We all understand the importance of valuing and respecting those we care for, when we speak about how you can truly deliver dignity in care, it might be hard to conjure up an exact idea of what that really means or looks like. Luckily Dignity in Care has come up with the 10 Dignity Do’s – an easy list that describes the values and actions of a high-quality care service that respects and upholds people’s dignity to the highest standard.

A Dignity Champion is a person who believes that being treated with dignity is a basic human right, not an optional extra. They believe that care provision must be: compassionate, person-centred, efficient and effective, and are willing to take action in order to achieve this.

“I have handed out Dignity in Care 10 Point ‘Dignity Do’s’ Cards to all staff in my care home – each time we have a team meeting we focus on one of the 10 Dignity Do’s and discuss what we can do to meet that challenge. Each meeting results in us making changes to the way we provide care.”

– A Dignity Care Champion

Dignity Champions are those in a care organisation that champion and uphold the 10 Dignity Do’s, as well as advocate and share the importance of dignity in any form of care. This includes:

You can find out more about becoming a dignity champion and the 10 Dignity Do’s by visiting Dignity in Care’s becoming a champion or register page. Another helpful resource is the Dignity Champion’s Toolkit for Action, which includes actionable insights, ideas and advice for people in a range of different care roles to help make a difference and bring dignity to care.

There are many ways that the Dignity Do’s can help care groups, teams and organisations improve their level of care and adapt to offer a continuously improving level of service. Championing the Dignity Do’s is only the start, we believe that in order to provide the highest quality care, moving to digital care planning enables you to create personalised care plans, record care accurately at the time of providing care and understand and act on trends about those you care for. By using digital, you can be much more efficient and spend more time providing person-centred, quality care.

To find out how care software and technology can be used to enhance your care service, or help you to better care for those you support, book a demo or get in touch with the team.

Thank you to Warrington Community Living for sharing the following article on their website. We love hearing how Nourish‘s digital platform  is helping and improving care services across the country!

Elizabeth Lodge is a well-established and family run residential care home based in Alverstoke, Gosport.  It has a team of twenty-seven lovely staff, devoted to looking after 18 individuals, the majority of whom have some form of cognitive impairment.

Nourish has been a partner of Elizabeth Lodge since 2016, and have been able to see them flourish through going paperless. I spoke with Emma Curtis, the manager of Elizabeth Lodge & Amelia Pullinger, the deputy manager to discuss all things Nourish. Amelia was previously a bank staff carer alongside studying for about eight years, before becoming a deputy manager in February 2019.

We used to have these big paper folders of paperwork, which we would all have to sit down and go through at the end of every shift. Things would often get missed out, because by the time they’ve sat down to write their notes at the end of a long shift, people would forget things.

Although we did log things in the paperwork, they were not as detailed as what we have now on Nourish, as we now have the day grouped into all the different care interactions. Before it was just text. Because Nourish enables you to record things as you go, it is more thorough and more detailed.

The mobile handsets have definitely cut down our time on writing. The younger staff, who are used to using their phones, just think it’s brilliant, but there was a learning curve. For some of the older carers, it did cause anxiety and it was a big change.

Definitely, one of the biggest challenges was people who were nervous about technology and didn’t want to change. This did take time, but now they’re more confident using it.

David, our Head of Account Management at Nourish, has worked closely with the team at Elizabeth Lodge over the years and has seen first-hand how they’ve developed: “As an early adopter of the Nourish system, the care team at Elizabeth Lodge have embraced all sorts of changes within the home and have our full support. Three years on, we are really pleased that Elizabeth Lodge continuing to have a strong partnership with Nourish.”

In the residential care home sector, completing paperwork has long been a laborious task, often left until the end of shifts. This was certainly the case at family-owned Richmondwood Residential Care Home in Charminster. But when you walk through the homely hallways and into the lounge today, there’s no frantic scribbling to be heard; only the sound of happy chatter, the hum of Dickinson’s Real Deal and the occasional chirpy bark from Sophie, one of the resident’s Toy Poodle.

The carers station is free of piles of paperwork. They are instead going about their daily care with smiles on faces and small devices in hands.

Like any care home, Richmondwood used to have hundreds of paper records to complete, update and store. Care plans, risks assessments, daily notes, weight charts, fluid charts, nutrition charts; the list seemed endless.

