how to get the most out of monitor

PERSON CENTRED SOFTWARE | HOW TO GET THE MOST OUT OF MONITOR | PAGE 1

Mobile Care Monitoring How to get the most out of Monitor

August 2018


Welcome How to use this guide

The “How to get the most out of monitor” reference guide is designed to sign post you to the

various parts of Monitor that enable the effective management of care process and provide

insight based on the care delivery.

The guide assumes that a user has received training in Monitor, has sufficient user rights and can

navigate around the application.

The guide is divided into

• Service User Details

Identify what actions are required for a service user and navigation to other parts of

their care record. The place to start when looking for information about an individual

• Planned Care

A summary of the planned care that has been set up for a resident

• Personal / Resident’s Charts

How to access the charts from a service user record. Charts are generated from the

data captured on the Care App

• Resident’s Observations

Weight, BMI, Blood Pressure and other medical observation graphs

• Community Dashboard

A series of tiles and alerts designed to give an overview of a community, identify what

needs to be done and help with compliance

• Location Charts / More Charts

Additional charts and a way to view charts for all residents in a community

• Reports

Interrogate the system using various reports

• Process

A series of process reports to help manage care planning, adverse incidents and

alerts

• Analysis and Group Reporting

KPIs and performance monitoring


Service User Details

Service User Details page

The Service User Details page enables users to navigate through a resident’s care record. There is a lot of

information available on this page which will then take you to the various sections of a resident’s file.

Highlighted below are the main sections of a file and a brief description.

Details of the

person’s record

you are viewing.

Watches (e.g.

bowel, fluids

offered and

drunk, emotional

support)

Live alerts such

as MUST scores

and new message

notification

Click on the tiles to assist

with navigation to the

details or to find more

information



The Assessment

tools, Care plans

and Medical tiles

provide alerts

when action is

required and to

take you to the

relevant sections

Use the “quick links” to take you to care plans, assessment tools, wound care

and infections etc.

Other tiles:

Hospital Pack

Charts

Documents

Social (i.e. the

Relatives

Gateway)

Recent care note

icons, up and coming

planned actions and

ability to add daily

records for events

such as doctor visits.

There is also a tile to

view 24 hours worth

of care note actions



The quick link

to care notes

will take you to

a page that

allows you to

view weekly list

of care notes

details

View existing

contacts or click

add to set new

ones up.

Manage friends

and family

connections to

the Relatives

Gateway

View the “Risks

to be aware of”

and other social

and medical

information.

Click Edit

details to

amend this

information


Planned Care

Planned care:

This takes you

to a page that

summarises

actions that

have been set

up in “Plan care

day”

Click on the

“plan care day”

icon to set up

planned actions


Personal / Resident’s Charts

Charts provide Care Intelligence

The evidence of care interactions captured on the Care App do more than create your care notes, they

will automatically update various charts and records that form a resident’s care record. This section of

the guide will help you find what you need to gain insight to a resident’s care and support and make

informed decisions about their care needs.

Where to find

personal charts?

First up you’ll need

to navigate to the

resident you wish

to view.

Tap or click on the

charts tile as

highlighted. This

will load the Charts

page for the

selected resident



Activities: A chart showing a resident’s activities they have participated in, along with the amount of time spent outside each day

Bed rails check: A chart showing each day and the hour of the day that bed rails have been evidenced as being checked and whether they were put up or taken down.

Bowel movement: Chart displaying when bowl movements have been recorded. The numeric values refer to the Bristol stool chart types or where a “?” is shown, this means that the type was not recorded.

Check OK: Displays the records for when staff have used the “Check OK” action



Emotional support: A chart showing the care note details for any behaviours presented using the action icons in the Emotional support ADL.

Meals chart: Evidence of breakfast, lunch, tea and supper. Any snacks and other supplements are also shown.

Fluids: A daily summary of the amount of fluids offered and drunk per day

Hygiene: Details of what personal hygiene actions are being evidenced and the initials of the staff who provided support

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Environment: Care actions relating to supporting residents with their personal safety and environment

MAR chart: Medication records from medication, cream and PRN action icons

Mattress checks: Specific details of when mattresses have been changed and the time of day



Turning: When residents have been repositioned and what position they were moved to

Weekly check: Time bands for when care interactions are happening. The darker the colour the more interactions are occurring for a resident. This can be useful to see the amount of support an individual is receiving and when.


