Worked Example Provider Information Return: Is the Service Effective? (Example of a Good

Worked example – Provider information return: is the service effective? (Example of a good service)

Suitable for care home and nursing home settings.

Note: This worked example provider information return (PIR) is for illustrative information only. It may be used by a care home or nursing home as a basis upon which to complete its own PIR but should be fully customised and adapted to the specific needs of the home concerned.

2a. What do you do to ensure the service you provide is effective?

By effective, the Care Quality Commission (CQC) means that people's care, treatment and support achieve good outcomes, promote a good quality of life and are based on the best available evidence. In residential care, this means that people are supported to live their lives in the way that they choose and experience the best possible health and quality of life outcomes.

Providers should consult the Provider Handbook: Residential Adult Social Care Services, CQC, March 2015.

• We surveyed our residents and 97% of people rated our service as excellent for effectiveness; 3% rated our service as good.

• Our staff development programme ensures needs are met consistently by staff who have the right competencies, knowledge, qualifications, skills, experience, attitudes and behaviours. Our target is to have 100% of staff trained and competency-assessed in: compliance training, e.g. manual handling; service-specific training, e.g. dementia; and personal development training, e.g. English for speakers of other languages. Our current statistics are: 94%, 92% and 75% respectively.
• Staff have induction which begins on day one of starting with us and is developed over the first 12 weeks of employment; this gives them the skills and confidence to carry out their role and responsibilities effectively. We have recently adapted our induction programme to reflect the Care Certificate.
• Our registered manager has attended external seminars run by CQC, the Health and Safety Executive and external training providers, in order to keep abreast of new research, guidance and developments. These are disseminated through the workplace via our staff newsletter, supervision sessions and staff training.
• We have begun to form links with organisations that promote and guide best practice. We use these to train staff and help drive improvement.
• We regard supervision and appraisal as vital tools to develop and motivate staff and review their practice or behaviours. Our target is to undertake five annual supervision sessions plus an annual appraisal on all staff every year. Our current compliance is 86%. This is because we needed to train line managers to undertake supervisions correctly.
• We are fortunate to have a group of volunteers called friends of the care home. These volunteers add great value to our service and are equally supported and trained for the role and tasks they carry out.
• Staff understand and have a good working knowledge of the deprivation of liberty safeguards (DoLS) and Mental Capacity Act 2005 (MCA) and they put these into practice to ensure that people’s human and legal rights are respected. For example people are always asked to give their consent to their care, treatment and support.
• Our observations show that staff consider people’s capacity to take particular decisions and know what they need to do to make sure decisions are taken in people’s best interests and involve the right professionals. This is evidenced by staff recordings.
• We are very proactive regarding health and observations and supervisions show that staff know the routine health needs and preferences of people and consistently keep them under review. Our audit reveals that we made appropriate referrals in 100% of cases in the last year.
• Everyone has a nutrition and hydration plan; this identifies any risks associated with poor nutrition, dehydration, swallowing problems and other medical problems. These plans are regularly monitored and reviewed and relevant professionals and people using the service are involved.
• Our survey results indicate 91% of people who use our services rate the quality of food as excellent and 6% rate it as good; 3% rate it as satisfactory.

• Continue to develop our staff development programme to achieve 100% compliance in the three types of training. Timescale: within 12 months.
• All staff to have completed the Care Certificate. New staff will complete the certificate within 12 weeks of beginning it, and existing staff will complete it within the next three months. Timescale: three months and on-going.
• Build on the links formed with organisations that promote and guide best practice in order to use this to train staff and help drive improvement. Timescale: 12 months.

 Develop partnerships with other local care providers to arrange joint training of staff to improve efficiency and effectiveness via discussion and reflection. We would like to set up a Skills for Care Workforce development innovation fund (WDIF). Timescale: 12 months.

• Improve our systems to provide information to service users in an accessible format. While these are in place we feel that there is room for improvement via assistive technology such as iPads. Timescale: 12 months.
• Work towards 100% compliance in undertaking five supervision sessions plus an annual appraisal on all staff every year. Timescale: 12 months.
• Appoint and train champions within the service who actively support staff to make sure people experience good healthcare outcomes leading to an outstanding quality of life. We aim to appoint six health champions and to always have one health champion on duty. Timescale: begin now and complete within 12 months.
• Improve the care home environment to better promote people’s freedom, independence and well-being using decoration, signage and other adaptations in accordance with best practice set out by the Dementia Service Development Centre at Stirling University. Timescale: commence now and completed within 24 months.
• We would like to work with families to ensure that people feel informed about and involved in their healthcare and are empowered to have as much choice and control as possible. At present families feel that they should have the ‘final say’ and this means that people’s needs and preferences are not always taken into account consistently. We will work with families to educate them to empower people who use our service. Timescale: three months and on-going.
• We are working towards the Gold Standards Framework in end of life care. Timescale: 24 months.
• Improve the specialist or adaptive equipment available by researching new technology and attending trade fairs. Timescale: 12 months.
• Build on our good links with dietetic professionals to ensure that our nutrition and hydration plans are robust and based on best practice. Timescale: three months and on-going.
• Carry out random blind care plan audits to ensure that staff are aware of people’s individual preferences and patterns of eating and drinking. Timescale: three months.
• Work towards 100% of people rating the quality of food as exceptional. Our chef and cooks are enrolled on a professional development course and we plan to review best practice around care home food and implement the best aspects into our care home. Timescale: 12 months.