At the start of #youcancare week we look at how we’re using technology to change how we demonstrate to care workers that their judgement and skill is valued and trusted. CoCare is an app and information portal designed to capture the information that matters the most – information about people’s well-being, their social care needs and health conditions. It’s an easy-to-use information platform, too with messages that help families stay informed and notes and workflow for professionals to share vital information. Reporting is designed to help develop better care for individuals and better contracting with care providers – and supporting outcomes based commissioning.
Piloting in Southwark
We’ve been piloting CoCare in an extra care facility in Southwark. Somewhere between care in people’s homes and residential care is the concept of extra care. It’s a bit like sheltered housing plus. Inside this extra care facility are stories, important stories that aren’t always being told.
CoCare does monitor visits. And when we started piloting CoCare, care workers were suspicious. Many of them have worked in people’s homes in the community and they’ve experienced traditional call monitoring. They’re used to having only enough time to do the task that’s on the sheet – help someone get dressed, get breakfast and then they only have time to write all that down in a notebook and then get out. They also know that traditional call monitoring is about monitoring them – what they do and where they are.
Initially we found care staff using CoCare in this ‘traditional way’ – seeing themselves as the monitored and measured. Staff tended to fall into two categories – the super-compliant and the non-compliant. The super-compliant were recording everything. They were writing down all the things they do that are supposed to happen as a defensive mechanism – demonstrating that they are doing their job.. The non-compliant weren’t recording much of anything. It doesn’t mean that they weren’t doing their job, it means they weren’t comfortable being asked to gather the information they assumed would be used to make their work lives harder and give them even less autonomy. They know that we’ve developed a culture of care where care workers aren’t trusted and they don’t trust that this is tool designed to help everyone in the care system.
Monitoring the little things that make a big difference
CoCare is different. CoCare is designed to help care workers monitor the care needs and conditions of people who need care. It’s designed to help families and care professionals work together to set and monitor goals. But when care staff have been used to a regime where all the monitoring is about them, it’s hard to switch to mindsets.
It’s a management job to get people to use systems, but it takes a shift in mindset to use systems in a different way. Our ‘non-compliant’ care workers are now recording and we’re getting the super-compliant staff to stop seeing CoCare as a defense mechanism to prove they are doing their job and to focus instead on proactive communication. We are starting to see people using CoCare to record things that need to happen but also to share things that bring people joy and make a difference to their lives. If we spend too much time recording the things that are supposed to be happening anyway, we can miss the little things that make a big difference.
The CoCare way of recording personal goals, means that everyone in someone’s care circle can see what the goals are and help them to achieve them. Some people have goals to maintain mobility, and staff broke this down to measurable, actionable goals of walking instead of using a wheelchair to go to communal activities, for example. The visibility of the goal in CoCare means that staff could arrange their day to take that little bit of extra time to help someone walk. We are seeing CoCare goals set to help individuals with mental illness regain control of their appearance, by helping them to get haircuts, for example, where that was a source of severe anxiety. It’s also being used to help everyone focus on a new resident settle in and make social connections that we know are so important.
We also see it being used to record the things that make a difference to someone’s life. One resident really likes having her nails done. When a care worker took some time to do her nails, she was thrilled. Showing it in CoCare meant that everyone could see how much that meant to her quality of life and therefore her wellbeing.
A few times when I’ve been at the extra care facility, I’ve seen staff singing with residents. It was a wonderful thing. It took no extra time, but it was transformational to mood and wellbeing – and that’s just the effect it had on me. Recording that in CoCare demonstrates that these very human connections are what is valued above ‘just’ making someone breakfast. It’s sharing that information with the wider practitioner group and with family members, too – so that everyone can be part of working toward personal goals and working to transform the culture of care.
Seeing CoCare being used to record these life changing ‘little’ things and creating connection to everyone in the care circle has been such an uplifting thing to witness. It isn’t that these things were never happening, but that they were getting lost in the system. Not everyone knew or could know the little wins and preferences that make a difference to someone’s life, but CoCare supports sharing the little ‘wins’ that make the big difference among all professionals and family in the care network.
Of course, this is only part of the CoCare story, in another update we’ll share what difference easy data gathering and smart reporting makes to understanding what helps someone live a happier, more independent life.
Find out more about CoCare. CoCare was developed as part of LGiU’s innovation work in partnership with technology and design firms and local authorities.