Last reviewed 6 December 2013

The Care Quality Commission (CQC) has published a case study of a care home that has implemented new ideas such as a “fluids champion” and “intentional rounding” to drive improvements in the quality of care of its residents, writes Christine Grey.

Following an unannounced CQC inspection in March 2013 of Moorwood Cottage Care Home in Hampshire, a number of serious concerns were identified and enforcement notices were issued for care and welfare, nutritional needs and staffing levels.

Many of the residents had very high nursing and dependency needs but CQC inspector Julia Adey felt that after the follow-up inspection in May 2013 she had seen efforts made by the care home to move in a different direction. She said: “Moorwood Cottage took our concerns very seriously and very quickly started to implement some new ways of working.”

A new registered manager, Gary Briggs, was appointed and within a month all care plans for residents had been reviewed and rewritten, making sure the individual needs of the residents had been identified. He confirmed: “Next on my list is to further improve the clinical training for all of our staff at Moorwood, which I’m hoping to start to do in the next few months.”

The ideas introduced include appointing a fluids champion to ensure that people were supported to drink. The CQC inspector said that on her first visit people in Moorwood Cottage were unable to access fluids independently and were often not supported to drink. She said that with the fluids champion there was a system to support people to drink more regularly, fluid charts were maintained for all people who were unable to drink unsupported, fluid intake was monitored daily “and staff could ensure that people’s fluid intake was sufficient for their needs”.

A structured process called “intentional rounding” was also brought in whereby staff carry out checks with individual people at set intervals. Briggs explained that intentional rounding “is a simple and effective way of monitoring people at regular intervals throughout a 24-hour period. At Moorwood Cottage we use it to record the checking and changing of incontinence pads, and the position and turning of those who are unable to reposition themselves. This means that not only are we systematically recording key information about our residents, but it is consistent, clear and easy to read so all staff can manage the care needed”.

Additional staff were recruited to support the new way of planning the work and organising the teams, nurses took charge of the care, and care workers worked in teams with an extra care worker available to assist with personal care and nutrition.

Although there is more work to be done, the CQC praised the positive reaction from the staff and management and the way they embraced the new practices at Moorwood.