Fastroi to Attend Birmingham Care Expo – Expo is rescheluled until November

It is great to be returning to Birmingham and we are delighted to announce that we have two speaking slots this year. Please note that the expo organizer has informed recently that the show is rescheduled until 9th and 10th of November 2020. 

Seminar Topics

In preparation for this event, we have created two white papers to accompany the seminars. You can download both of them or pick up a paper copy from our stand.

The first presentation will be given by Jim Ward, Fastroi’s UK Head. His presentation will be “Improving the Quality of Social Care Through Technology and Lean Thinking.” The term “Quality of Care” often fails to address underlying poor processes that prevent care staff from providing high quality care. In this seminar, Jim will explore the difference between Quality of Care and the underlying Quality of the processes that often sit, unnoticed beneath them. He will examine how using the concept of Lean Thinking can be combined with an electronic care management system to bring about sustainable improvements in the way care is provided.

Our second speaker will be Mike Richards. Mike is the UK Sales Manager for Fastroi and he will be speaking about how Care Management Software can solve many of the problems associated with the Care industry. To do this, Mike will use stories to illustrate different aspects and scenarios where technology can make better use of resources which ultimately leads to a higher standard of care.

Both of the White Papers for each seminar are available for download here or you can find a paper copy at the the Fastroi stand (H1102).

Conclusion

2020 promises to be another amazing year for Fastroi, as we will be delivering our first major installation to the UK and continuing to grow our operation. This is a fantastic time to come and meet with us in Birmingham and find out how we can help you transform your care business. We can provide solutions to the problems faced by large and small organisations alike. So just drop by the stand for a chat, watch the presentations or even book a one on one meeting with us ahead of the event.

Let’s start our journey together in Birmingham!

Lean Thinking Within the Care Sector

Obviously if the company are still using pen and paper to manage their daily activities, then, they may be finding themselves at a disadvantage when compared to companies who have made the transition to digital tools such as Care Management Software, but it isn’t that simple.

Fine Tuning All Processes

As Fastroi have developed our Care Management Software over the last 15 years, we have realised that the process of running a care company is actually made up of two very different processes that exist together. The first is the care process which covers how you go about administering the care to people. This includes the things that need to be done, to whom, by whom, at what time and to what standard. These are vitally important to ensuring that the care people receive is of the highest quality, but this does not reflect the whole picture of what is happening within a care company.

After the 2nd World War, the Japanese car industry developed new techniques and tools to improve the quality of their processes. Many of these techniques became known as ‘Lean Thinking’ and can be found in businesses the world over. The ideas are quite simple, but the application requires a huge commitment from the whole organisation to continuous improvement.

Our latest White Paper takes a more in depth look at how some simple Lean ideas can be implemented within any care organisation with incredible results. Combining these ideas with Care Management Software such as Fastroi’s Real-Time Care™ will have the effect of breaking the false connection between inspections and quality care. We will look at some examples where a quality mindset has brought about some amazing results from delivering lunches to office workers in Mumbai to finding out how UPS saved a fortune on fuel and time by applying a simple rule when drivers are out on deliveries.

Build Quality into Everything You Do

Simply put, your business won’t need to worry about another CQC inspection as your quality levels will become focussed on constantly improving the way things are done by paying attention to every aspect of the process and not just ticking boxes and hoping for the best when the inspectors come.

We believe that Real-Time Care™ provides the tools that will allow the home care of the elderly to go beyond Outstanding.

Click Here to Download the White Paper: https://fastroi.com/en/lean-thinking-within-the-care-sector

The State of Care Report 2019

In our blog post, a year ago, we discussed how we believe that the adoption of care management software can help providers improve and maintain their overall ratings by automating many of the tasks that take time away from caring. The report reserves a whole page within the Adult Social Care section regarding the use of technology. It discusses the barriers that many companies face when considering starting to use technology, some of the issues that we at Fastroi are constantly trying to address. Issues such as lack of funding, low knowledge levels, fear of replacing personal support and data protection and security issues. One of the most interesting comments was that people are reported to be very cautious about adopting new technologies due to bad experiences in the past.

