Turas Care ManagementSafety Huddle and Staff Screening Guide

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Contents

Welcome ........................................................................................................................ 2

How the tool works .............................................................................................. 3

Impact ............................................................................................................................ 4 COVID-19 Response ............................................................................4

Supporting our workers ....................................................................5

Feedback ...................................................................................................................... 7

Evaluation .................................................................................................................. 7

Support .......................................................................................................................... 7

Users with new Turas Accounts ................................................................. 7

Users with existing Turas Accounts ........................................................ 8

If you need to reset your password ........................................................ 8

Request Support..................................................................................................... 9

Screenshot Walkthrough ................................................................................ 9 Turas Log-in .......................................................................................................... 9 Populate the initial Care Home information ........................ 10 Information Displayed on your Care Home’s ....................... 11

Summary page Staff screening information.................................................................. 13 Creating a Safety Huddle ........................................................................ 14 Health Protection Teams Tab ............................................................ 16 IPC Measures Tab.......................................................................................... 18 Staff Absences ................................................................................................. 19 Landing Page ................................................................................................... 23

Reports ........................................................................................................................27 Filtering ................................................................................................................. 27 Navigation ........................................................................................................... 27 Focus ........................................................................................................................ 27 Date Trends ........................................................................................................ 28 Data Tables ......................................................................................................... 28 Report Viewing ................................................................................................ 28 Security.................................................................................................................. 28

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Welcome

Thank you for your support in the roll out of Turas Care Management.

The aim of the Turas Care Management Safety Huddle is to enable a consistent approach to data collection, support staffing decisions, provide escalation, early warning and timely intervention. It will reduce the data burden and make data analysis and reporting easier for all key stakeholders.

Care home managers will be able to visualise trend reports which will support quality improvement initiatives. In addition to this, it will provide key stakeholders with the right visibility and access to data, which will fulfil some of the key requirements as set out in the Cabinet Secretary letter of the 17 May 2020.

The tool was developed in collaboration with Care Home Managers, Group Care Home Managers, the Scottish Government, NHS Education for Scotland’s Digital Team and other stakeholders.

The data that is requested by Care Inspectorate will continue as per normal process. There are future discussions with the Care Inspectorate which will support collaborative working

The Turas Care Management tool provides the Safety Huddle and Staff Screening form in an online format. The tool reduces the data burden for care homes by making data analysis and reporting easier for all key stakeholders. Care Homes enter the data once a day where it can be used for multiple purposes in the care home, care home groups, and relevant hierarchical reporting structures. Care Home and Group Care Home Managers can visualise trend reports supporting quality improvement initiatives.

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How the tool works

This guide includes a screenshot walk through.

1 | Login to the tool using your Turas Account

2 | If you are a Group Care Home Manager, you will be able to onboard managers in your care provider

3 | If you manage multiple care homes, you will see an overview of the care homes you manage showing: Care Home Name, Date of last completed Safety Huddle, Date of last completed Staff Screening

4 | If you manage one care home, you will be taken directly to your landing page where you can complete a Safety Huddle

5 | All users can populate the daily Safety Huddle from the appropriate care home’s home page

6 | All users can populate the Staff Screening Form from the appropriate care home’s home page

7 | There is an automated system in place to export the data to the relevant groups

8 | Escalations must be addressed outside of the tool as per individual care home processes. There are currently no automatic escalation routes built into the tool

9 | This tool does not replace any Care Inspectorate data or forms

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Impact

COVID-19 Response

Safety Huddle

During the Covid-19 Health Pandemic, Care Homes are requested to provide a wide range of data to a variety of different sources, such as HPS, H&SCPs, Care Inspectorate, SSSC and Boards. A Safety Huddle template developed with Care homes in April 2020 provides a Scotland-wide approach for consistent data collection. Core data was agreed in the letter from the Cabinet Secretary on the 17 May 2020. Testing many iterations of the template resulted in widely agreed improvements.