Resident’s Observations

Observations: A page showing a series of graphs and data for the medical observations recorded for an individual


Community Dashboard

Service User Community Dashboard

On the right of the page features informative tiles and alerts for the community designed to show

important information. The tiles and alerts will vary depending on the state of play and only show if they

are relevant (e.g. if there have been no admissions/discharges, then this tile will not show)

If you click on a tile or alert, this will highlight those service users affected :


Community Dashboard

Service users – Present/Away: This tile shows how many service users are in the community (present) and any that are away because they have been suspended. Any service users who are suspended will have a pink outline around their picture on Monitor and they will not show up on the Care App

Service users – Weighed/No Height: This tile shows how many service users have been weighed this month and how many service users have not got their height recorded. You should aim to have as many service users that are present measured each month and no service users to have no height.

MUST – at risk/no must tool: This tile shows how many service users have a nutritional risk, which is calculated through weight loss of more than 5% or BMI over 20 or less than 18.5. Service users who have a nutritional risk should have a MUST assessment tool in place so the tile also shows which service users have no MUST tool when it is required.

Falls – Had fall/No assessment: This tile shows which service users have had a fall in the last month, and which service users who have had a fall don’t have a Falls assessment.

Fluids – Being watched / <1L in 24 hours: This tile shows which service users are being watched with the ‘Fluid watch’ action on Plan Care Day, and also shows which service users have drunk less than a litre of liquid in a day.

Fluid watch – Needs watch/Not watched: This tile calculates which service users need to have a fluid watch in place from the following assessments: Barthel, Braden, Dependency and Nutrition if they identify a nutritional need. If a service user needs a fluid watch it should be planned on the service user’s Plan Care Day. ‘Not watched’ shows any service user without the Fluid watch ac-tion planned in Plan Care Day who requires one.


Community Dashboard

Planned care – With plans / <3 actions personalised: This tile show how many service users in the community have Plan Care Days set up, and shows how many service users have personalised ones with preferences added into the actions in their Plan Care Day.

28 day admissions/discharges – admissions/discharges: This tile shows how many service users are admitted and how many service users have been discharged in the last 4 weeks

Picture not updated in the last 6 months: This tile shows how many service users’ pictures have not been updated in the last 6 months to conform to regulations.

Wound Care: Any wound care / skin integrity records that are due for review today and records that are due within 3 days

Reviews overdue: This tile summarises where residents care plans or assessment records are overdue for a review


Location Charts / More Charts

More charts

Many of the charts available within an individual person’s record can also be accessed via the Charts

menu. Most of the reports are the same, but will show each service user in the selected community.

There are also some additional charts and options available when accessing via the Charts menu. This

section of the manual will highlight additional charts and options available.

Each chart will have a series of parameters and relevant keys to explain the data presented. Some reports will

also let you click through to see the underlying data/carenotes.



Behaviour observation - a weekly view of key behaviours presented based on the activity and observations recorded on the Care App. Certain activities and behaviours will show coded on the relevant day of the week and the time they occurred.

Hygiene Chart - A wash/shower/bath summary is shown for all the service users making it easier to spot who is or is not getting a thorough wash regularly. If there are multiple records for a person on one day, then it will give priority to any records that indicate a bath or shower that has been marked as “Done”



Fluid chart— when accessing via the Charts menu, there is an additional option to summarise the report or to show the detailed records for each service user for all drinks, bowel movements and passing of urine.

The SSKIN care bundle is a five step model for pressure ulcer prevention and presents a series of measures that help reduce the risks to residents. The data from the Care App will automatically populate the fields where the relevant actions and sliders options have been completed.


Reports

Reports

There are various reports available from the Reports menu option. Most of these reports are fairly self

explanatory and will feature date ranges and other filters, groupings and options.

Activities summary—In addition to a record of each resident’s activities that they have participated in, this report

has a summary for each activity type and shows the number of people who attended.

Accidents— A list of care notes that have been flagged as an accident. This report includes them all (regardless of

whether they have had forms processed or not). You can click on the details link to see any form that has been

submitted.


Reports

Care notes—a particularly useful report for almost any query where you want to see a list of care notes. This could

be for a particular resident, staff member, ADL category or for particular action items. Simply set the report

criteria and refresh the page.

