Missed home care visits – The damaging truth
Care agencies and home care providers have a duty to attend their visits on time, missed visits can have huge implications on the people being cared for. They may need certain aspects of their care plans doing at certain times, as well as medication and even company to support with mental health. For people living with dementia late or missed visits can be distressing for obvious reasons.
Shorter visits can be a catalyst for these issues. A report from trade union UNISON back in 2016 showed that almost three quarters (74%) of councils were limiting home care visits to only 15 minutes. And in most cases, home care workers were being asked to carry out activities such as helping people to wash or preparing a meal in that short time. This highlights one of the main problems. Carers could be seen to rush visits and it’s important that shorter visits are only taken if pre-agreed or the carer knows the client well. Being understaffed, due to recruitment issues or uncovered absences can similarly lead to late or missed visits. The National Institute for Health and Care Excellence (NICE) has since released guidance stating that visits should last at least 30 mins and should be long enough “for home care workers to complete their work without compromising the quality of their work or the dignity of the person”.
In February, a home care provider in Manchester was put under scrutiny when the Care Quality Commission (CQC) carried out an inspection after whistle-blowers raised alarm over the service missing care visits. The service was reported to have missed 15 visits. The CQC found the agency was in breach of several regulations, including those relating to safeguarding people from abuse, properly vetting staff, and the safe management of medicines. These issues caused the provider to go from ‘good’ to ‘inadequate’ rating and meant they needed to make significant improvements if they wanted to continue to provide care.
The National Institute for Health and Care Excellence (NICE) published guidance around planning for missed or late visits and showed some key points that need to be considered when planning for these within a home care plan. A plan for responding should include:
- How and when a missed or late visit will be communicated to the older person or their carers.
- Emergency contact details.
- Arrangements for a family member, carer, or neighbour to visit instead.
- An assessment of risk and what should happen if a visit is late or missed.
They also note that "Home care providers should recognise that older people living alone or those who have cognitive impairment may be particularly vulnerable if visits are late or missed. Providers should therefore make it a high priority for back-up plans to be actioned as soon as possible for these specific groups."
Having a backup plan is very important, but what’s also key is to have the relevant processes in place from the start, and software can be a great asset in helping this.
Visit Verification – why it is essential?
While most care workers are diligent and conscientious, there will always be some people who will not do their job properly, even going so far as to avoid delivering care at all.
This is one reason why a system to verify and evidence that all care visits have happened on time, for the required length of time with all necessary tasks taken and notes completed, is essential. Even if care workers are abiding by all your internal and external standards for visits, it is necessary to have a system in place that records and proves this. It gives care management teams the oversight they need and the ability to take proactive action where there are late, missed, or other visit issues, before those issues worsen.
If care visits are not being completed as required you can take whatever action is required, whether that’s addressing concerns with specific staff or improving scheduling or staffing to meet provides peace of mind to relatives and funders of care and gives care inspectors reliable evidence that care visits are being completed to the highest possible standards.
Is electronic call monitoring/visit verification legally required?
In the United States, Electronic Visit Verification has been mandated as of 1st January 2020 by the 21st Century Cares Act. While the same is not true in the UK, for many years most local authorities have insisted, contractually, on some form of call monitoring being used by care providers delivering services for them.
Initially, this took the form of landline telephone-based systems, now verification methods included in mobile apps used by care workers are more common. These apps vary in their methods of verifying that a carer has arrived at the right location, at the right time, completed a visit and left at the right time. Some, including the system below, includes extra functionality to evidence not only that a visit was at the right time, at the right place, but also the care delivered in any visit.
A system to manage, verify, monitor and evidence visits
Access Workspace for Care is a complete and integrated home care management system and the most widely used in the UK. It includes Access Care Planning and Access PeoplePlanner, to encompass everything from scheduling care visits to electronic care plans, visit verification, electronic logs of activities completed in care visits and more.
Access Care Planning, our comprehensive care management mobile app includes complete digital care plans and forms, eMAR and other useful elements in supporting care agencies to avoid missed or late visits.
Family and funder access can help clients loved ones keep track of the care being provided. They can view care visits, actions from them along with medication taken and when future visits will be using this feature.
QR Codes and NFC tags functionality within Access Care Planning allows managers and operational teams to see when and where their carers have been. It allows carers to clock on and off at clients’ homes so management can ensure they’ve been to the right place. We hear about a lot of systems that don’t offer this NFC tag feature. They have had issues with carers taking QR codes and logging in from home which can have very serious consequences. But with NFC tags, a location stamp can be placed at the service user's home and can only be used when they’re there. It will stop working if the carer tries to remove it or take it somewhere else.
Check-in time has been added as another method too. This prevents mobile users changing their device time at check-in. Some other systems haven't closed this loophole which allows a carer to complete the morning visit and then check-in and out of the afternoon visit whilst on location, appearing to have completed the afternoon visit. Access Care Planning prevents this.
Access People Planner, our community care scheduling and rostering solution include integration with Google Maps. This can efficiently plan routes for your mobile care workers. It’s built to be fully integrated to ensure accurate travel time calculations, correct staff payment and client invoicing. But also, can be used to monitor carers travel plans, again ensuring they’re at the right place at the right time and visits aren’t cut short.
Educating carers on the importance of being on time and the repercussions on client’s welfare if they are not a clear way to avoid missed and late visits. But having a plan in place if this does happen and utilising software so at a management level, they have visibility of routes, timings and missed visits is the best way to be prepared for if it becomes an eventuality.
To find out more about how Access Workspace for Care and the solutions within it such as Access People Planner and Access Care Planning can support with this, fill out this form and a member of the team will be in touch to discuss whether our solutions would suit.