Long Term Improvements

As always, the four gradings are the first things that we look at. The information within the report only gave data for 2018/19, and there only seems to be small improvements over the last 2 years in any of the 4 ratings, but a quick look into the archives, found that the data has been presented in a similar way for the last 5 years.

Fastroi CQC State of Care report blog

Statistics from 5 years worth of CQC State of Care Reports detailing the variation in Adult Social Care ratings. *

From this we can see that actually, while the numbers may have plateaued for the last 2 years, there has been a significant improvement in the results over a 5 year period. Inadequate results have fallen from 7% down to 1%. Requires Improvement fell by 18%, Good has increased by 21% and Outstanding has gone up 3%. If we look at the values for Inadequate and Requires Improvement together, then we can see that these values have dropped from 40% down to 16%. These are excellent results that seems to have been missed by the CQC. If the industry can continue this steady improvement, year on year, then the quality of care that the industry provides looks good. Perhaps the thing that is needed now is to try and get the number of Outstanding ratings to improve more.

In addition to this information, this year, the report focuses on how the system is failing both the service users and the care workers and the fact that the statistics continue to improve even slightly is a testament to the staff working in the sector.

Funding Problems

The most glaring piece of information within the report was the figure on page 40 is that only 1 in 7 councils in the UK are paying local domiciliary care companies enough to to allow them to comply with the National Minimum Wage. So if it is not financially viable for care companies to take on local authority funded service users, instead opting to take on more privately funded service users. This could be one of the reasons why there are 1.4 million older people who are not getting access to the care and support that they need and of the 7500 unpaid carers interviewed, the majority were providing more than 50 hours of care per week.

If we ever want more than a few percent of care services to to be rated as outstanding, then they must be paid properly for the work they are doing. If Local authority funding doesn’t even meet the minimum wage, then how does the industry expect to be able to recruit outstanding people who can then provide outstanding care.

*Reference: 2018/19: P34, 2017: P55, 2016: P19 and 2015: P12.  

Fastroi-Tiera-asiakaspaivat-2019

Fastroi’s yearly Customer Training Days in Finland

The main difference seemed to be that the general attitude towards social care in Finland is a lot more positive than in the UK. The people who work within the sector are held in a lot higher regard and one of the biggest areas this is reflected in, is the amount they are paid to do the job, as well as the role being seen in a similar light to nursing. The main similarities were that in both countries the people who work in social care are deeply committed to their jobs and the people they support, and also to making a positive difference in their lives. The other thing I noticed,  was that by making digital improvements within the way they work, it has a big impact on improving how you deliver a service and the outcomes of the people receiving it.

We do it Together

The Fastroi and Tiera training and yearly customer days were held at Tampere House on 4-5 September this year. Across both training days, there was a total of over 220 participants. The theme was “We do it Together” and we took this theme into account throughout the whole program. We organized the event in cooperation with our biggest customer, the Kuntien Tiera team. During the days, numerous workshops were held on the different features of the RTC and Nappula systems, interesting discussions were held between different actors in the social care field and some networking also took place. The evening program featured pampering and crafts followed by a dinner and live music.

Our partners join the event too

Fastroi Real-Time Care™ can be connected to dozens of systems through its interfaces. In addition, our partners,Kuntien Tiera, Atostek, Causalus, Parasta Palvelua, Raisoft, Tunstall, Visma Solutions/Netvisor and Vivago , presented and explained how their software can be utilized by our RTC system customers.

Feedback from the training days

We asked our customers for feedback during the event.  They told us that training in small groups was very useful based on how they work within their own organisations. Our customers also appreciated listening to others’ experiences & practices of using the software and networking with others was also a big part of the training days. In addition, we received suggestions for improving the content of the programs and training for next year’s event.

We also conducted a feedback survey after the event, almost 82.3% were satisfied or very satisfied with all the training days and content (45 respondents). Tiera Mobile Home Care Days and the educational content reached 100% satisfaction (18 respondents). Our clients appreciate and enjoy our annual training days and are were happy to note that we were able to provide the same level of content that they found interesting as the other years we have had the training days. We are working on developing the event so that we can create a whole new kind of program for next year’s training days.

A big thank you to our clients and partners who participated in the training! Hope to see you again next year!

Crisis in Care – Thoughts on the Panorama Documentary

They are Us and We are Them

When we heard about the 2 part BBC Panorama documentary looking at Crisis in Care, we knew as a technology provider for the care industry, we had to watch it.

