Why do many Carers record negatives not positives? This question was asked recently on a NAPA training day by a bewildered Manager. She was working hard to get the whole team to recognise the part they played in offering meaningful engagement to the residents. She knew that lots more, really good interactions were taking place because she saw them as she worked around the home. Checking on what was written in the care plans and daily notes made her realise that little, if any, of this great work was being written down. Instead she saw note after note that identified what a resident hadn’t done or couldn’t do. Lots of the notes detailed things like increased use of a hoist or poor appetite today. Where was the comment about the lovely lady that had her nails painted by a Carer and then took charge of the nail varnish and swapped roles? Where was the record of the gentleman that had spent all afternoon carrying light bulbs around for the Maintenance team?
At NAPA we think this is indicative of a gap in training for carers. In their defence, in the past, little importance was placed on how people spent their day and as a result no thought was given to writing it down. The focus was always on recording personal care and clinically based interventions. Best practice has shifted, and so has the Regulators’ requirements, to seeing everyone as an individual with a life to lead. Well-being and good mental health are now seen, among other things, as indicators of good care. Recording things that support this, like meaningful engagement, haven’t yet caught up with this way of working. One of the challenges is the time it can take to record lots of short exchanges. We know of a number of initiatives to address this problem.
One care group has a ‘Golden Moments’ scheme. All staff have a small post-it pad in their pocket to quickly write down what happened and who with. These are handed in towards the end of the shift to a Senior responsible for documentation that day. The information is pulled together and captured in the care plan. The advantage is that, for example, a resident may have had a number of conversations with different staff about something he really enjoyed the day before. This information is priceless for the Activity team when they are making plans with him but also means that the care plan is recording his well-being and something that holds meaning for him too. The bonus is that staff members can get due recognition for the activity they are carrying out and, hopefully, greater understanding of the need to get up, washed, dressed and ………… enjoy the day.
Sylvie Silver, Executive Director, June 2018
For further information please visit www.napa-activities.co.uk