Staff Screening

Recording testing information helps individual care homes understand progress towards weekly testing of staff and where support may be needed. The information is needed beyond care homes to understand progress at a Health and Social Care Partnership and Health Board/regional level. A positive result means that contact, trace and support can be enacted helping to protect staff, residents and the wider public. This is particularly important when a member of staff may not be displaying symptoms.

The data will be used for monitoring the progress of the policy. No individual personal details are recorded so numbers are not attributable to specific staff. Aggregate data at NHS Board level are published on the Scottish Government website which demonstrates the number of staff that are tested by a Health Board on a weekly basis. The data is published for transparency and allows interested parties—including the general public—to access testing information on care homes. This complements other testing data that is published on the website.

The rationale for the policy is that staff who do not have symptoms may have the virus and can pass it to their colleagues or vulnerable care home residents. Weekly staff testing within all care homes helps

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protect residents, staff and the general population. It is an important part of the national effort to tackle coronavirus. Both the First Minister and Cabinet Secretary made a commitment on 18th June 2020 to test all staff in care homes for Covid-19 weekly.

A key aspect of this work is supporting and encouraging staff to participate in testing, seeking to understand any concerns staff have and overcoming them. We would like to thank all care home staff and managers for everything you are doing at this hugely challenging time and we encourage participation in weekly staff testing.

Supporting our workersTuras Care Management was built to ease the reporting burden on care

homes and make data analysis and reporting easier for key stakeholders.

Requests for information have to date come from Health & Social Care Partnership’s (H&SCPs), Contract monitoring teams in Local Authorities, the Care Inspectorate, NHS Boards and Directors of Public Health. These information requests are all similar in nature and place a heavy data burden on care home managers to respond to the requests in a timely and efficient manner. It is also recognised that the care home managers are unable to utilise the data provided in a way the provides benefit to the care home on an individual and provider basis.

The data for care homes will provide trend reports and opportunity for quality improvement interventions. This is done by delivering aggregated data and overview at Local, Regional and National level. The tool will offer data reports, trend analysis and early warning through use of escalation which will support early intervention by the relevant stakeholders.

The tool will enable Care Home reporting that may impact on the health, safety and wellbeing of residents by providing one place to capture information on daily activity for example, infection prevention and control measures, dependency and complexity, outbreak, staff testing and staffing requirements.

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The Turas Care Management tool is for the care homes and care home groups managers or equivalent with management data reporting to H&SCP, NHS Board Directors of Public Health and Nurse Directors (as part of the oversight and assurance arrangements during COVID and for the foreseeable future, Local Authorities contract monitoring teams, the Care Inspectorate, COSLA and Scottish Government). It is not intended these reports will be publicly published.

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Feedback

As always, we welcome your feedback on any of the functionality within Turas Care Management, please pass feedback to us via nes.caremanagement.support@nes.scot.nhs.uk

Evaluation

As the tool was developed to support you and your team, it is imperative to the project collaborators that Turas Care Management is fit for this purpose and continually improved upon. Users may be asked to participate in interviews and evaluations. Your time spent on any evaluation will be very appreciated.

Support

How to access Turas Care Management

Use this URL: https://turascare.nes.nhs.scot

Sign-in to access your Turas Care Management dashboard.

Your username and password are the same as your normal Turas account if you already have one.

Users with new Turas Accounts

The email provided to the NES Digital team will be checked for an existing Turas account. If this email is not associated with an account, a new account will be set up and be given access to Turas Care Management. You will receive an email from Turas with log-in instructions.

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Users with existing Turas Accounts

If you already have an existing Turas account, you will be given access to the Turas Care Management tool and the tile will be available on your dashboard. You will not receive an email from the Turas team.

If you need to reset your password

1 | To reset your password, click the option Can’t access your account? below the sign-in button. Enter your user ID, which is your email address, and captcha.

