Radical Paperwork in Home Care

25 February 2015 | By Helen Sanderson

I started to learn about how home care could be different with Hilda. Hilda is a bit of a legend in our team, as she was Gill’s Aunty Hilda, we heard a lot about her and enjoyed her excellent Christmas cake as well.

With Hilda, was developed a process based around a one-page profile, with a clear service specification developed from the doughnut, and used matching support too.

Our next challenge was how can you do this across a whole service? Over the last year we have been working with Lowland Care, part of Real Life Options in Dumfries.  I am getting read for our webinar next Tuesday where Sylvia and I will share in more detail what we did, but here is a summary. It was a partnership with Lowland Care, RLO, the commissioner and the local housing association, and we came together as a leadership team throughout the project.

We started by looking at how people experienced the service now, and Brian, the chief executive of RLO shared the story of someone he had met when he spent the day shadowing one of the care workers. Then we looked at how we could change and improve it, by using person-centred practices. This graphic is a summary of what we have been trying. I guess you won’t be surprised that the new process starts with a one-page profile, and includes a person-centred review. As well as supporting the care co-ordinator and manager to implement this, we also worked with the team. We began by supporting all of the care workers, and the leadership team to develop their own one-page profiles.

 

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I have got a bit obsessed with paperwork recently. I think our paperwork  Рwhat we record and what we expect staff to read Рshows the best and worst of services, and always focuses on what is important for people rather than what matters to them. I am taking a radical approach РMichelle calls me a paperwork ninja РI think we need to have policies and procedures in a way people can read, keep with them and use. My challenge here was to take their 300 plus pages of procedures and develop something that care workers could use in their day to day work. I am proud that I got it down to 38 pages. I took each procedure, looked at what the carer needed to know or do, and stripped it down to:

  • What does it cover?
  • What you need to do
  • What you must not do
  • When you need to contact your manager

We have created a care workers handbook, that also explains why and how the person-centred practices are used, as well as what they need to know and do around procedures.

I am really proud of what Lowlands have achieved, and there is a full evaluation starting now. I hope that we have made a difference to the care workers experience too, with their one-page profiles, and soon they will have their care workers handbook now. They are going to print now, but we have had a few extra done, so if you would like a copy please emailHeather@helensandersonassociates.co.uk.

Here is an extract from the beginning, before the section on policies and procedures:

Every person we provide a service to is an individual. We take great trouble to get to know them and to find out how to give them the best service.

 

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We use a number of person-centred practices to find out as much as we can about each person we work with. We find out about you as well because it’s important that you and the people you work with are well matched, and it helps us to support you too.

The person-centred practices we use are called:

  • One-page profiles
  • Matching
  • Learning logs
  • Person-centred reviews.

In this section we explain how we use them to help you do a great job.

 

One-page profiles and matching

There are three important pages of information that you will have about each person you are supporting:

  • Their one-page profile – to help you get to know the person well, and know how they want to be helped
  • The ‘what you must do’ list for each visit, and a list saying what you must do on each visit and what it is really good to do if you have time
  • The emergency contact numbers for that person.

One-page profiles

The care co-ordinator will develop a one-page profile with the person. This is one page of information that describes what other people like or admire about them (on the one-page profile we call this ‘appreciate’), what is important to them, and how they want to be helped or supported. This is all on one page, and the care co-ordinator will decide with the person the best place for this to go, so that you know where it is, and can see it. For example, it might be stuck on the inside of the mug cupboard.

This is the information that you need to be able to get on well with the person, talk to them about things they are interested in, as well as know the best ways to help them.

Please make sure you know this by looking at it every day until you are familiar with it. Having a good relationship with the person is one of the most important areas of your job. The one-page profile will really help you to do this.

Your ‘must do’ and ‘can do’ lists

The care co-ordinator also writes two lists for you – what you absolutely must do on each visit (for example medication) and what you can do if there is enough time.

Your one-page profile

It is also very important that you have a one-page profile. This is for three reasons:

1) Using your one-page profile for matching

Your one-page profile tells the care co-ordinator what your hobbies and interests are. This is important when he or she makes decisions about who works with whom. The care co-ordinator will try to put together people who are more likely to get on well together, and have interests in common. This makes it easier for you to develop a good relationship with the person.

2) Getting to know you as a person

One-page profiles help us get to know each other in Lowland Care. We have a ‘meet our team’ book in the office with all the one-page profiles of people who work here, and there are mini one-page profiles on the wall.

3) Helping you do a great job

A one-page profile has good information about how to support each other. We need to know how to help each other do a great job, and this is very important information for team leaders.

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