Care Services at Full Stretch

The programme left us feeling somewhat deflated. The documentary focussed on numerous people in Somerset who were facing issues with the care they received from Somerset Council. Carers were being stretched beyond their limits as the levels of services were being cut year after year.

It was reported that Somerset Council had overspent on their budget and needed to find £13m in savings. This meant that libraries were closing, children’s services were being cut, the roads were being gritted less in winter and 120 jobs were being lost. Of the £13m that needs to be saved, £4m was to be cut from adult social care.

Funding Conflicts

There is a funding conflict between the service users, the local councils and the NHS. Service users are forced into financing their own care until they have less than £23,250 in savings or assets (that includes the homes that they may own). Social workers fight on behalf of the service users to get the NHS to pay for care if their medical needs are sufficient, but this is under constant review, so it could all change in as little as 3 months. The pressure on everyone involved must be tremendous. The commitment of the staff working in the care organisations was clear but the system is clearly under strain and as the population ages, the amount of funding needed to care for them needs to be going up not down. Something is not working correctly if the number of care places has fallen by ½ million in the last 9 years.

It is difficult to see how Person Centred Care can be achieved in this environment. We find ourselves asking what kind of difference Care Management Software can make in a situation where the gap between the amount of funding and the cost of running the service is so large that even the largest care provider makes losses of hundreds of thousands of pounds every year.

Whether people need care due to illness or old age, it shouldn’t matter who pays for the care. It is frightening to think of how much money is wasted in meetings alone, between social workers and the NHS as they try to decide who pays for an individual’s care. If care is needed it should be there. For an elderly couple to be forced into selling their assets to pay for care after a lifetime of paying taxes does not seem like the right thing to do. Neither should any vulnerable, elderly person be faced with the prospect of living in isolation due to the care she needs being scaled back.

The Panorama documentary made for difficult viewing and one can only hope that when it is screened in Parliament, enough MP’s will feel compelled to do something. One thing is clear to us as a technology provider. We can help and while we may not have the ability to solve all of the issues around how and who funds social care in the UK, we are in a position to change the way care is managed and if that can help free up more resources to provide better care in a more accountable and robust way, then we are doing our bit. We must never forget that at some point, any one of the people in the programme could be us or one of our loved ones. Their stories are our stories.

The Humble Checklist and its Use in Domiciliary Care

Lessons from Disaster

Major Pete Hill was the chief test pilot of the US Army Air Corps and he had the responsibility of testing the plane. As Major Hill took off, he must have realised something was wrong quite quickly. He wasn’t able to level off the plane and it kept on climbing until it quickly stalled and fell back to Earth killing all on board. Boeing carried out a meticulous investigation into the crash and they found that the plane had no mechanical faults but that the pilot had forgotten to unlock the elevator control flaps. This meant that they were locked in place making it impossible to level off the plane after take off. In response to this, Boeing created something that would change the airline industry. It wasn’t more training or more technology that was needed. After all, Major Hill was one of the most experienced and well trained pilots of the day. The problem was that the pilots had become overwhelmed by the complexity of what they were doing. Simply put, humans are fallible and prone to forgetting things. So in order to resolve this Boeing created the ‘Before Flight Checklist’ and it led to such a significant improvement in aircraft safety.

Surgical Checklists

This story was told by Dr. Atul Gawande in his book ‘The Checklist Manifesto’. Dr. Gawande developed a Surgical Safety Checklist in 6 hospitals around the world ranging from the UK, Tanzania, Canada and the Philippines. The results were impressive. Postoperative complications and death rates both rates fell by 36 percent on average. Dr. Gawande realised that the levels of complexity that had developed in medicine meant that there was more specialisation. This meant that there was more team activity for every case than in the 1930’s, when a single Doctor would manage the treatment with the support of a small nursing team.

