It’s been a great year for MHA (formerly known as Methodist Homes). The not for profit provider has increased its number of homes achieving Good or Outstanding from 69% to 87%, with its latest top rating at Willersley House near Hull where they achieved Outstanding in all five areas. CHP asked Director of Quality Annie Webber how they’ve done it.
“A couple of years ago we made quality an organisational priority in all that we do and had sign up from the Board as well as all staff right across the organisation,” Annie explained.
Annie, together with the leadership team and senior managers, examined a range of indices before determining where significant improvements had to be made. It soon became clear that a radical change in working practices would have to be made to enable joint working between quality and operations staff to really make an impact.
Examining data was a key feature and helped focus energies and steered the necessary improvements.
“The information gives us an indication of how well a home and scheme is doing. We then decide with the area manager what the priorities are – it may be training or sharing lessons learnt or best practice,” Annie said.
MHA asks home managers from its outstanding homes (the charity now has four, placing it third in the country – see table below), to share with other managers how their inspection went and how they managed the whole process.
Annie highlighted that great leadership was a key ingredient to providing outstanding care.
All new managers to MHA receive an induction, which includes emphasis on the charity’s values, providing them with a ‘buddy’ manager from another home, as well as additional support from their area manager and area support manager.
Finance, HR, quality business partners and an administrative manager provide ongoing support to the care home managers. This allows them more time with residents, relatives and staff as well as enabling them to build strategic partnerships in order to nurture community relationships, which benefit the lives of residents.
“Enabling and empowering our staff has also been crucial in the whole process and to really enhancing the manager’s confidence so that when they meet the CQC’s inspectors they can fully articulate care management in a MHA care home,” added Annie.
“Our managers are taught how to conduct an inspection and how to best support the Inspector whilst on site. In addition, being absolutely committed to meeting the needs of the resident and truly providing person centred care is about knowing your residents really well,” Annie said.
“It’s about communicating with them and listening and liaising with their relatives.”
Reducing the administration on care staff through the use of technology is an area MHA is seeking to address. Annie stressed the need for MHA to move towards electronic care planning in the future. The organisation has already adopted Boots e-med digital medicines management system.
Annie also emphasised the importance of MHA’s volunteer network and the role it plays in providing person-centred care. Volunteers are able to spend vital time with residents, engaging them in meaningful conversations and supporting them on activities such as playing cards or crossword puzzles to help cognitive functions, or provide support for physical exercise in order to help prevent falls.
“It’s also about getting the outside community to come in to enhance the lives of residents,” Annie added.
“It’s about looking at what it means to be a resident and asking yourself how you would like to pass the day.”
Each MHA home has a designated MHA chaplain who plays a crucial role in helping residents stay in touch with their local community. Residents can attend their local church or join in with services held in the home. Chaplains also play an important part in supporting relatives and staff in what can be an emotionally charged environment.
MHA has also linked up with Tesco, who have built chicken coops in its homes, and also engages in pet, art and music therapies.
“What is key is knowing residents’ histories, their lifestyles and what they used to be engaged in so that our staff can encourage them to re-engage in those same activities,” Annie said.
The charity has also set up ‘Quality Circles’ to look at ways of improving the quality of life for residents, which include relatives and, where possible, residents so they have a voice in choices and options at their home.
“We want them to feel able to have a real voice and feel supported in their later years, enhancing their quality of life,” Annie stressed.
“We want to see them smiling and enjoying life – there is nothing nicer than the sound of residents’ laughter.”
As part of its residential and nursing dementia services, MHA regularly reviews staff training and engages with families, volunteers and the wider community to increase awareness of the condition. In addition, it provides award-winning music therapy to residents living with dementia, which makes a significant difference to their lives by helping reduce agitation and anxiety.
Continuity of care by staff known to residents was also highlighted by Annie as another key component of outstanding care.
“We are absolutely committed to looking at how we can try and retain our staff,” Annie said.
Low staff turnover is a common factor in MHA’s outstanding homes. Willersley House, for example, has had no agency staff for more than 18 years and maintains an employment level of 110% to ensure staff training and leave do not affect the level of care provided.
“All our outstanding homes have good staff satisfaction surveys and a good level of education and training compliance,” Annie added.
Across the organisation staff turnover averages around 23%.
Agency use is used as a last resort and avoided whenever possible by asking staff to carry out extra duties to cover periods of higher absences in order to maintain continuity of care.
None of MHA’s outstanding homes are nursing homes and Annie acknowledged that achieving excellence in this area is more difficult in the current climate of nursing shortages.
She was keen to highlight that MHA had recently won an award for innovation in end of life care, however, and the charity’s nursing homes are currently among the best in the country in terms of quality compliance.
The size of service is clearly also a factor when looking at how MHA has managed to provide outstanding care. The charity’s outstanding homes average 37 beds (see table below).
“Smaller teams with a family feel are key to providing outstanding care,” Annie explained.
“They provide greater opportunities for staff to get to know the residents really well and it’s not uncommon for their relatives to become volunteers. They become a big family. The bigger you get, you tend to lose that a little.”
Not for profit organisations feature prominently amongst the providers with most outstanding ratings and Annie feels this is very much because their institutional values are conducive to offering person centred care.
“We have the ability and choices to invest our profits into making a real difference for residents and for us to invest in continuous improvement in our search for excellence,” Annie noted.
It’s a formula that is clearly working and through its inspirational leadership, MHA looks set to continue to raise the bar in terms of providing outstanding care.