Participants from Cohort 11 discussed Care Home staffing levels in relation to resident dependency. A consensus was gained around the pertinent issue of staffing ratios, especially considering there is no clear guidance from external stakeholders.

Quality Improvement Session 2 explored available staffing tools and dependency assessments currently utilised across various Care Home settings. Cohort 11 participants had direct experience of staffing tools such as CAPE and CREST (Four Seasons Care Group. Participants agreed due to time restrictions and increased workload relating to ongoing Covid 19 pandemic that the development of a stand-alone staffing tool would not be feasible.

Previous exposure to the Enhanced Clinical Care Framework (ECCF) through the “Safer Mobility” pilot presented an opportunity for Cohort 11 participants to support potential work streams around acuity and dependency.

Linda Graham (Regional Manager SPA Nursing Home Group) Co-Chair Workforce Planning Subgroup ECCF kindly presented ongoing work completed through ECCF for NI Care Home Residents and opportunity for Cohort 11 participants to partake in Acuity/Dependency Tools pilot.

Two staffing tools were piloted in Northern Ireland through ECCF – Care Home Staffing Tool: Scotland and The CHESS Model: Four Seasons. The group agreed to support the pilot for Scottish Care Home Staffing tool in two care homes.

Pilot feedback included:

  • The tool is user friendly and pulls information to create easy to read graphs
  • The tool does take 1-2 hours to complete weekly
  • There are more areas within the activities of daily living that should be included to decide on safe staffing levels
  • The graph showed we were overstaffed as it did not take into consideration service users requiring 3:1, 2:1 and 1:1 staffing ratios as per Care Plan.
  • The tool as it currently stands needs work to support the changing needs of our service users and the job role of staff
  • Managers are faced with decisions daily on what is safe staffing within their Care Home and in turn meeting RQIA minimum standards
  • To have a tool support the manager’s decision making would be extremely beneficial and I hope work continues to develop it.

Additional pilot support was discussed during further Quality Improvement sessions. Participants identified further considerations for dependency and a change to potentially outdated terminology for pilot feedback.