‘Confirm – Do’ Checklists give Peace of Mind

So with a well written checklist, we can see that significant improvements can be achieved not only in the way individuals work but also in teams. With Fastroi’s Real-Time Care™ we were able to implement checklists into the domiciliary and residential care system – While we call them task lists in RTC, they are essentially checklists for the care workers to ensure that nothing is forgotten. We understand the power that taking the pressure off of care workers and placing it within the tools and processes can have on staff. As with any activity, if we record it, then we can prove that it happened. Having this kind of checklist built into Care Management Software, we are able to provide the care staff the reassurance that everything they need to do during a visit will be presented to them in the form of a task list which can be customised for every visit. As every task is confirmed as ‘done’, it is saved on to the server so that an electronic record of the visit exists which can then be used to evidence what was done during the visit.

Where an electronic task list can be superior to a paper based one is in the level of information and detail that can be incorporated. We can add information about the clients needs, wants and requirements so that it becomes truly person centred. The checklist has changed the lives of millions of people from aircraft passengers to patients in operating rooms and their families. The beauty of the checklist is that it also benefits the airlines and the engineers who prepare the planes and the surgeons, nurses and other OR staff who no longer have to worry about forgetting a critical activity brought about by unmanageable complexity.

By skillfully designing the checklists into the tools that are being used for reporting, recording and planning we can reduce the chances of mistakes being made due to staff being under pressure. Less mistakes means greater quality, greater quality means better care.

5 Top Tips to Providing Better Care

If you are, then it might be time to consider moving to a digital solution. Care Management Software to be precise. If you’re not sure what this means, then we have put together these 5 Top Tips for providing better care with Real-Time Care from Fastroi.

Step 1. Analyse your Current Situation

Running any care business is not easy. Margins are tight, the pressure to give the best care possible is high and above all, you are responsible for caring for people’s loved ones. However, it is worth taking some time out to look at the way your business is being run. Analyse the information that the CQC have provided you in their reports. It’s really valuable to have this kind of objective feedback! How have their ratings changed over different reports? Have you had good reports followed by not so good ones? Have you struggled to maintain the high standards you hope for? Is your business still being run using a pen and paper? If an incident happens, how do you modify the way you work in order to prevent it from ever occurring again? How do you communicate with your staff, customers, their relatives or other agencies?

Step 2. Identify the Process Issues

If you have identified the areas where your business is struggling to maintain a high level of care, it is time to look at the ways your care business works. Many times we are so busy with our work, that we don’t even realize that many of the activities we do on a regular basis are simply process related tasks. We do them because we have always done them. Whether this is preparing the weekly staff rosters, writing up reports or even holding a weekly or daily staff meeting that highlights any issues. All of these activities and others, take time away from the main activity of caring for people.

Step 3. Take Steps to Control those Processes

There are many ways that an organisation can improve their processes, but one of the things that we have found is that people are often being expected to bear the burden of poor processes. By this we mean that instead of automating basic tasks such as rostering, invoicing or reporting, the staff have to carry this additional burden on top of their regular duties. This are two consequences to this. First, the staff feel that most of their time is spent on paperwork or other admin tasks and secondly, the staff spend less time away from the things they should be doing – namely caring for others. The result of this is reduced productivity and a higher risk of mistakes.

Step 4. Automate

As we saw in the previous step, poor process control leads us to reduced productivity and a higher risk of mistakes. Investing in automation can be one of the biggest game changers to improving the performance of a care service. Now we don’t mean having robots taking the place of care staff. What we mean by automation, is the idea that many of the tasks that are still being done by staff using pen and paper can be done much more efficiently using a digital based solution. We still want to see people in the care roles, looking after others, but we don’t want to see them stretched to breaking point because of tasks that can easily be carried out. Imagine if a report on a domiciliary care visit could be completed and saved before the carer has started the engine on their car? Any issues could be immediately flagged up and dealt with instead of waiting until later in the day for the report to be submitted. Imagine being able to automatically plan your staff rosters and have the flexibility to adjust is a staff member calls in sick. These are just some of the basic things the are possible. As you dig deeper into the possibilities, it becomes clear that care management software can address many of the issues that bring down many CQC ratings. Connected care plans, lone worker protection, medication control, alerts to name but a few. In fact, by automating many of the tasks, you could start to regain control of your processes and improve the overall quality of care!

Step 5. Arrange a Demo!

Fastroi have been developing our ‘Real-Time Care’ – care management software in Finland for over 15 years. In fact, we have about a 60% market share there. From large cities and municipalities to small privately run family businesses, we are the natural choice for many. We are now growing our UK side of the business and we are seeing the same levels of interest as back home.

