Care Dynamics

We talked with Owner John Beukes, and Manager Simone Garland, about choosing and implementing PASS at Care Dynamics and how that has helped them achieve a CQC "Outstanding"

Background

Annefield Grange is a residential care home in Ryde on the Isle of Wight. It has 25 care staff and 5 domestic and office staff caring for 18 residents with a relaxed, family feel. We talked with Care Home Manager Katie Meadows and her Deputy Manager Louisa Brook about choosing and implementing PASS at Annefield Grange.

How have you found the process of training and implementation? How long did it take you to really get used to the system and start using it and how many people were trained initially?

John: We took a very different approach to getting started. We like to get the job done ourselves, so we decided not to get training the normal way. We looked at PASS and figured it out ourselves, which was not difficult. The screens present themselves in a very user-friendly way, easy on the eye and not cluttered with detail. We found it very easy to navigate. That’s the secret of good software, that you can use it intuitively.

Simone: I had some training online. After I had played around with PASS for a bit and written the bare bones of the care plans, I got the staff in and asked them to go through what they do with each service user so I could set up the tasks with them. By doing that together I think the staff were ready to embrace it when we went live because they had been involved and knew their input was valuable. They felt that they were part of a new system and so they embraced it. The process was not disruptive or traumatic because we didn’t give ourselves a cut-off date. It was very fluid. Firstly, we got all these care plans up and then it just grew from there. So, in the end it took around 8 weeks to go live.

John: Now it’s on our induction form, we get the field supervisors to start new staff on the job when they’re shadowing. Then they do the ongoing training too.

What’s your policy concerning mobile phones?

Simone: Some staff use their own phones, some have work phones, it’s their choice. We had staff that would fully embrace it because they are into technology and love it and it’s so easy to use it. Then you’d have the old-school carers that would be like, “Oh no, no I still use a Nokia, I still play Snake on it.” They took longer to accept it – but actually, they now write the best care notes, they are fantastic, and it’s become second nature to them now.

What about remote access for management? How has that changed or impacted your working day?

John: Remote access is a game changer for us. I live part time in Spain but can be in touch as if I was in the office at any time. And the field supervisors use the remote access on their tablets constantly.

Simone: I use remote access quite a lot. It’s also very useful at outpatients’ appointments with clients as the doctor will ask me questions and I can say “Hold on a minute, I’ll log in. I can get that for you now.” They’re really impressed.

How do you find the customer service and support from everyLIFE?

Louisa: They’re really good. Every time that we’ve called, which hasn’t been very often, they’ll usually answer our query straight away.

Katie: Yes, it is really good. You just call them whatever the time. I’ve never had an issue where they haven’t called me back, which you do find in many other busy customer services. Here they tell you, “I’ll ring you back when I find out”. They’ve always rung back straightaway or when they said they were going to ring. They always have a solution.

Compliance and Managing Risk

How has PASS helped to improve these?

John: A medications error can almost not really happen anymore because of PASS.

Simone: Notes are far more detailed because they are related to each task. Everything that we’ve done is evidenced. Compliance is vital.

For example, on Monday, I had a client who had no medication in his house when I went to do the visit and the daughter is responsible for collecting it. I had to raise a safeguarding alert because the medication wasn’t given. Immediately, when I was talking to the safeguarding team on the phone, I was able to tell them exactly what she’d missed, the dosage and everything, without having to go to her house, find the MAR chart and write it all that down, as previously. PASS just saved so much time. So much time! I also immediately knew if any of those medicines were time-critical, which could possibly have caused a looming crisis.

John: That’s an exceptional feature of PASS. I think it’s an important focus giving that power to the managers who can’t physically check every single service user. That’s the one thing that’s always been wrong in the industry. Reports only arrive a month later on your desk.