Carers would have to sit down at the end of their shift and spend at least half an hour writing their notes, taking precious time away from the people they were caring for. Lucy Glazer, who co-manages the home with her sister Holly, said: “They would have to free write a paragraph about the care provided in the morning, afternoon and evening covering everything from assistance required and food and fluid intake to mood and activity involvement. They would then need to store these in various different folders; folders which senior carers would later have to sift through in order to review and update the required care plans.”

For Lucy, going digital was a no-brainer but Holly wasn’t so sure.

“I was very hesitant about moving from paper to electronic records,” said Holly. “I’ll admit I’m somewhat of a technophobe and liked the comfort of having something I could physically touch. You knew that if you wrote something down in ink, you could always see it. Of course, a piece of paper could be lost or damaged, but I was just worried about records being deleted.”

Fortunately, Lucy was very thorough in her search for a supplier and knew exactly what she wanted from a digital system. When she came to understand who Nourish Care were and what our system could do, she set about alleviating her sister’s concerns.

“I’d been super keen to go digital for ages but nothing was right in the market,” added Lucy. “When I discovered Nourish Care, their solution was just what I was looking for. It would allow our senior management team to create digital care plans and our carers to make their daily notes on the go with small handheld devices similar to Smart Phones. Being completely secure, nothing could be deleted and everything was instantly searchable in one place. It was great.”

Working closely with the team at Nourish Care, Lucy and Holly were able to configure the system so that their care plans and daily notes were tailored to the care they provide at Richmondwood and to the individual residents’ needs. Carers now see a personalised timeline of care tasks for each resident, so that they can easily see which tasks are due when and add in the care notes directly after the care is provided; either by typing or talking into the device.

Having all of the information accurately recorded in real-time and instantly accessible means that the carers in the home are kept informed of any changes throughout a shift. Not only does this save the carers time, but the senior management team too. Lucy and Holly now see a real-time overview of their home and can search for notes at the click of a button. This makes dealing with external enquiries from health care professionals, family members and CQC inspectors that much simpler.

Care plans are now also reviewed more frequently, because all the information from the carers automatically feeds into the plans and reports can be generated instantly; changes in health or mood are therefore more easily tracked. The quality of the information recorded has improved significantly and as a result, so has the quality of care provided.

Lucy said: “The biggest difference is knowing more. We now record more data than we ever did before and therefore we have more knowledge. It’s definitely improved accuracy. Just being able to manage fluid charts more effectively has had a huge impact. We can input residents’ fluid requirements individually and then a reminder will pop up on the system every couple of hours with fluid levels. It’s the same with MUST scores too. Before, you only had to make one tiny mistake in the equation for the score to be wrong, but that’s all done automatically. It’s amazing.”

Since using the Nourish Care System, the team at Richmondwood have freed up an entire cupboard, which once stored paperwork, and filled it with games and puzzles for the residents. They’ve saved financially on shredding costs, and deciphering hand-written notes or spilling coffee on paper forms are no longer issues. More importantly, they have improved the quality of care they are able to provide and the residents and staff are happier for it.

Lucy added: “There has been a benefit at every level. Yes, it saves time, but it’s what we are able to do with that time that really matters. Physical care and human interaction can never be replaced and the idea of using technology is to give carers more time to actually care. Using Nourish Care’s system also provides Holly and I with peace of mind as we can access the information from anywhere, even when we are not in the home, and provide support to the team if we need to.”

This week it’s Nutrition and Hydration Week, where people are encouraged to raise awareness of the health benefits of eating enough of the right foods and drinking enough of the right fluids. A message which is of great importance in the world of care.

Being well-nourished and hydrated contributes significantly to someone’s overall physical and mental wellbeing, and the risk of malnutrition and dehydration only increases as we get older, as do the consequences. So it’s an important topic in care of all shapes and sizes and something that every care service or provider should bear in mind.

Here are three ways that the Nourish digital care management system can help care providers to effectively monitor the food and fluid intake of the people they care for; minimising the risks of serious health problems, encouraging good health and making it easier to provide a more personalised service.

Maintaining good hydration is incredibly important for a number of reasons; not least because it aids digestion and gives people strength, but also because it can significantly minimise hospital admissions, in the event of falls for example.

With the Nourish fluid intake tool, care teams can set fluid targets for an individual based on a number of individual factors including;

The amount and type of fluid offered and drank can be recorded throughout the day, and total intake will be automatically calculated to show how close to the target an individual is.

To encourage regular fluid intake, checks can be diarised so that care teams will be alerted throughout the day if someone is seen to not be drinking enough because it hasn’t been recorded, furthering to support care teams and help them work smarter, not harder, to provide those in their care with the hydration they need.

