How we use Outcomes to Improve Our Service

Rather than sit back and accept a standard service to suit all clients, we prioritise those things that matter most to our client, ensuring the service is best suited to improving the health and well being of each client.  

The reason we love what we do at Right at Home is that we help people.  For many, growing old in declining health, can be the hardest challenge they face in life.

Every client is unique.  With their own needs, routines, preferences, hobbies, interests and dreams.  A busy care manager running a team of carers providing hundreds of hours of care a week, are naturally focussed on making sure the service runs smoothly and that each client’s immediate needs are met, every day every visit.  Supporting each client takes a team effort form us as the care provider, the individual carers, the next of kin, friends and family as well the GP, pharmacists and district nurses.

In this daily torrent, we must continually remember each client’s individuality and avoid the service becoming too routine, too task driven or “one size fits all”.  We do this, first and foremost, by adopting an “outcomes based” mindset.  By listening closely to our client, we seek to identify the things that are important to them in their lives.  We ask, what changes can we make, what action can we take, how can we help, to maintain or improve our client’s well-being?

This is not rocket science, although some skill and care are needed at times, to help our client express their own wishes.  Empathetic engagement, and listening are very important in gaining trust and making the client feel comfortable enough to say what they are really thinking.  Some people do not like to ask! Or do not want to be too much trouble.  Or in some cases, don’t like to admit they need help at all.

Examples of outcomes can include:-

• Seeing friends or family regularly
• Being listened to
• Improved morale
• Having control of daily life
• Staying as well as can be
• Improved mobility
• Making a contribution
• Feeling safe
• Managed Symptoms
• Being treated as an individual
• Being valued and respected
• Having things to do
• Belonging to the community
• Having people to rely on
• (Re)gaining skills/confidence

By thinking this way, we move away from just identifying needs and problems.  Instead we can ensure the whole team focuses on a common purpose making sure we deliver the desired outcome – and those things that matter most to our client: hence ensuring our service is as effective as possible.  By responding to the client’s priorities we can help to significantly improve their health and wellbeing.

Case Study

Our client Mr D aged 94, came home from hospital after a series of urine infections.  The first thing he said to us was “I am not going back to hospital”.  From what Mr D said, it was clear he felt this time, he had come home to die.  18 months later Mr D is still going strong, eating well and happy to be safe and secure at home.  He has not had any further infections (despite being fitted with a catheter) and has not needed to go back into hospital.  The first few weeks supporting Mr D were challenging as our carers gained his trust and confidence.  As we got to know him, form this low ebb, we were slowly able to improve his health and well-being. 

The outcomes we identified – the things that were important to Mr D were staying safe at home, avoiding infections/readmission to hospital, and lifting his morale from a very low ebb.

Our carers were especially careful in attending to Mr D’s personal care so as to reduce the risk of infection.  Over time, they managed to improve his morale through companionship and attention.  It was important for him to feel listened to and valued once again.  Mr D likes having someone to talk to and (with no family) he had got lonely. 

His morale was further improved achieved by improving his diet.  The carers prepared more home cooked food.  Mr D has few pleasures, but he can still enjoy good food.  He enjoys our carers’ cooking and has gained weight steadily under their care.

The outcomes approach helps us to focus us on what matters most to each client.  Once identified the outcomes are shared and applied as a common thread running right through the service including care plans, personal care and companionship, activities, performance and reviews.  The Outcomes create a common understanding for the whole team and a shared goal, for us to work towards together.  Families and next of kin notice the result we achieve through this approach and have been extremely kind is giving us some amazing and much appreciated positive feedback.   Thank you all!

Right at Home Mitcham, Streatham & Dulwich was recently awarded a ‘Top 20 Top Rated Home Care Provider 2021’ Award.  This is in recognition they are one of the 20 top rated Home Care Providers in London based on reviews from service users/clients and their family/friends.

Michael Scott