we would expect nothing less. What really matters is what both our customers and their relatives, and our carers and their managers, told the CQC about us.

Here’s a summary of what they found:

From our customers:

“People were wholly complimentary about the quality of the service they received with one person describing staff as ‘really lovely’ and said staff went ‘beyond the scope of what they need to do.’

Other people described staff as ‘respectful’ and ‘very well trained.’

One person said the manager was ‘very particular about the staff they employed.’”

This is exactly one of our top priorities and it’s good to know it’s being noticed.

From our staff:

“Staff felt supported and one, who was new in the post, found the support helpful in making them feel comfortable in their role. Staff were also motivated and said they enjoyed their work.”

And here are some first-hand remarks that support our top priorities — the report highlights that we keep our promises.

Involving people in their care plan, giving them control and respect:  “We saw there was a clear schedule of support the person had planned with staff and the times this was to be delivered. The schedule was supported by detailed individualised care plans. People we spoke with said they had been involved in their care planning and were able to request changes and we saw these requests were acted upon.”

Treating people with dignity:  “Staff spoke with confidence about how they ensured people were treated with respect and dignity and gave examples of how they did this when supporting people with their personal care needs. People using the service, and relatives, said staff were always respectful and showed regard for people’s dignity and independence.”

Keeping people safe from abuse:  People who used the service told us they felt safe with the care staff allocated to provide their support. Staff told us they were up to date with their safeguarding training and we saw records of certificates, in staff files, to confirm this. The information provided, together with our observations demonstrated that people were protected against the risk of abuse.”

Regular vetting and training of staff:  “We saw that staff were regularly assessed. Managers carried out regular checks to assess staff performance and also to offer support and guidance to staff. Staff said they had enough time to carry out their duties effectively and we saw that staff always stayed at a person’s home for the allocated time to ensure they were providing the most effective care they could.”

It’s great when a homecare agency can be upfront about its operations; none should have anything to hide.

 

 

Winter Dementia Care: 6 Ways to Care for People with Dementia

Homecare250pxWe all respond in different ways to longer dark evenings, colder weather and the changes in family routines that Christmas and the holiday seasons bring.

Dementia care at this time of year is essential. People who suffer with dementia are often more affected and can become more confused during periods of change, necessitating more attention. Careful dementia care is important. As a professional care agency we incorporate all of the following practices into our care management and advice for our customers:

1. Think about inclement weather planning
Berkshire may not be famous for snow-drifts and white-outs but this means our transport systems are sometimes more affected than towns in Siberia when the snow and ice comes! So, we need to manage the risk of difficulties in getting to the shops by keeping a minimum of 3 days’ food in the house. Using even a small freezer compartment for a small loaf and a pint of milk is something to consider. If solid fuel is used for heating, then regular checks on stock levels are essential.

2. Only go out when dressed up for the cold
We now know that the number-one cause of illness and death in winter is down to very cold weather! So, Halcyon discourages customers from going outside and asks whether there is someone else to go to the shops or get things delivered. If they must go outside, we encourage them to dress warmly in layers with hats, gloves, scarves, windproof and waterproof jackets, and wear shoes that are waterproof and have a good grip. That means storing those items so that it is difficult not to “forget” to wear them when they go out. And, where we can’t find those items easily to hand, that we notice it and encourage family members to buy winter-weather clothes.

3. Keep the home warm
Although we all worry about energy costs the home must be kept warm. Some people with dementia can get confused or anxious about heaters and central heating systems. Try to arrange for automatic timer systems that keep the living area in the home at around 18-21°C. We also discourage the practice that is prevalent among many elderly people of sleeping with an open bedroom window – both to save energy and for security reasons.

4. Take action against loneliness and isolation
For reasons that are often linked to sunlight and sunshine, loneliness and depression are more apparent in the winter months. For those suffering with dementia and living on their own, regular and routine visiting is an essential part of their wellbeing. Late afternoon visitors need to take the responsibility to pull the curtains and switch on a light for when it gets darker later. Try to start or bring some activity to get them involved with, doing it together if possible. If it is not possible for the family to sit down with a dementia sufferer, arrange with a care agency to stop by for a regular companionship call during the week.

5. Eat Well
People with dementia are prone to “missing” meals; but our bodies keep warm by burning the food we eat! Hot meals with plenty of carbohydrates (potatoes, bread, pasta and rice), stews and soups help keep illnesses at bay and maintain health and wellbeing. There is also no quicker way to warm the body from inside than with a warm drink of hot chocolate, tea or coffee. Our carers work to care plans, ensuring at least one cooked meal a day in winter, with plenty of hot drinks during the visits and throughout the day.