Also, when other agencies, for example an OT or a social worker, call you to speak about an individual, you can immediately look it up. They usually call without any sort of background information or context, so they want to know everything: the state of mind of this person, what kind of care they’re receiving, extra tasks etc. I just look at PASS and even if I don’t deal day to day with that service user, I have a very good idea because I can get it all right there, live. The summarising notes tend to be very much about how staff find the service user, where they are located in the house, what their current mood and state of mind is. All this in addition to the tasks which are performed: their well-being, as opposed to just their physical state.

That’s a bonus because that is the ‘positive outcomes’ bit that I feel is so vital. How is the service user responding to the care they get? Also, from a staffing point of view you can very quickly pick up if that’s not a match because of the state of mind or the response, PASS reveals patterns. Once you pick up a pattern, you can correct or review behaviour or actions immediately.

Business Efficiency

What are the main efficiencies that you’ve gained through using PASS? How do you sum up the benefits?

From the start, we wanted to be proactive: proactive in our caregiving; proactive in management; proactive in identifying issues, patterns, etc. With the old paper-based system, log books that only get reviewed once they’re full, we were helpless. You can only audit once it’s finished for the month. It doesn’t give you enough time to respond or to see mistakes, whereas PASS is live and up to date.

That was the primary motivator for me, the real-time. The important thing is to focus on what is going to make this job really efficient and proactive.

Another great help is to be able to schedule resources efficiently. For example, when you have a service user who has been admitted to hospital overnight: you will have been notified, but then you’ve got a staff member with a gap in their rota and domiciliary staff hate gaps. They hate them! “Why have I got to sit in my car for 45 minutes? Isn’t there anything else I can do?”

Simone: It’s great because I can just go in and allocate another shift. You just tell them, “Log out, log back in, and you’ll be going there.” It’s very, very immediate.

John: PASS saves money on things that can’t necessarily be measured, because we can’t always measure the fallout of a mistake. You need to look at the added value. It’s completely reinvented our business. We have created more roles because of PASS and it has enabled us to bring more business in.

It gives you a level of expertise that I think is generally lacking in the industry. As a company, we’re efficient and we function well, we understand regulation and follow it, we provide care with peace of mind that has been lacking in the industry, and that’s priceless, isn’t it?

Simone: PASS gives me as a manager, complete reassurance that my clients are well cared for. If I’ve got a strange feeling about someone, I just pick up my phone, log in. There we go. I can do that at any time of the day and night!

This morning is a classic example of PASS as a management tool. The carers reported that one client is taking longer in the mornings due to deterioration. With PASS, I could easily check how long they’re spending there with him and I can see it really clearly. Yes, it’s 46 minutes. It’s 52 minutes. They are going over their time and I can see such tiny details just by looking at recent calls. I phoned the council and said: “I’d like him reviewed,” and I’ve got the evidence at my fingertips for them before they even ask. I can go in knowing I’ve got a strong case. If you were relying on a log book for that, you would have had to go to that client’s house, read all of that log book, then take it away for evidence gathering for the council, put another log book in and it’s just such time wastage, when actually I just click a button, and there it is.

PASS gives you more certainty and if you can feel reassured that everything’s okay when you’re going to bed at night, well you can’t put a price on that, can you?

Better Care

How has PASS helped to improve your care? Do you feel that PASS has helped you to avert any situations from becoming crises like hospital admissions, for example?

John: It’s very person-centred and that, I think, is really important for the whole outcome-based approach. You can immediately update any change in situation, and you can respond to everything in that household, to the person, the person’s needs. It is so person-centred.

Simone: That’s one of the wonderful things about it, that it will tell carers everything: how to get in, it will even tell them where the light switch is, it will list all the medication on there, everything is there. There is nothing that they can miss.

John: And it doesn’t just tell them once, it gives me the opportunity at various points to say the same thing. It could become quite repetitive but in the world of social care that’s a good thing, because you are constantly reminded of the important things.

Simone: You can quite easily see exactly what’s going on really clearly.

John: And why.