Reports can also be generated using data collected over longer periods of time, to help care teams identify if there has been a reduction in fluid intake, and therefore investigate the reasons as to why this might be and flag any potential issues with those they support.

This functionality can also be replaced by a fluid in and fluid out tool if the passing of urine needs to be recorded, for people who may suffer from fluid retention for example.

Care providers who have adopted the Nourish system no longer have to record lengthy and time-consuming written notes on what a service user has eaten throughout the day. Our software features remove the need to try and remember what was eaten and when it was eaten as this information can be recorded at the time the meal was given.

To save even more time, the Nourish system can be configured so that four-week menus are built in, enabling carers to select which specific meal was provided from a drop-down list rather than making them have to type out the details.

Carers are also able to record how much of the meal was eaten, whether the service user enjoyed it and if they required any assistance. All of this information is reportable in a graph format, so that again, trends can be tracked and any issues can be raised.

Finally, food preferences, dietary requirements and allergy information is clearly visible to ensure the correct type of meal is given and there are never any mistakes, another way our systems are designed to help carers provide the highest quality of care possible.

Our elderly population is particularly at risk of malnutrition as the ability to chew and swallow can decrease with natural ageing, health changes and poor oral and dental health. As well as ensuring a varied and healthy diet, care teams should use the Malnutrition Universal Screening Tool (MUST) to help establish whether there is a nutritional risk.

Within the Nourish care system, carers can record MUST scores using the BAPEN scale in just three clicks of a button, all previous or historical numerical data is pulled through from previous scores, migrating the information to eliminate the need for manual calculation and reduce the risk of human error.

These can be scheduled at regular intervals so that care teams are alerted when MUST assessments are due. Reports can also be generated quickly and easily that compare previous records within an unlimited time frame, allowing for the identification of any decline or improvement as well as trends and insights based on this.

With fluid intake, meal preferences and consumption, and MUST scores all recorded/stored in one place and instantly available, updating nutrition and hydration care plans has never been easier or more effective.

To find out how our care software for real-time care planning, as well as our daily notes can enhance the amount of information you can record and help to improve your quality of care, get in touch to book a demo with the team.

This post is by Mabel Lazzarin a User Experience (UX) designer from Nourish who focuses on developing the technology we use for use in social care and home care settings. It was originally posted on Medium and we thought it would be good to share it with you here, as she is helping to shape the way that we evolve our design system for home care.

The world is getting older. The number of older people is growing faster than in any other age group. A combination of low birth rates and longer life expectation is driving the ageing process. This scenario forecasts reduced labour forces, lower investment rates, while expenditure in health tends to increase strongly.

Changes in our society also may raise the pressure on hospital admissions and primary care. Whilst in the past it was part of a cultural tradition that older people rely on family and friends to help out with everyday needs, from shopping and help around the house to a conversation. In an urban or nomadic context, these networks may be less reliable. So attention has turned to how support of this kind can be better provided, sometimes by paid professionals, sometimes by volunteers and sometimes through time banks and exchanges. How might we create better experiences to engage a networking of care?

“People helping themselves, one another and health services represents a set of new social movements for health: changing the basics of how the health system approaches the prevention and management of health, in particular long–term conditions.” The NHS in 2030, Nesta

Emerging technologies are transforming the way people engage with their own health. Patients and carers are increasingly using mobile technology to research information online, share experiences, identify treatment options, rate providers and help to anticipate diagnoses.

Most of these solutions are focused on a younger population. Small buttons, fiddly controls,and unnecessarily complicated interfaces can all be barriers to older users. Certain fears regarding technology due to expenditure of a large amount of money with a low benefit return, breaking the equipment or doing something wrong, could also generate anxiety and frustration for the elderly audience.

The lack of solutions designed especially for elderly people reveals a potential unexplored field to investigate. How digital technologies can bring scale to innovative projects that help older people overcome the constraints of location, mobility or lack of memory. How design could adopt a more holistic approach and explore a flexible ecosystem, integrating technology with elements that are already part of these people’s routine.

Map of existing solutions x basic human needs

Some examples of companies working to build the confidence of older people and their carers in using digital tools to improve their quality of life:

Nesta recently launched Dementia Citizens, a platform that brings together researchers and those affected by dementia to help find ways to improve care. They started with two new apps:

The idea is to gather information submitted through the apps and from questions and feedback sent to the users.