2 | You will be sent an email to reset your password. Please note that the verification code is only valid for five minutes. If the code you enter has expired, you will need to press the Send New Code button to get a new code.

3 | Click the Set Password link in the email. You will be presented with a welcome to Turas page.

4 | Enter your email address then click the blue button Send Verification Code - Do Not Close the Screen.

5 | You will receive an email from Microsoft on behalf of Turas: msonlineservicesteam@microsoftonline.com. Copy the verification code in the email.

6 | Enter the code from the email into the verification code box then press the blue Verify Code button.

7 | You will then be presented with a screen that says email address verified. You will see that your email address has been pre-populated here. Press the blue Continue button.

8 | You will be presented with a new screen that asks you to enter then confirm your new password. Do this and press the blue Continue button, you will then be taken to the login screen.

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Request Support

If you experience any technical issues with the tool, please use the green helpdesk button to contact the Turas Helpdesk.

Screenshot Walkthrough

Turas Log-in

The user will log-in to the tool using their Turas account via the Turas Care Management URL: https://turascare.nes.nhs.scot

If needed, users can reset their Turas passwords by going to sign in and reset their passwords by clicking “can’t access your account.” Follow the password reset instructions in the user guide.

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Users with three or more will see blocks. Users with four or more care homes will see a table.

The staffing levels and skill mix should be based upon individual assessment of care needs within your care home over the 4 week roster period – Guidance is available within the Care Inspectorate

You will then be asked to enter the planned staffing levels and skill mix requirements agreed for a typical 24 hour roster period

Populate the Initial Care Home Information

Once logged in, users managing multiple care homes will see them listed either in blocks or a table. Users with only one care home will be taken directly to their care home’s summary page.

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The number of Care Home Places has been pre-populated from the Care Inspectorate database but can be over written. The other information required is noted below.

Information Displayed on your Care Home’s Summary page

Status Bar

The number of care home places comes from the previously input care home data. If this information changes, it can be updated via the Care Home Details button.

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The number of residents, number of positive residents, the number of covid-19 related deaths in the last 24 hours and whether the care home is open or not, is populated by the most recent safety huddle.

Safety Huddle information

The safety huddle table shows user’s potential escalation points from the safety huddles performed at this care home. When there is more than one safety huddle populated, the table can be sorted and filtered.

Escalation items are highlighted by the red escalation icon. Remember, please continue to use your care home’s escalation processes. There are no automated escalations built into the tool as of yet.

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Staff Screening information

The staff screening table shows if users have completed a staff screening form for this week, if it is in draft, and if previous forms are closed because they have been exported for reporting.

Forms which are complete, and not yet exported for reporting can still be updated. Forms, which are reported cannot be edited, but can be viewed as read-only.

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Creating a Safety Huddle

Click “Create Safety Huddle” to populate the safety huddle. This button is not available if you are up to date with your safety huddles.

It will default to today’s date, but the safety huddle can be back dated for the previous week. An error message will show if you try to go back further than one week.

The safety huddle template comprises of the following tabs: Local information, HPT (Health Protection Teams), IPC (Infection Prevention and Control) Measures, Dependency & Complexity, and Staff Absences.

Users can navigate by clicking on these tabs as well as the “next section” button at the bottom of the screen.

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Mandatory fields are marked by a red asterisk. Items which trigger an escalation, will be highlighted by the escalation icon.

Help text is automatically displayed. The help text will be concealed behind information buttons after the tool has used for the appropriate amount of time such that users are comfortable.

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The following is an example of how the form might be filled in.

HPT Tab

On the day this care home is recording the safety, there are residents who are displaying symptoms compatible with Covid-19. Further fields appear when “yes” is chosen.

The staff are currently waiting on tests to be returned to confirm an outbreak.

The status of the care home is “open with control measures in place.” This decision is be determined by the environment, layout of the care home and on the decision by the Health Protection teams advice.

