Reviews of people’s care and support plans should be completed more frequently than once a year, a report by Healthwatch, the service user watchdog, has said.
The report said reviewing care plans should instead be a “continuous process”, particularly in cases where a person’s ability to do things for themselves might be changing rapidly.
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Under the Care Act 2014’s statutory guidance, councils should review care plans no later than every 12 months though this is not a legal duty.
Missed medication
The report looked at the experiences of people using home care services. It included information from 52 local Healthwatch organisations, and the experiences of 3,415 service users, their families and frontline staff, collected through events, surveys and site visits.
It also found that care workers were frequently unfamiliar with their clients’ care plans and when it was a staff member’s first visit, there was often not enough time to read the plan. In some cases, this was leading to “serious problems”, such as medication being missed.
A survey of 363 people in Newcastle, found one in seven had experienced medication being missed because of the home care provider. One in six respondents also said they felt the provision of medication was either “partly” or “never” safe.
The report recommended that automatic notification systems could be introduced to update staff about important changes to care plans, or prompts could be left around people’s homes as a reminder of their preferences.
Lack of time
The report also said local authorities needed to be more realistic in care plans about how much is achievable in the limited time available in most home care visits.
It found that only half (56%) of 73 people responding to Healthwatch Blackburn with Darwen’s survey felt there was sufficient time to complete all tasks set out in the care plan.
A service user told Healthwatch Redcar and Cleveland: “Sometimes they give me a shower but they go over their time but most of the time they haven’t got time to give me one so I go a couple of weeks without one and that’s not right, I feel dirty.”
Home care workers in Torbay also reported “unrealistic staff rotas” that left them exhausted and having to carry out double-handed care tasks on their own.
Some service users also reported that staff lacked basic skills such as being able to boil an egg or make a bed, which resulted in poor care.
Neil Tester, deputy director of Healthwatch England, said: “We heard examples of compassionate care from dedicated staff, but people also talked about care that doesn’t meet even basic standards. Given the challenges facing the social care sector, it’s more important than ever than ever that people’s voices are heard.”
Margaret Willcox, president of the Association of Directors of Adult Social Services, said: “Most adult social care services in England are providing people with safe, high quality and compassionate care. That they are doing this in the context of rising demand and inadequate funding is a tribute in itself, but there is always room for improvement.”
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It is not the care plans that need reviewing but the care providers. The care plans need to take into account action time during each visit. Ie prepare medication. Bathe/shower/shave and clear up. Dress patient. Give food/drink and write report. This cannot be done in 30 minutes and the carer must NOT have to shave travel time off each visit between customers. There is no accounting for travel time so a carer arrives delayed and hassled and always trying to catch time up as the next customer is waiting, probably a few miles away. Care providers do not train staff either leaving customers open to poor care and in some cases abuse. Care providers need the shake up. Not the poor patient who will be feeling under more stress and upset and constantly being reviewed. Such people need dignity and respect not to be made to feel as if they are a nuisance to society by needing support and constantly hassled by social workers checking up on them. Remember-the days of having a named social worker are gone. What one reviewer thinks could be totally different to what another writes up and leads to more appeals and reviews which cost MORE money.
First- get the care worker to actully read the care plan! Many don’t bother.
Second – ensure the care worker understands the care plan! Many don’t.
Third – get the care worker to realise that care plans are for the individual and said care worker should not be following the care plan for a different client – happens all the time!
The above points are only useful if the care plan itself is workable, accurate, well written, relevant to individual need, not copied and pasted from somebody else’s care plan, provides manageable and clearly defined instructions and is produced by somebody who knows what they’re doing.
So if Hyperthetically there is enough time to review more than once … which there isn’t and all is not good, then What??
The whole care industry needs a review, low pay, extreme pressure, poor retention and recruitment.
Providers in my experience do the best they can majority work hard and are dedicated.
Poor time allocation is a resource and financial issue, a response to continued austerity measures, more needs to be done.
It would be interesting to see how many local authorities are actually able to comply with the duty to review annually before we try and suggest increasing it without and additional staffing resource.