Breezie created a senior-friendly tablet solution in partnership with Samsung. Designed to promote practical and social well-being in ageing populations. With simplified versions of everyday services such as email, games, music or video calls.

The digital inclusion could mitigate the feelings of social isolation and the loneliness, which contribute to better long-term mental and physical health.

Nightingale is a speculative healthcare service created by Method. They have been experimenting with Artificial Intelligence, connected devices (IOT), as well as exploring the value of data as a raw material for design. The result is a software platform to help improve the persistent challenges associated with treatment adherence.

The use of technology to monitor changes in patients’ health status outside of conventional clinical settings has increased the potential for remote monitoring through IoT, apps and wearables. However on another hand, there is a big discussion about the balance between data analysis and privacy. What is the minimum information needed to provide a better assistance?

An interesting case of a non-intrusive solution is Howz. It is a mix of inputs from patient’s network of care and data collected from low-cost sensors. It tracks daily patterns on electrical, lights, heat and movement activities, and send alerts to the family when it spots anomalies. By tracking the use of everyday objects and points of contact it is possible to help a frail elderly, their personal networks, families, hospitals, social and other services stay connected through their daily routine.

Recent advances in the development of bio-sensing wearables are extending their capability to move beyond simply tracking activity. New products are able to monitor continuously a broad range of physiology (from posture to brain activity) and convert this information into outputs, through advanced connectivity and computing power.

GSK and Verily are examples of investors in bioelectronic medicine, a relatively new scientific field that aims to tackle a wide range of chronic diseases using miniaturised, implantable devices that can modify electrical signals that pass along nerves in the body, including irregular or altered impulses that occur in many illnesses. This new technology could impact the treatment of certain chronic conditions such as arthritis, diabetes and asthma.

The circle of care could be integrated by family, friends, volunteers, local community, professional carers. This process could significantly change relationships, putting both caregiver and loved ones in new contexts. Chronic or long-term conditions among care recipients seem to be particularly likely to cause emotional stress for caregivers.

It is a challenge to  balance a personal life and a person’s needs. Some companies are working to offer better information and advice from those who have faced the same situation. Unforgettable, for example, offers support to people with dementia and memory loss. New ways of connecting to professional carers, as Honor or HomeTouch can create new scenarios of mixing care support, alleviating the responsibility of a unique caregiver.

Honour

More than technology and existent solutions, it is important to go deeper about the home care routine, expectations, decision points, challenges, fears, motivations and achievements from different perspectives. At Nourish we are exploring new ideas for a better home care assistance through research: listening, observing, investigating people’s story and real needs.
If you want to be part of this journey. We would love to hear from you!

At Nourish we don’t take the typical path when it comes to care plans. Rather than telling care providers how they ‘should’ go about their care planning, we prefer to learn how they like their own care plans built. We know that care plans are not a one-size-fits-all exercise. There are a whole host of good reasons for care providers to adopt different styles in the care plans they choose to use.

How is a robust care planning template created?

Much has been written about how care plans should be put together. But ultimately, the structure of the care plan template needs to be decided by the senior team of the care provider (including its owners) who will set how the service should be led and by the care managers who will conduct service delivery day to day.

Care planning isn’t just about documents, its about shared journeys with each person

Although it is tempting to shrink the care planning exercise to a structure of needs assessments, a list of support services and the risks involved; good care providers are increasingly recognising that a good care plan covers a representation of a person as a whole. This means they need to cover their wants as well as their needs, their abilities as well as their frailties.

Getting this information goes well beyond an admission interview, or a comprehensive assessment; getting to know a person takes time, and people change their preferences and habits. Care planning is part of all interactions with the person and their close circle of support, family and close friends, not just at discrete times.

Care providers are different and so is their care planning

Some care providers may prefer to tackle recovering mobility with garden activities, others will focus on dancing, this will allow different care providers to resonate with different clients. This is why care plans cannot be the same for all care providers. Because care providers decide, which services to provide and together with their team decide how they are provided, how they are adapted to each individual’s wants and needs, the care planning framework must support the team in this journey.

Fundamental building blocks to a robust care planning framework

The building blocks you need to consider when building each care plan include:

In a modern care planning framework, people receiving care have the ability to continuously give feedback about their care, as well as help to improve and adapt the care they receive. This includes the ability to manage consent, allow a next of kin and other informal carers to record relevant notes, raise warnings and alarms, as well as help to stay involved in the care of the person.