We believe that every residential and domiciliary care service deserves to be rated as ‘Outstanding’ because of this, we would like to offer you a free demo of the product and a consultation about how Fastroi can help you become ‘Outstanding’.

You can also meet our team in Birmingham at the Dementia Care and Nursing Home event on the 26th and 27th of March.

Comparing the Scottish Care Inspectorate to the CQC in England?

As we head into the new year, we are planning to attend the Digital Health and Social Care 2019 in Edinburgh in February. As a result of this, we decided to take a look at how Scotland deals with their care environment.

Where the CQC operate in England, a body called The Care Inspectorate is responsible for the quality of care North of the border. We have been very impressed with the quality of the CQC reports and the data that it provided. It gave us the opportunity as a software vendor looking to enter the UK market, to gain a significant insight into the issues that many residential and domiciliary care services are facing.

Comparing Apples with Apples

The Care Inspectorate publishes reports from their inspections, however they have recently changed their inspection process. We looked at data from May 2018 (we have assumed this to be the old inspection framework) and data analysed in January 2019, relating to the second quarter of 2018/19 (assumed to be new inspection framework). Care Inspectorate Scotland have indicated that they will start using the new approach in care homes for older people from July 2018.

The old system assessed the quality of services against 4 criteria, with no overall quality assessment score being given. The criteria were: Environment; Staff; Care & Support; Management & Leadership.

There are 6 quality scores, plus a ‘Not Assessed’ option which was frequently used:

The new framework is structured around five key questions with the same score system and again, no overall grading:

  • How well do we support people’s wellbeing?
  • How good is our leadership?
  • How good is our staff team?
  • How good is our setting?
  • How well is our care and support planned?

Even looking at a small data set of 17 care services, we have been able to see that the percentage of ‘Weak’ and ‘Unsatisfactory’ assessments is very low for both residential and domiciliary care services. Something like 3-4%. This corresponds to figures in the CQC data of 20-25% of similar ratings of ‘Inadequate’ or ‘Requires Improvement’.

How Accurate is the Data?

We also see some significant improvements as we move between the old and the new inspection system. One thing we observed,  is that comparisons are difficult to make due to the fact that the assessment criteria in Scotland changed, but it is also quite different to the way the CQC carry out their inspections. One aspect of both the old and new reporting system that makes the data difficult to interpret, is the use of ‘Not Inspected’ in the reports. We saw many reports that didn’t seem to carry out a complete inspection. This was concerning, since many issues are interconnected. For instance, not inspecting ‘Management & Leadership’ will not give a complete picture of how the overall service is run. The lack of a single aggregate score also makes it harder to get a quick view of how well the service is performing.

The Digital Solution Still Makes Sense

The reports also showed an apparent lack of authority on the part of the Care Inspectorate to bring about change within services. Many reports made recommendations which were still being raised as issues, in follow-up reports. It seems that there is little point to having an inspection system, if the inspections are incomplete and any recommendations are not enforced.

The overall feeling from looking at the reports, is that the inspection system in Scotland is not as demanding as the CQC in England. The percentage of services that are Weak or Unsatisfactory is much lower, which begs the question – Are the care services in Scotland doing much better than those in England? Or is the inspection system just more rigorous in England?

We are very keen to learn more about how care services are regulated in Scotland, since we are sure that many of the issues faced in Scotland will be the same as those seen in England, and as we have pointed out in our White Paper, most of the most severe issues can be solved with the implementation of a good care management software system such as Real-Time Care from Fastroi.

We will be attending the Digital Health & Care conference at Dynamic Earth in Edinburgh on the 20th and 21st of February. We look forward to meet you there!

The CQC State of Care Report. 2017/18 – Part 2.

Maintaining Standards is Not Easy

The original rating clearly has a significant bearing on this statistic. If the original rating were Good or Outstanding, then no change is a perfectly satisfactory result. In addition to this, services receiving a poor original rating have a clear incentive to improve. For services graded as Inadequate, there was an 89% improvement in the overall ratings, which by any standards is impressive.