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This care home currently has 3 residents exhibiting symptoms that need to be tested.

There are 2 residents that have declined or have been deemed not appropriate for testing.

Residents will be required to provide consent for undertaking testing, if the resident does not provide consent then this would be noted here. It may be that the test would be considered too distressing for the resident. The resident may have a cognitive impairment and would be unable to provide consent. In that case, the resident would need to have a power of attorney in place for someone else to consent to them having a test.

Alternatively, the resident may have been tested within the last 24 hours

This care home is currently waiting on those three tests coming back, so the number of positive cases is 0.

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IPC Measures Tab

The IPC Measures Tab is where users will indicate if the care home has adequate PPE, if they can comply with infection and prevention control measures, and if there are restrictions in place on resident’s movement.

Dependency and complexity

After populating the dependency and complexity tab, users will be asked if they have reason to escalate based on their professional judgement. Teams might have concerns that they do not have the staffing resource to support this additional complex care, or it might be the case that the team may also not have the necessary skills therefore need to reach out for support. See the help text for further information.

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Staff Absences

This is not a workforce/workload tool or data collection on the overall short or long terms absences within the Care Home, this information is currently collected by the Care Inspectorate.

The aim of this section is to:

1 | Indicate the short-term absences that have not been able to be covered by your own resilience planning i.e. covering shifts with Bank/Agency changing roster, re-locating staff groups

2 | Review your available staffing, using your professional judgement you will be asked to consider based upon activity, complexity and dependency how many staff would you require on duty over the 24-hour period to be able to deliver safe and effective care. If there are differences in current available staff and the number of staff required using Professional Judgement, the care home manager will then be required to make decisions to escalate or mitigate risks

3 | Identify the number of occasions where your staffing has fallen below agreed levels and what action was taken

4 | Key stakeholders will also be able to identify and prioritise quickly where care homes require staffing support if they have not been able to mitigate risk

Example of local resilience planning

This care home had a late sick call from a Registered Nurse. However, this was covered by deploying a senior Social care worker from other parts of the service to work in a registered nurse capacity. Therefore, the number of Registered Nurses absent is 0.

The care manager had a further call during the night that a care worker is not able to attend for duty this morning. The care manager was unable to cover the absence with local resilience planning; therefore, this would be recorded as an absence.

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Fields will have validation to help prevent accidental mistypes. For example, if you have 2 Registered Nurses, the tool will not allow you to say 3 are absent.

Total staff available will sum automatically, taking into account the normal staff as noted in the care home details, and the number of staff absent.

There are three options at the end of the Staff Absences tab: escalation, no escalation or risk mitigation.

For escalation

For example, if the manager had absences and were not able to find additional staff to provide safe and effective care, then the care home manager would choose to escalate this as a risk.

The care home manager will use their professional judgement and might decide they cannot provide safe and effective care when considering the complexity, dependency and activity in the care home.

If users choose to escalate, the reason will be pre-populated for the tab as “staffing concerns.”

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There will be an action plan box, please provide details to provide evidence of decision making

For no escalation

If the care home manager uses their professional judgement and deems that the care home can deliver safe and effective care with no further actions or risk mitigation required, then they would choose no escalation. For example, if the care home usually has 30 staff, and have 3 absences, the manager could decide that they can provide safe and effective care with 27 staff. This could be because there is low complexity, dependency and activity in the care home.

There is an additional information box, please provide evidence of your decision making.

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For risks mitigated

If for example, there are 5 late staff absences, but the care home manager feels confident that by using supplementary staffing or other local resilience that these absences will not impact on ability to provide safe and effective care, then the risks are mitigated. The available risk mitigation options are shown here.

Another example might be that the care home manager might be a registered nurse and is able to work clinically to support teams. In this case, they would choose the “other” option.

There are non-mandatory free-text boxes at the bottom of the decency and complexity and staff absences tabs. As mentioned, please use them to provide further information about your decisions or any other information you believe is relevant. This information is visible by any users able to view the care home and will pull through to reporting. It is the hope that users will find it helpful for audit trails.

