Understanding how the current paper-based routines look at any given care home, makes us wonder what this is all about. How so much time has come to be allocated to documentation has its reasons and own course. Meanwhile, a lot of time is consumed producing more negativity and constraints than promoting actually improved care outcomes.
A few articles have been well worth the read, examining the pressure on care homes evidencing the care they provide.
“If it isn’t recorded, it didn’t happen”
Creating a transparent auditing trail is required, for when authorities like the CQC come knocking. All documentation must be up to date and easily accessible. However, these articles unanimously question how heaps of paperwork are of any proper assistance here.
One of the findings of the Joseph Rowntree Foundation, when examining this field, was a risk of staff being assessed based on their ability to produce paperwork – rather than their actual skills for care. As the sector is facing a struggle of attracting new employees, this looks like an issue needing to be worked out.
Also, when the paperwork is partly fuelled by the fear of litigation, simply reducing the amount of paperwork that carers need to do cannot be the answer.
Looking at how paperwork is being compiled and done in the care home reveals a certain necessity for support and streamlining. Forms being duplicated and never cross-referenced with their respective or updated care plans doesn’t safeguard neither residents nor care workers, who ideally would be able to showcase what has been done to meet the individual wishes, interests and needs of any given resident, any given care plan, any given day.
At a glance, care and paperwork seem like two incongruent concepts. How can you even measure care? How is a meaningful conversation scored? The real question is probably more likely to be if we should try this at all?
In the research by Joseph Rowntree Foundation it was found that while care plans are important for securing that the needs of the residents have been fulfilled, there is also a risk that the single resident’s voice could be lost when he or she is deemed a set of needs rather than an actual person.
“In risk assessments, the focus tends to be on avoiding risk rather than on managing risk and enabling residents, whose wishes and priorities can be a secondary consideration. Paperwork associated with staff supervision and performance is rigorously assessed by regulators yet does not always result in effective staff development. These are just some of the areas in which paperwork does not necessarily help achieve intended outcomes.”
Recently, Jenni Mack from Holmes Care published a blog sharing a fine and granular best practice distinction between person-centred and person-led, opening up for a more preference-based service approach:
Paperwork is the never-ending ever-increasing burden and the mountain just keeps on growing and growing unless you tackle the root cause of the problem. At the same time, the ministerial “Cutting Red Tape” paper announces a lack of consistency between LAs creating insecurities with providers. Again, leading to over documentation.
In this “Review of adult social care – residential and nursing home sector” paperwork is mentioned 39 times. Only to be surrounded by negative stereotypes such as “unnecessary”, “burden” and “duplication”.
Out of 49 responses, 25 people raised the issue that “Paperwork takes staff away from care”. The top ringer only evened out by another 51% also stating that “Duplication of local authority contract monitoring requirements with CQC inspection requirements”. Read the full report “Cutting red tape” here.
Altogether, making a case for a somewhat different format and scope. Something much more outcomes based seems in the making.
“The review team heard that an important concern for providers is what they report as the disproportionate time spent on form filling and pre-inspection work and how this significantly impacts on the time staff can spend with residents.”
Sekoia
