Learn how collaboration between CCG, Local Authority, Community Health and the 100+ Care Homes, created a digital Care Home standards system which supports efficient processes, the sharing of best practice and a standardised framework of excellence to ensure the highest level of Infection Prevention Control is achieved and maintained.
"..staff can clearly see the relevant standards they need to align themselves to. If they realise they're not currently aligned to them, they can quickly put actions in place to facilitate that, it's fantastic."
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Just to say a bit more about the Council really, and its role in developing this tool within InPhase and the Community Trusts in the care home sector.
So, the Council, of course, has a statutory duty to shape and support the local markets, and we have an opportunity with the infection prevention control grant that's been issued to local authorities to work with both the care home sector and the get with the wider community care market.
And we chose the discretionary elements of phase one of that grant to invest in our local IPC team to support us to both increase the number of IPC nurses in the team and also to help to follow some of the developments of this programme for the care home and group in Wirral anyway, as part of the "Healthy Wirral" programme, we've got a big push on digital and move to digital away from paper-based services.
So we're working with all of our community care market to move on to that, so what we really need is assurance from the market that their practices are safe. And we also need to have assurance from the market that the quality of the services that they're delivering are meeting both their regulatory requirements and standards, and also our local infection prevention control standards. So really the investment in the team for us. And the development tool gives us the assurance that we need as part of our local authority offer in terms of managing that market and element. And also, lets the IPC team and our existing quality improvement team work hand-in-hand to get the best outcomes from the care homes. Just a bit about us as a local authority - we have no in-house provision. So we have no…
We have no social work service for adults anymore. We've delegated that to the Community Trust which is where Emma works. And we have no in-house local care homes or domiciliary care services respite services were incomplete needs commissioning Adult Social Care Unit, so we've got everything out. And as of the 4th of November, we've got about 3,600 beds in our local market working at currently 14.2% vacancies, which is about 5 or 6% normal, we would normally deal with an unusual year, and CQC rating. And you can see that we've got at 1% outstanding, 60% Good, 25% RI and 6% inadequate. And since the start of COVID, we have lost three care homes who have opted to close. We, as of that date, we add 19 care homes that had a Covid infection rates.
So, in terms of the background of the project, it's a good collaboration between Wirral Health and Care Commission and Wirral Community Health and Care Trust, and also of course our care homes and SAFE, as the system provides us with an assurance and governance framework standardised across the care home sector, so that all care homes will be providing the same information in the same format.
At the same time, and we can get Commissioner oversight of those dashboards, as well as the IPC having oversight from an infection prevention control that we've moved on to this digitised and improved system. It gives us a clear framework and across both areas and makes sure that we're all doing the same thing at the same time, and it makes sure that we have with our quality improvement officers where we are services that we currently work with or either requires our improvement in adequate or inadequate. We've got a clear framework for health and for infection prevention controls and move those back up to the standards that we that we need to have.
So we procured it earlier in this year after the first phase of the infection control grant. We had some very quick development meetings with Emma and her team and we've organised the configurations of the system as, as we've done that and we it was customised and ready to test in. In August, we recruited the nurses, quickly, and we identified a cohort of around 20 homes to work as part of the pilot phase of rolling out the care home module. And that was a mix of care homes of older people's homes both big and small, and also some specialist homes that were either at homes for people with mental health and also adults with learning disabilities where we also experienced outbreaks. We've moved through training the first 20 homes, and we're aiming now to train up all of the other homes. 127 I think we have in total. I think 70 older people, 72 older people's homes, and by December by Christmas so that they'll... we should have them all in the system is now live and our pilot phase. So we should get them all trained up and fully working by the end of the year.
Again, welcome. So, that's brilliant so I'm just going to know a little bit more specifically about how SAFE has translated over to the care home environment. And so the modules consist of a number of checklists, and a very similar way to what I've just described, there to be completed on a monthly basis, so that's PPE checklist and a manager checklist. It also includes a monthly hand hygiene observational audit and a quarterly environmental audit. And of course, the wonderful dashboards reporting.
So we've talked quite a lot about some of the benefits and again, you know, this is kind of synonymous across the InPhase tool for other organisations - it's about that transparency, that provision of assurance and accountability, providing a repository of evidence memory, relating to regulatory standards, and it wants support with seek inspections and improve that performance specifically for IPC, hopefully as well to support that improvement around care home reputation.
But really putting that emphasis on providing safe and effective care for some of our most vulnerable people and providing that assurance to not only them, but also their families.
Okay, so InPhase have produced a short video user guide which we're now going to show you, because I feel demonstrates how easy the system is to navigate and how visual and pleasing it is to the eye.
Hi, I'm Aden, I'm a Care Home Manager from InPhase Care Homes. This morning I need to update my environmental self-audit and hand hygiene observations. I start by clicking "environmental self-audit" in the menu. I did some earlier today, as you can see by the sunburst - the grey ones are what's left to do.
When I click on the segment I want to edit, will automatically change the table below, with all the questions I need to answer.
To make my update, all I need to do is put the table into data entry mode and select my rating.
Then hit the "Save" button.
