Homecare Team transform business processes to increase efficiency

The Homecare Team have undertaken two projects during 2023. The first reviewed entailed a move away from paper timesheets, and migration of over 300 staff on to the Councils Resource Link system. The second saw the removal of hard copy Service User files held  centrally in Spilman street, to Service User records that are now electronically stored on the Councils Eclipse system.

Who are the Homecare Team?

We are a team of registered Social care professionals responsible for providing care and support to citizens of Carmarthenshire enabling them to live in their own homes as independently as possible. The team includes over 300 carers working across the entire county. The carers are supported by a team of Senior Cares, Supervisors and 2 Registered Managers. We support circa 320 Carmarthenshire citizens. We also provide key short term preventative services in the form of a Reablement team, and a Home Based Care Team both of which key pillars of an award winning Intermediate Care. The Homecare team’s workload is managed by an electronic call monitoring and scheduling system called CM2000. This allocates the calls to each carer, and monitors each visit in real time so the service ensures that every service user has had the care they need, at the right time, and by a carer they know.

What were the issues?

1. Overly bureaucratic Payroll systems with duplication of effort.
2. Heavy reliance on paper based systems.
3. Delays in carers receiving overtime payments
4. High printing, stationery and postage costs
5. Difficulty in tracking annual leave
6. Hard copy Homecare Service User files kept in central location in Spilman Street office.
7. Storage space at a premium
8. Requirement to hold records for six years resulted in time consuming archiving of hundreds of case notes.

Paper timesheets.

Despite the use of an electronic call monitoring system there remained some cumbersome processes around how each carer was paid. Each week over 300 carers were required to complete, and post in, a paper timesheet, which detailed the calls they had undertaken, and the time they spent travelling between calls. A separate claim paper form had to be submitted for carers to claim their milage. Once received back by the service each paper timesheet was scrutinised by a supervisor, and again in monthly meetings with Payroll where the timesheets were then entered into the payroll system.

This labour intensive process saw delays on carers receiving payment for any additional hours they may have worked and often times paper timesheets were lost or delayed in the post. A round of postal strikes meant that the service had to put in place systems to physically collect and hand deliver timesheets for a number of months.

The reliance on paper based systems incurred printing and postage costs, the team consumed over 300 paper timesheets each week (circa 16,000pa), print and reprographic costs were high.

Holding hard copy files

A full copy of each Service Users Homecare plans, and assessments must be available both in the Service Users home and in the Homecare head office (3, Spilman St). Storing these notes in the office required a room full of filing cabinets. Updating information or finding information required staff members to attend the office and to produce 2 copies of all documentation one for the office file and one for the Service Users home.

The Service is required to retain all records for six years. Each persons file would hold up to two years of information, while older records were boxed, labelled and sent for archiving. This meant that the service were constantly visiting files to remove old records for archiving.

Similarly, if there was ever a need to produce records, for example in response toe a subject access enquiry, or to respond to a complaint, the service had to request the archived files, and return to archive.

This process was inefficient and costly.

What have they done?

The Homecare management team have used vanguard based methods to review and analyse their systems. This enabled them to identify changes which would support the increased efficiency of their processes.

Working in collaboration with payroll, carers and Trade Union colleagues they have implemented a change to the payroll process which moved staff from manually detailing on paper all activities within their day to reporting only the exceptions ie hours over the standard working day, and milage claims, electronically via the existing ResourceLink system.

This reduced the time taken for staff to complete the timesheet, reduced the amount of checking required by managers, stopped pieces of paper from being moved around the county and eliminated the need for payroll to manually input the provided information.

Utilising the existing Resource Link system meant the team could implement the changes at zero net costs and ensures staff can take ownership for their timesheets, milage claims and annual leave and have access to a clear claim history.

The team have also utilised the existing eclipse system, working with the developers to create a dedicated area on the system for Homecare files to enable all the Service Users records to be stored electronically eliminating the need to duplicate paper records and increasing the efficiency with which records can be viewed and stored.

The Homecare business support team were instrumental to the implementation of both improvement projects. They worked with Payroll colleagues to ensure that carers were properly set up on Resource Link, worked with Homecare managers to develop a training manual for carers, and took responsibility for the scanning of records saving the cost of having an outside company undertake the work and completed the work.

A recent CIW inspection has highlighted this as excellent practice, and the team is looking to continue its digital journey with the digitisation of staff files in 2024.

Results:

Costs saved and avoided:
• Staff time
• Printing costs
• Travel expenses
• Postage costs
• Stationery Costs
• Reprographic costs

Improved Staff Experience

Improved Business Controls

Staff feel the new process offers increased equity with other care colleagues and they feel valued and respected.

Staff View:
‘Staff were worried about the changes, but they love it now and wouldn’t go back to paper.’, Senior Manager Home Care

This is what some staff had to say about the changes,

‘although I have only been using resource link a short while, the positives for me is the increased control I have over my overtime hours, the system allows me to go back and make sure my hours have been inputted accurately through the summary outline, it also gives me full control of my annual leave, with a press of a button I can see what I have taken and what is left remaining instead of making phone calls to supervisors and then waiting for someone to get back to you. I find the system user friendly and easy to navigate.’

‘As an older member of the homecare team, we don't particularly look forward to change but with the support from yourselves and my Supervisor it has been a relatively easy process. Of course, I have made phone calls to clarify things, making sure I was inputting the correct details. As for negatives I don't really have any.’

Conclusion:
Any department currently using hard copy systems should contact the Digital and Customers transformation workstream and explore the options available for digitising systems.