A lunch call that should have stopped
A client's social worker rings the office on Tuesday. The lunch call is being dropped because the client is attending a day centre, and the morning call is going up to 45 minutes. The coordinator who takes the call writes it down and means to update the rota. The coordinator is then pulled into a missed call crisis.
On Wednesday a carer turns up for the lunch call. Nobody is home. They ring the office. On Thursday a different carer does the morning call in 30 minutes because that is what their rota says. The client's daughter complains. At the end of the month, the lunch calls are still on the invoice.
Why changes arrive late
A package change has to reach several places: the rota, the care plan, the carers who visit, the invoice and sometimes the commissioner's system. Each is updated by a different person or at a different time. The change is only as good as the slowest of those updates.
The first record of the change is often a phone call. It relies on the person who took the call to write it down and pass it on. If they are busy, off tomorrow or the change was mentioned in passing, it can be lost.
Carers are the last to know, and the most affected. They see only their own rota, and a change to a client they visit twice a week may not be mentioned at all.
Temporary changes are the easiest to lose. A client wants a later call for two weeks while a family member stays, or a call is added for a short period after an illness. When the period ends, the rota has to change back, and nobody set a reminder to do it.
What late changes cause
| Missed update | Effect |
|---|---|
| Rota not updated | Wasted journeys or visits at the wrong length |
| Care plan not updated | Carers following old instructions |
| Carers not told | Confusion and complaints on the doorstep |
| Invoice not updated | Billing for calls not delivered, or missing new ones |
| Authorisation not recorded | Extra time delivered before it is agreed |
The last point links to income. Extra time delivered before the commissioner has authorised it can be hard to be paid for.
A change record that drives the updates
- A short change form any office member can fill in during the call: client, what is changing, from when, who asked and whether it is authorised yet.
- Tasks created automatically for each update needed: rota, care plan, invoicing and commissioner notification, each with an owner and due date.
- The rota change pushed to your rostering system through its API where possible, or listed for the coordinator where not.
- A message to every carer on that client's calls in the coming weeks through your carer app or SMS, with a read confirmation.
- A hold on changed calls until authorisation is recorded, if you want one, so extra time is not delivered unknowingly.
- A client history of all changes, with dates and who agreed them, for the next review or query.
Changes to care content are agreed by the right people under your procedures. We make sure the agreed change reaches everywhere it needs to.
Changes that land the same day
When a change comes in, it is logged in a minute and the updates follow as tasks. The coordinator sees any that are still open. Carers get a message and confirm they have read it. The invoice reflects what is delivered.
When a family asks why a call changed, the history shows who agreed what and when.
Recognise this?
- Package changes arrive by phone and are written on notepads
- Carers turn up for calls that were cancelled
- The care plan lags behind the rota
- Invoices still include calls that stopped
- Extra time is delivered before it is authorised