Quality Monitoring in Care Homes
November 2015
Background
• Bath and North East Somerset Clinical Commissioning Group (BaNES CCG)
commissioned a six-month quality project in Care Homes commencing in March
2015. The project was coordinated by the BaNES CCG and the data collected was
analysed by R-Outcomes Ltd.
• 870 questionnaires were completed anonymously by residents from 16 care
homes.
• A small survey of staff in eight care homes was also done at the end of the study,
with 57 responses. Each home had between 4 and 9 responses (average 7).
• Three sets of questions were asked:
1.
NHS Friends and Family Test (FFT), which asked residents if they would
recommend the home.
2.
The howRwe patient experience measure, covering kindness,
communication, promptness and organisation.
3.
The howRu health status measure, covering physical discomfort, emotional
distress, disability and dependency.
• Comparisons have been made between the homes and the average of all homes
and with results from a survey of about 300 UK homes (2012 data).
Main conclusions
• Results yield information that varies between homes and month by month within
homes.
• However, compared to the average of all homes in the UK, four homes were
above average and three were below average.
• Kindness scored highly, while promptness scored poorly.
• On a scale from 0 – 100, the average (and range of average scores) for each
home for the key dimensions is as follows:
 Friends and Family Test: 85% (range 70% – 93%)
 Kindness: 86% (range 76% – 95%)
 Communication: 80% (range 69% - 86%)
 Promptness: 70% (range 57% - 88%)
 Organisation: 79% (range 66% - 88%)
• A breakdown of the results by residents and staff is presented on the following
slides.
Residents: Friends and Family Test
The funnel chart below shows the mean Friends and Family Test (FFT) score for
each home, plotted against the number of responses received.
The blue line is the overall average
The green line represents the upper 95%
confidence limit
The red line the lower 95% confidence
limit.
• One home (4) is well below the average on FFT, with two others (1 and 5) on the
boundary. Home 4 has a much higher proportion of men than any other home.
• Three homes (6, 8 and 17) are at the upper boundary and scored well
comparatively.
Residents: Kindness
The funnel chart below shows the ‘treat me kindly’ scores for each home, which
measure residents’ perceptions of compassion and empathy.
The blue line is the overall average
The green line represents the upper 95%
confidence limit
The red line the lower 95% confidence limit.
The dotted line represents the average
scores obtained in a large UK-wide survey in
2012.
• Three homes are above or close to the upper confidence limit (11, 12 and 8).
• Five homes are close to the lower confidence limit (4, 5, 7, 9, and 14).
• Home 9, which only participated for one month, had the highest score on the
FFT and the lowest score on ‘treat me kindly’.
Residents: Communication
The funnel chart below shows the ‘listen and explain’ scores for each home.
The blue line is the overall average
The green line represents the upper 95%
confidence limit
The red line the lower 95% confidence limit.
The dotted line represents the average
scores obtained in a large UK-wide survey in
2012.
• Three homes scored well and close to the upper confidence limit (12, 6, and 8)
• However, three homes were close to the lower confidence limit (9,14 and 5).
Residents: Promptness
The funnel chart below shows the scores for ‘see me promptly’ with substantial
variation between the homes.
The blue line is the overall average
The green line represents the upper 95%
confidence limit
The red line the lower 95% confidence limit.
The dotted line represents the average
scores obtained in a large UK-wide survey
in 2012.
• Three homes are significantly above the average (16, 11, and 8); while two
homes are well below the average (5 and 7).
• Performance in home 5 deteriorated throughout the project, while home 7
recovered in months 4 and 5 before deteriorating again in month 6.
Residents: Organisation
The funnel chart below shows the scores for ‘well organised.’
The blue line is the overall average
The green line represents the upper 95%
confidence limit
The red line the lower 95% confidence limit.
The dotted line represents the average
scores obtained in a large UK-wide survey in
2012.
• Overall the majority of the BaNES homes score well and are above the UK
average (dotted line).
• Two homes (6 and 8) are above the upper confidence limit, with three other
homes (16, 2 and 12) close to the boundary.
Staff: Friends and Family Test
The chart shown below shows the results from the two Friends and Family Test
(FFT) questions shown below:
How likely are you to recommend this home to someone who needed the
care and support it provides?
How likely are you to recommend this home as a place to work?
• FFT recommendation scores for care were better overall than for work across
most of the homes except for one (home 4). Home 4 also received the lowest
scores overall on FFT.
Staff: Perception of resident experience
Staff were asked to rate the service provided in their home on a scale ranging from
excellent to poor on the following four items:
Treat people kindly
Listen and explain
See people promptly
Well organised
• Overall, kindness scored well across most of the homes in BaNES, followed by
communication. There was however variation in the scores for promptness and
organisation. Home 2 scored the highest for promptness and organisation, while
homes 4 and 5 scored the lowest both for promptness and organisation.
Staff: Confidence in doing their work
Staff were asked to rate the extent to which they agreed or disagreed with the
following statements using a four point scale :
I understand my work well
I can manage my work well
I know how to get help if I need it
I am involved in decisions that affect me
• Results show that staff in the care homes are most confident about accessing
the help they need to do their work. They also understand their work and are
generally able to manage this in their homes.
• Staff however do not always feel that they are being involved in decisions that
affect them. Home 3 in particular scored very poorly in this area.
Summary
• This project has demonstrated the viability of collecting experience data routinely
from care homes at monthly intervals.
• The results yield information that varies considerably between homes and from
month to month, and should therefore be used to facilitate quality improvement
discussions between commissioners and the care homes.
• BaNES CCG would like to thank the residents and staff in the care homes for
participating in this project.
Thank you