Evacuation report—Summarises information from the PEEPs forms completed and lists residents that are in the

home as well as those that are suspended (shown in a separate section for ‘Suspended’ service users)


Reports

Infections register—view a monthly summary of the infections being managed, including details of types of

infection, time taken to clear, reviews needed , whether an infection was acquired in or out of the home and if

barrier nursing is required or not.

QR codes—this is where you can generate the QR codes that are used to evidence attendance to rooms for night

checks.


Reports

Nutrition—A report that pulls together the information collected from the Nutrition assessments. The report is

designed to give kitchen or serving staff a summary of dietary requirements and preferences for the selected

community.

Care story—a summary of the care interactions put into a more human readable format designed to give an

overview of each person’s morning, afternoon, evening and night


Reports

Staff Supervision analysis—This report has multiple purposes designed to help give feedback to staff when

conducting supervision or appraisals. The Ranking index refers to how common it is that a person is on shift when

missed actions occur. For each action that is missed an index point is divided amongst the staff who were on shift

at the time, essentially a lower ranking indicates better performance relative to colleagues.

Other information includes time spent, records evidenced and a %age of notes that are being personalised from

the default text.

Nightly check—shows each member of staff who has worked between the shift start and end times, which

residents they have supported, the times checks have been made and observations made.


Process

The Process tab covers reports that support explicit process cycles within the system and are designed to quickly identify work that care planners or senior nurses have outstanding.

Process – Shift handover: Here a summary of the care delivered to each service user in the past 24 hours can be found. Important information to be handed along from each shift is shown as well as any missed critical care actions. Care managers should ensure that shift leaders use this process and carers are reading the shift handover notes on the Care App.

Process – Alerts: The alerts process runs for all service users and shows missed actions and other alerts such as if a 2 handed action (bath temperature and 2 handed hoist, or anything planned that needs two or more carers) has not be recorded by 2 staff or if the action is recorded with more than 30 minutes between both staff entering it


Process

Process – Outstanding reviews: Where you can see all outstanding reviews of care plans and assessment tools/risk assessments

Process – Care planning needed: This report shows the care plans and assessments that are needed in the next week. Red dots show overdue care plans and assessments, orange dots show care plans and assessments that are due, and green dots show anything that doesn’t need a review in the next week.


Process

Process – Care planning done: This report displays all the care plan and assessment reviews done in the last 28 days, shown with a tick.

Process – Care planning audit: A summary of changes made to resident’s care needs, assessments, forms and planned care


Analysis and Group Reporting

Analysis

Find out what is happening at

group level or at a location;

highlighting KPIs, trends and

insight into the running of a

service, performance and risks.

Group reporting—A series of data collectors run on a nightly basis, allowing for the retrospective analysis of trends and enabling insight and comparison of weekly or monthly KPIs across your organisation’s locations for system use, compliance, safeguarding and business performance.



You can drill down for more detail for any of the available charts. Once selected the graph expands out in the space below.

Clicking on a column will then show the details that make up the statistics. In the example below you can also see additional details of which days of the week a care need was overdue. Remember: group reporting shows the state of play in the past and is not a live reporting tool (e.g. the care needs may have been reviewed today)



Analysis – Weekly: Gives the last week of analysis for the community in the form of charts. Monthly analysis and Quarterly analysis also shows the same graphs but for longer periods of time.

The analysis reports are useful to highlight where improvements could be made, for instance If you have things recorded as ‘not needed’ then care plans may need to be revised, or to highlight areas where more evidence is required (e.g. are the staff evidencing about emotional support).

Analysis – Care interactions: The Care interactions report compares planned care and delivered care, so it a useful tool for staff supervision – to make sure that care is being delivered and evidenced on time, and for care planning – to see if a service user’s care needs have changed. Any additional adhoc care is displayed in blue, and any missed interactions in red, suggesting the planned care should be updated due to a change in the service user’s condition. Click on the coloured blocks to see details of the care interactions and who was on shift at the time of the interaction. The report can also calculate the cost of care per service user.



Analysis – Residential care routine: The residential care routine report serves two purposes: first to check on the quality of carers entering information and secondly to highlight any changes in the care pattern of service users. The report shows where care time has increased or decreased in ADL’s across the last 4 weeks

Secondly at the bottom of the page is a section showing recent observations.

Analysis—Falls matrix: analysis of when falls are occurring by hour of the day. The graph can be grouped by Service User, Impact or Location


Notes A blank space for you to make any notes