Now I need to put my commentary against this. Again, that's really easy to do. I just click the "Add commentary" button. And as I have rated question 115 as "yes", my comments are simply "yes, witnessed Michelle doing this earlier this morning." Then click. So I also now need to add an action. I just got a new starter joining tomorrow, and we need to make sure that this is covered in the training. I'll mark this down as a reminder. To do it, I just click on the "Add action" button. I type in my action name.
Set the due date,
And then click "Create."
From yesterday, I had an outstanding action on the staff toilets, so let me go and change that now to "complete".
I needed to replace the carpet to wipe the flooring, and this is now done. So I put the table into data entry mode, lock it down as "complete" and then click "save".
Now I need to do my hand hygiene audit, so go to the "hand hygiene"; page at the top menu.
I can see my observation scores at the top of the page, and they all add up to my overall score on the left, as it's my second observation today. I click "observation" to go into edit mode by clicking here and here.
And then add the name of the person I'm observing and the date, and then click on "save".
Now I'm going to add in my responses to 001. I'll mark it down as it "yes." Then I'll add in my assurance comment as "witnessed". At the moment, I don't have any other evidence for this, so I won't click on the evidence link area. And then I click on "save".
If I wanted to find out previous results for this question easily, I'll just click on the icon, and I'll open a popup, which shows me all the details results, and previous trends.
And that's an easy way to update my environmental self-audit and hand hygiene observations in one simple place.
So I hope that that gets across, and, you know, that sort of dynamic way that the system can be used rather than just seeing a screenshot of something, you can see how easy it is. So by selecting a segment of the sunbeam on the audit page, the standards relating to that area appear and it can be seen, you know, the standards can be seen a staff cannot align themselves to their standards and if they're not aligned, then they can put actions in place, which is fantastic. And so, you know, the hand hygiene module that's supporting care home manages to carry out a number of observational audits, relating to best practice for hand hygiene, and they can see that completion and compliance rate and again, put actions in place to bring about improvements if they're not meeting those standards.
So, although it's still really early days in terms of this project, the feedback's been really, really positive from care and managers, as you can see on this slide. The engagement's been really good, which is a credit to the care homes, given the really challenging circumstances that they're operating in right now. And as you can see from the feedback, you know this is exactly how I feel about the system and how, you know, we felt with the use of rural communities - the fact that it's very useful, it's easy. That's really important to staff - it identifies all areas by PC, and this is really clear. I think some of which wouldn't necessarily come straight to mind, it's a reminder of what those standards are and it helps you to remember what should be in place. And again, the fact that it's all together, you don't have to go into lots of different places. You don't have to go and look in the folder in the office, on, on the shared drive, it's all there in one place.
Okay, very good.
It's really, really helpful.
Although we were showing the demonstration there on a desktop device, of course it also works on the tablets, the iPads or even the smartphones, particularly for the mobile staff and for care homes, that might be important. So I think the multi-device elements of that is important too, so sorry, carry on.
So, just to finish really, I don't know if Jane has anything to add, you know, SAFE is constantly evolving, both within the care home market and also within the Wirral community, and that's to reflect the needs of the community, the organisation. But as we've clearly seen over COVID, the wider global context for future developments, the Wirral community Trust include an environmental audit with interactive maps and drill down to specific rooms, the care home module will have a policy checklist and assurance page for triangulation and Quality Framework based on the IPC criteria. So by the end of February, we will have over 120 Wirral care homes using SAFE for IPC assurance, which is fantastic and very exciting.
Jane. Yeah, I was just gonna come in as well to say we... Robert and I... have had very initial conversations about other bits of the sector that we work with, so including domiciliary care and supported living sectors, and to see if there's potential to develop to use there. So we've had some very preliminary discussions about that, so we've got other modules in development, and we're looking to see if we can, we'll phase those out at the moment, given all the other current pressures, but yeah, because we've had the funding, we've got the development of those in place so we can deploy them as and when.
Yeah, that's all I wanted to say and thank you for letting us in to speak to you, I appreciate it.
Jane, Emma, I have got three questions come through.
The first one: "Do you feel that the IPC tool has helped improve the culture and approach to IPC within the care homes and join the process more closely with the Community Trust?"
Yeah, I think so. I think what's good for us and in terms of the care home sector is that it aligns the infection prevention control very neatly with the NHS provider.
So while the statutory duty is with the local authority, it aligns the standard with the NHS standard of working. It gives us the consistency that we need across the sector, because previously all 127 homes will have all used something different, with a variety of, you know, paper and their own spreadsheets and all kinds of things that they developed, so it gives us the standard approach that we need so that we've got oversight and IPC oversight as well.
Can I just ask if all the care homes have direct access to the network the system is on, or is some remote access required?
I think I can partly answer that in terms of InPhase, it's completely web-based. It's up there on the internet, so anyone can access it.
So just to tell you what we did with the care homes, because about two or three years ago, we introduced "tele-triage" to the care homes. So, also with the Community Trust doing the tele-triage response, so we provided them all with business-strength broadband, whatever they needed, and also we provided them all with secure iPad Pros at the time, it was... we issued them with other kits, so we've had to kind of invest in the infrastructure to get to the phase where we can make sure we've got, you know, access to digital, so we can help. We've got lots of other things... projects that we're working on the care homes with, so we as a council invested our own capital to support both the tele-triage process, and now the "tele-health" process SAFE. So the infrastructure is there to support all the projects that we want to do.