Interactions in someone’s day to day care are typically recorded by carers as daily notes. However increasingly, there is information from connected devices, Telehealth or Telecare equipment, wearables and internet of things (IoT), as well as notes from relatives and volunteers outside of the care provider’s organisation. All of this information, when managed digitally, can be used to automatically update care plans, trigger reviews and enable care managers to have the best possible representation of the context of the person and their care, and feel reassured by the clarity of transparency of the quality of the care being provided.

How can Nourish help with your care planning?

Nourish is designed to support organisations in transforming how care information is managed, with radical improvements to the operation of care services and continuous improvement to care delivery. To find out more please don’t hesitate to get in touch.

We’re going to be attending this year’s Health Plus Care show held in the Excel, London from the 29th to the 30th of June. Billed as the largest national integrated care conference, we’re hoping the event will be a big one for the industry and will be showing off our care management system on stand Q30.

Health Plus Care aims to bring together four different shows, which means that over 9000 attendees from the NHS, care providers, public health and local authorities will be visiting across the two days.

We’ll be demonstrating how Nourish empowers carers and health professionals in almost all health settings, and offering some yummy treats for hungry event goers too. This year we’re also offering one lucky care professional a fantastic spa weekend. All you have to do is visit the stand and talk to the team to find out more.

As a final note we can also provide some last minute guest tickets for any Nourish clients who might’ve missed out on signing up for the event, but still want to go. As tickets are almost sold out at this point, we’d like to make sure all of our clients have the opportunity to attend.

To find out more, drop us an email to caring@nourishcare.co.uk or get in touch  via Intercom and we’ll make sure that you and your team have some complimentary guest passes on us!

We’re looking forward to seeing you there.

At Nourish there are a number of principles that guide our work. Firstly we understand the importance of planning in care, which is why we put care plans at the heart of what we do. Establishing a care plan is key to providing truly personalised care, so we designed Nourish to make that process as smooth as possible.

No two care settings are ever the same, which is why Nourish is flexible and customisable. Our approach is to tailor Nourish to work for care teams, not the other way round. So if a care team has well-established care plans that they are already using, we work with the team to take those care plans online with Nourish – creating the same order that carers are used to. Other settings may prefer to use Nourish care plan templates and then customise them to the care they provide – from nursing care to dementia care to domiciliary care to learning disabilities.

Secondly we use clear, user-friendly design to allow Nourish to fit into carers’ daily work. Care plans can be set up to generate tasks on a daily schedule – for example, if part of a person’s care plan is to monitor a person’s weight loss, daily tasks can be set on the timeline to check nutrition and food intake. Carers have told us time and again that the two hours they used to spend at the end of a shift on paperwork has simply gone, because by the time the shift has finished they have already made all the notes they need to.

Thirdly, care is provided not by a single person, but by a circle of care. Within a residential setting, this may involve the care team, visiting medical staff and family. In home care settings, friends and neighbours may also play a role. With Nourish, notes can easily be made by each person providing care. That information is then stored and organised in the care plan logs in a clear way so that others can access it when they need to.

With all this in place, generating reports no longer involves spending hours retrieving files from the shelves but can be done with just a few clicks, before, after or even during a CQC inspection if required. Care plans can easily be reviewed and audited, which is also vital when it comes to inspection. Reviews may be scheduled, but care teams also have the flexibility to react to changes in a person’s condition which may trigger the need for a care plan review.

Care requires both consistency and flexibility. We designed Nourish to support those needs. Which means care teams can get on with doing what they do best – provide the real, human, compassionate care that enables the people they care for to enjoy the best quality of life possible.

Nourish is proud to announce the launch of a game changing care management product. Writing notes and handling paper records are recurrently quoted as leading contributors to loss of productivity from care providers, and motivation from carers. Nourish removes the chore from daily note recording and care plan updating.

With an all new care integration product, combined with carefully designed mobile apps, Nourish enables carers to record tasks and outcomes on the go. Nourish has managed to bring back the joy of caring, and remove some of the most resource heavy aspects of the job.

Nourish’s apps are completely driven by a secure cloud care plan. This care plan is then used to coordinate everyone who needs to stay in the loop, reducing overall disconnect between families, carers and commissioners. The company is therefore enabling providers to step forward in full alignment with the guidelines of the upcoming Care Act 2015 in all aspects of care integration, community and family engagement in care provision and reporting. Care providers can in turn engage families by offering a secure app to the next of kin, who can stay in the loop of the care being provided.

Nourish Care is exhibiting at stand D14, Birmingham Care Show, 4-5 November 2014.