Users can choose to close without saving, save the safety huddle as a draft to return to at a later time or submit the form.

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Landing page

From the care home’s landing page, users can view their completed and draft safety huddles. The date of the last safety huddle and information at the top of the care home’s landing page will have been updated to reflect the most recently completed safety huddle. If the safety huddle was saved as a draft, these numbers will not update.

Via the actions drop down on the right-hand side of the table, the safety huddles are editable until they are exported and reported. They then become read only. Please review your data entry and review the escalation triangles to ensure that these reflect your situation prior to submitting.

Creating a Staff Screening form

The staff screening table is available under the safety huddle table on the care home’s landing page. Click “create staff screening form” to populate your staff screening form.

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Staff screening form data can be input with daily information, or users can choose to input only the weekly totals. This can be chosen at the top of the form via these radio buttons. The tool will remember the user’s preference in future.

Staff screening forms can only be populated for the current week and one week prior.

If choosing to populate daily figures, save the staff screening form as a draft until you have completed the week’s data. All fields are mandatory on this form and it will not allow users to submit with empty fields.

When populating weekly figures, the staff screening form is still editable until the figures are reported – usually around noon each Monday. If submitted early accidentally, it is editable from the home page until it is reported.

User Management

Users onboarded as Group Managers can access and administer the user management functionality. Group Managers can onboard, update, and deactivate users in their care home provider. Group Managers are not able to create other Group Managers.

For example, under user management -> users, this group manager can see the users that already exist in their group.

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If the group manger clicks on “Update” in the action dropdown, the group manager can update their details, including which care homes are visible to the manager.

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Group Managers can deactivate users that are no longer employed in their service provider via the actions drop down or from the view user page when “view” is chosen from the actions dropdown.

Under user manager -> grant access, Group Managers can onboard new users into their group and assign them the relevant care homes. The tool will notify Group Managers if the new user has an existing Turas Account. If it is a new Turas account, users will be sent a welcome email and be asked to set their password. If the user has an existing Turas Account, then the user only needs to log in as usual and access the tool through the Turas Care Management dashboard tile.

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Reports

The following explains how users can optimise their experience in interacting with the embedded report(s).

Filtering

While browsing a report clicking on an attribute within any visualisation will cross-filter all other visualisations on the page.

In addition, reports have filters at the top or to the right in the filter pane which can be used to filter the data in the report:

Navigation

Users can navigate through the different report pages by clicking on the tabs at the bottom as below:

Focus

Users can concentrate focus on a specific visualisation via the right-click menu (Show as a table), this will show the current visualisation in full screen mode and with a table of the related data:

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Report Viewing

User can also view the report in Full Screen mode or reset any filters which they have changed by clicking on the appropriate buttons within the application:

Security

Users will only be able to see data relative to their position within the national hierarchy, this is managed within the application, so for example a Care Home Manager will only see data relating to their Care Home.

Data Tables

A variety of options are available to the user by clicking on the top-right of a visualisation, particularly tables of data, including the ability to “Export Data”:

Date Trends

Data on the number of Covid cases, Transfers and Deaths are available at a daily trend but can also be displayed per calendar week. This can be viewed by hovering over the chart and using the visual heading and selecting Drill up to go from a daily chart to a weekly chart, or Expand all down one level in the hierarchy to move to a daily count.

ALTERNATIVE FORMATSThis resource may be made available, in full or summary form, in alternative formats and community languages. Please contact us on 0131 656 3200 or e-mail: altformats@nes.scot.nhs.uk to discuss how we can best meet your requirements.

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© NHS Education for Scotland 2020 You can copy or reproduce the information in this document for use within NHSScotland and for non-commercial educational purposes if referenced in full. Use of this document for commercial purposes is permitted only with the written permission of NES.