Reports, Evaluations & the CQC

Evaluation helps you to assess whether activities are meaningful, enjoyable and meet the residents’ needs. We look at some of the best ways to make this an easy part of your daily tasks.

When reporting, you must be able to evidence both individual and group activities. Inspectors will base their main judgement on what is happening for everyone in your care home on the day(s) of inspection. They will ask people who live in your care community how they spend their days, ask visitors about the quality of activity provision and look for signs of well-being based on their observations using the Short Observational Framework for Inspection (SOFI).

HERE’S HOW YOU CAN MAKE COLLATING THIS INFORMATION AN EASY AND NATURAL PART OF YOUR ACTIVITIES

Keeping records is essential

The records need to capture the engagement and meaningful activity each person has experienced each day – from a chat with the care staff or in a formal activity. You need to be able to show meaningful engagement with people each day and at different points in the day. If you don’t already have a form for recording group and one-to-one activity, NAPA have a well-designed form, or you may want to talk to other activity/lifestyle/well-being coordinators to find out what they use.

Assess on specific criteria

  • How did individual people engage with the activity?
  • How well did the overall activity work?

But – to be more detailed, and personal – try this:

  • How do you know the resident enjoyed the activity?
  • What reaction did the person have on their face?
  • Were there any changes in body language, tone of voice, or comments the person made compared to previous activities?
  • How did they interact with others?

Each resident should have an individual lifestyle/activity/well-being plan

This can be in the format of a care plan and should reflect elements of their life history, lifestyle preferences and preferred routines. If you do this for every resident when they join the care home, and revisit it every six months, it will be easy to manage.

Have an assessment of people’s level of ability

Use PAL, or another ability/well-being measure, and update it monthly or quarterly. It is helpful to set goals with people, for example: Mary had a fall and is returning from hospital, keen to be able to regain her mobility. By working with Mary and her carers you can show how Mary gained confidence with walking again.

Get feedback

One of the strongest sources of evidence for your evaluation is to have collected immediate feedback from residents at the end of the activity and record this on your notes. Have a specific notebook that you keep for jotting down comments and feedback as they happen.

Colour-code interactions

Normally there are one or two activity coordinators in the home, and between 20-100 residents per home. How do you know if everyone has been seen? A lot of coordinators design their own charts so they can see who has been seen that week, using a colour code and highlighting if a person has been to a group activity, had one-to-ones, been on a trip or outdoors and so on. With a colour-coded chart you can quickly scan to see who hasn’t been outside over the last few days. Then make the extra effort to take that person out on a one-to-one or ask another member of staff to support you.

Review and evaluate regularly

You need to be able to show what you are achieving and how this is improving the lives of the residents. When reviewing your notes, use a simple structure to evaluate individual activities. For example, you could ask the following three questions:

  • What worked?
  • What didn’t work?
  • What would we do differently?

Also make sure you have notes on:

  • How those who don’t engage in group activity also have access to meaningful activity.
  • How the whole team of staff are involved in providing everyday activity (eg supporting people to water plants, help with washing up, etc).
  • The top three things that you do well (eg provide opportunities for people to get into the local community).

HOW TO GATHER EVIDENCE

Make a note of key things that are said – Especially things that indicate a person particularly likes or dislikes the activity, or an aspect of the activity. For example, someone saying, “I haven’t laughed as much in ages,” at the end of an activity is a lovely comment to note down on your records and brings the evaluation to life.

Ask the right type of questions – Sometimes it is difficult to get a response, but the type of question you ask can help. If you ask a closed question (one that just requires a yes/no or one-word answer, such as ‘Did you enjoy that?’), you will get limited feedback. However, if you ask a more open question you may get something more substantial. (Examples of open questions: What did you like most/least? How could I have made it better for you? How did it make you feel?)

Be specific – Focus on what works and what doesn’t. For example, a person may enjoy looking through a reminiscence book, but find the book you have used too bulky. Make a note that it is the book size, not the activity, that needs adjusting, so that in future the activity can be more enjoyable.

Ask others for their views – As well as asking for feedback from those taking part in the activity, ask staff who know people well for their ideas on how an activity can be improved.

Record attendance and engagement as two separate things – Attendance is about who attended and how many attended. Engagement is about how those that attended took part.

Include actions for the future – For the ‘What would we do differently?’ part of the big question, make sure you include specific action, ie buy smaller reminiscence cards for use with Mr Y, reduce volume on music quiz, etc.

Include yourself – Don’t forget to evaluate how you (or others) felt about running the activity. It is important that we understand what works and what doesn’t work for us as well.

Be Personal – When writing about what the person has taken part in, it is important to write a personalised account. The best advice I have been given – and would remember each time I wrote in a care plan – was: if a person was to pass away and their loved ones read their care plan, what would they want to read, knowing it was their last day?
Would they want to read: Ethel sat in the lounge, ate dinner, had personal care, fell asleep, or would they want to read: Ethel socialised with two other ladies, Betty and Isobel, and spoke about life growing up on a farm and listened to the other ladies’ memories. She enjoyed eating sausage and mash, which she said reminded her of having to cook the same meal for over 15 people and she didn’t have enough food to go around so everyone had to fill up on bread and butter! Ethel had a smile on her face and laughed as we chose the clothes that she wanted to wear for the concert she was attending in the evening at the local village hall with a group of residents. After singing along to songs at the concert and gazing out of the taxi window on the drive home, she decided to go straight to bed rather than watching the TV in the lounge which she normally does of an evening. Ethel stated: “I’ve had a lovely day today and would like to do it again soon.”

TOP TIP

Don’t be afraid of the inspection team, be proud of what you do and ensure you have the evidence of what you and your teams do and the benefit it has on the people in your community. At inspection, inspectors are looking to find good provision, rather than to find fault. Of course, if something is not right they will identify it, but their main aim is to make a judgement about the quality of care.

Inspectors are keen to see good practice and to see the impact it has on the people in that care setting. However, they rely on you to showcase what you are doing by showing them, describing what happens and providing evidence.