The question is – What happens next? The data shows that 25% of services rated as either Good or Outstanding declined during the following year.  So the ability of the services to maintain their ratings from year to year is an important factor which is of real interest to us at Fastroi. The report acknowledges that high quality of care is not easily maintained and cites several areas that might lead to a ratings decline.

58% – No change
25% – Improved
17% Decline

Source: CQC State of Health Care and Adult Social Care in England Report 2017/2018. P31 Fig. 1.7
State of Care 2017/18: Full report PDF | 3.73 MB

A lack of leadership and governance is one of the major causes of declining quality, since the systems are not in place to monitor quality levels. Failures in medicinal adherence also puts customer safety at risk. Continuity of management and staffing concerns also carries risks for quality. Reliance upon short term agency workers is not cost efficient and also lowers the continuity of care that is so important to many customers. The report told the story of one person who received 42 different care workers in 1 week.  Staff retention levels are also affected by poor training and development, low wages with zero hours contracts and difficult working conditions. Poor relations between providers and managers have lead to out of date care plans, missing information, poor training and support for new staff and bullying to admit more customers.

Care Management Software Makes Helps Maintain Standards

It is clear that many of these services cannot be using any kind of Care Management Software. They may be able to make short term improvements and deliver high quality care for a short time, but they will always be susceptible to external factors. If changes creep in slowly, then they may be difficult to control and may only be spotted at the next inspection. If they occur quickly, then the results can be catastrophic.

Care Management Software is so effective because it is the tool that controls the process, not the person. This is significant because all of the issues mentioned above could not happen if the processes were properly controlled. It should be very easy for a manager to use the Care Management System to present all of the information about staffing levels, bed availability to service owners making the service less susceptible to influence or pressure. Staffing would become more stable, with staff feeling more comfortable in their positions and not being asked to run the service over capacity. This in turn will lead to higher retention levels and less agency staff being needed, lower costs, higher profits and a much less stressful environment. The result – Higher Quality of Care.

By running a Care Management System that controls the processes, services can improve and maintain the quality of their care from year to year. Clearly, achieving a Good or Outstanding CQC rating is not easy, and maintaining the rating also has its challenges. Employing a Care management System such as Real-Time Care from Fastroi, gives service providers and their staff the right tools to achieve Outstanding results for years to come.

The CQC State of Care Report. 2017/18

The Data Tells a Story

Through our analysis of the open data on the CQC website, we were able to learn a great deal about the issues that residential and domiciliary care companies are facing. We published the results of our analysis in a White Paper back in the Spring. The latest report from the CQC gives us a chance to look for any significant information that will help us understand whether we are supplying a product that meets the needs of customers in the UK.

We have focussed mainly on the Adult Social Care section but it is interesting to compare some of the higher level figures with the other sectors in the report. For example, there is a significant variation in the overall ratings across the sectors. Having a 30% variation across sectors ought to be setting alarm bells off across the industry.

96% of GP surgeries are rated as good or outstanding!
82% for Adult Social Care
78% for Mental Health
66% for NHS Acute care

Source: CQC State of Health Care and Adult Social Care in England Report 2017/2018. P29 Fig. 1.5.
State of Care 2017/18: Full report PDF | 3.73 MB

From this statistic alone, parity of care is clearly still a long way off.

How Does Technology Help CQC Performance?

Some other interesting things to note from the report. There is a huge amount being written about how technology can best be used to improve outcomes in both health and social care. The report only has a short paragraph which covers less than half a page on technology. One area that would be very interesting would be to understand the relationship between CQC performance and adoption of technology. This correlation is of particular interest to us at Fastroi and we will be looking into this in more depth the next blog.

The state of the adult social care system makes for interesting reading. The CQC inspected some 22,000 adult social care services which gives the industry a huge amount of actionable data. One of the more sobering statistics has seen the rate of emergency admissions for older people rising by 24-37% across the age groups. Clearly more work is needed to ensure that people are discharged from hospital as quickly as possible and can find the right care package as quickly as possible. One other aspect would be to understand the reasons for this increase and what could be done to reduce this.

The overall message from the report is one of maintaining the current situation. But with many services stretched to the limit, it is clear that improvements will be difficult to achieve. In our next blog, we will look at the causes and solutions to the problem of care companies who achieve high ratings one year, only to see them fall in subsequent years.