Safe staffing is my passion, which is why I created Establishment Genie. However, where legislation is in place in Wales and Scotland the word ‘safe’ is not mentioned, and to date when wards regularly fall below the agreed standards, nothing happens- it is recorded but not nurses arrive over the horizon to fill the gap, as there are not enough nurses to fill the gap. I am fully supportive of legislation, but not if it is just words on a page. Maybe we should look at addressing the global nursing shortage, before writing legislation that cannot be met. PS mandated staffing supported by the California Nursing Association is less that we deploy through our professional judgment, so be careful what we wish for....
This makes me want to weep. I have worked with more than 100 residential care homes using Establishment Genie in the last 12 months, and I have witnessed the most amazing care, not just evidenced in the care level metrics, but seen in the outcomes for both residents and staff. I sincerely hope that this does not tarnish all with the same maleficent brush - we have many wonderful staff whose heartbeat is providing exceptional care. Let us not forget all that they do.
Establishment Genie can capture staffing data across all health and care settings, and provide individual and benchmark reports. The work we have been conducting with Care Homes in Wales to capture data in support of the Nurse Staffing Act (Wales) 2016 provides all Homes with an instant individual report on staffing ratios including hours and minutes of care per resident by staff group; as well as residents per nurse / band 4 / HCSW, WTE per resident; and reports on any supporting staff, clinical supervision, training and uplift. The Homes are using this as evidence of deployment of appropriate and safe staffing with inspectors, commissioners and other funders, and with residents and their families, and the peer benchmark (variation) group anonymously compares all of the homes on up to 500 different metrics including outcome measures and is tangibly improving quality. It is not just America that is putting the person at the centre of care and empowering nurses and carers!
This is an exciting and much needed piece of work. We have been using Establishment Genie to understand staffing levels and costs across 45 care homes who accept CHC patients in support of work by a Welsh Health Board to look at staffing in terms of the Nurse Staffing Act and patient outcomes to identify how we can support independent providers of care better and reduce the need to access acute care and other community services. It is exciting times, as there is no other tool that has captured this level of data for care homes, and in conjunction with the data captured from other community services we are starting to create a picture of the current state across the Health Board to inform how we plan effectively for the future. More focus on independent care provision and how this links with our future services can only be a positive thing, as more care is provided outside of the NHS than within it, and this is predicted to continue to increase with even more reliance on independent providers of care in the future. I look forward to seeing the outcomes of the LaingBuisson work and triangulating these with our data to support evidenced based decision making.
It is great to see investment in supporting safe care. During the development of Establishment Genie, which was endorsed by NICE in 2017, we found that many of the senior nurses we worked with had not been taught or supported in learning about workforce planning. We have continued to see this in community teams, care homes, hospices and independent providers of care. The outcomes of the Establishment Genie process can be triangulated with SNCT and other tools, and provides benchmarking within and between organisations, which has been particularly welcomed by our community teams and care homes where there is little in the way of evidence based safe staffing to support their professional judgement.
I really hope organisations are able to release their staff to be part of this important training.