6. Manage expectations for the holiday period
People with dementia can become anxious with changes in routine and in unfamiliar places. Visiting them at home is often less stressful than taking them out. Family members need to be prepared, and understand that when faced with a new environment a common reaction for those affected is to ask to be taken home after a very short period. This is not a reaction to anything that has been done or said and offense should not be taken. Furthermore, if you are considering bringing in carers to manage in your absence over a holiday period, arrange for plenty of short visits prior to the departure in order to allow enough time for a relationship to be built before departing.

Big family gatherings around Christmas lunches with lots of “unfamiliar” faces can trigger confusion. The need to buy and receive Christmas presents can also increase fretfulness and concern. Families need to manage the Christmas presents issue, preferably by reassuring them that the presents have all been taken care of. But despite these issues, try not to leave someone alone on Christmas Day. Make them feel wanted and involve them appropriately in the preparations and the activities; suffering from dementia does not mean you are incapable of peeling potatoes! We always advise families they will have a more successful gathering when they manage both their own expectations as well as the event.

Ann Smith -Dementia Champion, Halcyon Home Care

 

CCTV and Elderly Care

Elderlylaptop250pxThe suggestion that the Care Quality Commission will investigate the risks and potential benefits of mystery shoppers and hidden cameras to monitor elderly care provision has become a major talking point. One social worker on Radio 5 Live commented that if a vigorous discussion into practices and standards in elderly care homes had been started simply by making the suggestion, then the CQC had done its job. That may be so, but there is another aspect of this suggestion that ought to be considered … and that is the use of technology to assist in supporting elderly care.

I believe that the potential for using technology to assist the elderly at home is huge.

For some time we have known that there are digital pill dispensers that will provide individualised prescribed medication to an alarm through the day; pressure mats, to indicate movement around a house or to detect falls, have been recommended for a number of years; pendant or wrist watch alarms provide an opportunity for an emergency response; and there is now talk of remote monitoring of blood pressure and heart rates over the internet. But these innovations are generally “preventive” or “medical responses” in nature and do not contribute towards enhancing the lives of the elderly or alleviating some of the reports of chronic loneliness.

I would like to see designers and developers applying their creative minds in this area of technological development. I am excited by products like the Care Messenger from i-Spy Digital that uses the television as a communication medium offering simple messaging into the home for care providers but also opening up the opportunity for elderly people to be involved in social media exchange with loved ones — all without having to learn new technology or leave their lounges!  Clearly, Smart TVs also offer the opportunity for Skype (or others) with the wonderful advantage of actually seeing who you’re talking to … an instant end to isolation! We welcome Jeremy Hunt’s support for more modern communications technologies in the NHS as a whole and the fact that GPs can start applying for funding to trial such use of technology.  However, we would always want to see technology employed mindfully, for example, elderly patients may be less receptive to Skype etc and not always find such transitions simple.

Of course, I see we need to manage any fears that this would lead to Big Brother care monitoring and strongly believe that technology can never replace the personal touch or indeed the training to complete professional personal care, but I can foresee a time where care workers will need to be capable of assisting in setting up modems, Skype, etc., as a part of a care plan that includes widespread technological applications .

However, hidden CCTV cameras to check on carers and the care provided? Well, it doesn’t make it into my vision of future care regimes for the elderly.

 

Care not Cameras

security cameraThe launch of the Care Quality Commission’s plans for future regulation of adult social care took the headlines today with its intention to discuss the risks and benefits of surveillance cameras in care homes as a way to flush out rogue care home operators.

While this attempt to garner press coverage succeeded, I think it is a pity, because the news that CQC is setting out ways to ensure improved regulation and inspection of the care sector is a good thing and shouldn’t need “dressing up.”

Contrary to any media speculation that care providers will be quaking in their boots, most of us welcome these plans, and we would welcome increased consultation and greater discussion on the issues of elderly care

Care providers want a care environment where carers deliver a safe, effective, responsive and caring service. We want prospective customers to question us on the style and quality of what we do, and not be led by press speculation that assumes we may need cameras to watch over us in order to do our jobs well.

These proposals have been widely consulted across the sector and we fully support the return of quality ratings between providers and the development of specialist inspectors. We particularly agree with developing inspections that differ between types of provider; It really is a nonsense to have the same approach to inspecting  a hospital as to inspecting a home care provider. We also like the commitment to move away from inspections based on paper-based procedures and documented evidence towards a proper assessment of the care delivered.

Regarding the headlines around  Hidden CCTV and Mystery Shoppers for Care Homes, we would question the feasibility of this as well as its effectiveness. How and at what point in the inspection process would these be installed? How and by whom would coverage be evaluated? It just doesn’t seem to be fully  thought out.

My additional concern is that the rogue care home operators that may require oversight, might welcome CCTV for the wrong reasons, that is, to cut down on staff by monitoring residents remotely from a control centre, rather than in order to improve care.

However, my opinion on regulation and inspection is that it is treating the symptoms and not the problem. For me the key to safe, effective, quality care homes remains well funded care that enables proper recruitment, training and reward for care staff and their managers.