Simone: Yes, and why. Because carers have to answer. It becomes the most up-to-date information that could possibly be wanted. You could go and read a log book, but it doesn’t tell you much real detail. It will be a load of writing that a carer has written and it’s the carer’s interpretation of what they’ve done. Whereas with PASS they’ve got to write every single thing. If they’ve given personal care, what kind of personal care have they given, have they given them a bath, a shower? They’ve got to tell me. There’s so much more detail of exactly what’s been done.

John: So, carers are never at a loose end. They never arrive without knowing what the first thing is and you can guide them very specifically. Then you can have feedback on whether those specific things were done and if not, why not. Which is also very important for review purposes. You can prompt people much more.

Simone: And that can easily solve problems. You get a relative on the phone saying, “They haven’t emptied mum’s bin for three weeks and the rubbish is overflowing.” And I can say, “Okay, I’ll have that one as a task.” Problem solved, immediately!

Because carers don’t have to write up all the notes now, they save so much admin time during a visit. Carers speak to their phone or they just type quickly with predictive text, they’re saving so much time which they can then actually spend with that client. It’s maybe only 5 or 10 minutes, but in that 5 or 10 minutes, they can curl her hair and have a chat with her, and it may be the only 5 or 10 minutes of conversation with someone else all day long!

John: I like the colours on the dashboard and the MARs. They’re not overwhelming, it’s very straight forward, either green or red. Okay, maybe we’ll throw in a bit of orange. It’s green or red and that draws your eye. Not to the written detail but to an activity

Simone: So you can immediately see if something’s not right.

John: There’s a moment. There’s a good moment or a bad moment. So, you can have peace of mind because of colour. It sounds corny, but that’s how it works.

Simone: A great example was when it snowed last year. It was absolutely horrendous. There was no way we could have got through it without PASS. We had John in Spain, looking into the system. We were all out on calls, phoning him and saying, “Right, okay, I’m finished here, where shall I go now?” or, “I’m near here, I’m going to go and do this call now and then I’ll go to the next call because of where I am and how I can move around in the snow.” It called for a radical, minute-by-minute change of the schedule and reacting to the situation we found ourselves in.

John: PASS showed us exactly what was happening so I could say, “Right, the next one needs to be this one. Can you get there? Is it going to happen?”. We managed to see 95% of our clients during that period and were probably the only agency in the area that did that. So, we saw everybody that needed to be seen at least once that day. The other 5% were people who had family members in the house, so they weren’t under contingency.

Simone: If we hadn’t had PASS and the live system to look at, we would have needed to have paper galore to understand where we were and who was out. At the end of the day, we were able to see that it had all gone green and then we were able to check that the last staff member was home, and they were safe. That’s the other point about it. Are my carers safe? It was a big relief. Absolutely invaluable.

How have your clients taken to having the digital technology going on around them? Is that something they’ve warmed to?

Simone: Yes. I will say to them right from the start that we’re very different to everybody else. We don’t operate like other people. We use PASS and this is how it works. They are very happy with that especially once they see it in action.

The Regulator

How was your latest CQC inspection?

John: Well, I called your office to let you know about our “Outstanding” rating after our latest CQC inspection, because I felt that PASS had played such a vital part in achieving that.

Simone: I have been inspected lots of times throughout my career and it was the first time I didn’t have any of that anxiety when she was sitting there.

John: PASS gives you a lot of confidence.

Simone: It’s so well organised. Everything is in order and I can produce any evidence required in support. Everything is in there. Just take them back to that. It’s there.

Would you recommend PASS to other businesses?

Simone: Definitely.

John: We do all the time!

Make the most of PASS for domiciliary care by:

  1. Logging in online every morning to download your bookings and ensure all your customers are up to date;
  2. Logging in offline whilst in areas of low signal to enter the app and view data downloaded from your last online login;
  3. Tagging in on arrival, as your visit time doesn’t start until you do!

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