A Focus on Individual Resident Satisfaction in High Care

The Maronite Sisters of the Holy Family Village (MSHFV) is a 97 bed high and low care facility located in 2 sites. The current average daily subsidy level has it placed 14th highest of all QPS Benchmarking facilities in the high care data base. Due to their frail condition most residents are unable to provide feedback via the formal survey process. Sr Elham and the staff at MSHFV however, prefer to see this as an opportunity rather than a problem when it comes to fine tuning and improving services for their residents and they have demonstrated over the past 14 months that a strong and individual focus on surveying and working with the small number of residents capable of providing feedback can provide dividends.

For the past three years MSHFV have identified approximately 12 residents that are capable of providing survey feedback and has consistently managed to get survey feedback from this group of residents. By and large, this group of residents has been the same people and this has provided a unique opportunity to see how surveying and management action can influence resident perception. The particular group of residents being surveyed presents some challenges as many come from a variety of cultural backgrounds where English is not the language spoken.

MSHFV has been benchmarking resident satisfaction with QPS Benchmarking since 2001 and the results compared to other facilities were strong until 2007-8 when satisfaction rates declined.

The result in 2008 prompted a call to action and a desire to understand where the facility and staff were letting down those residents most able to voice their concerns.

At the request of Sr Elham, staff members were asked to review the survey comments carefully and to further discuss with the residents the concerns voiced in the survey feedback. The analysis, whilst too long to reprint in full, noted that there were significant improvement opportunities in the following areas:

• Staff slow response to resident requests e.g. change of room temperature.
• Lack of variety in weekend activities.
• Food presentation and issues without some menu items.
• Staff walking into rooms without introducing themselves.
• Loss of personal items in the laundry process.

The following extract from the Resident Survey Action Plan indicates the action taken within two months of receiving the survey results.

Action Taken: RAOs on weekend were advised to provide more activities following the residents' choices. Also, staff were asked their opinion on how to improve the service provision in our village and how to fix the issues mentioned earlier. Staff stated that their aim is to make residents happy by answering their demands and attending to their needs. They stated that by answering the buzzer promptly and quickly the residents may be more satisfied with the service and nursing care. DDON (V1) stated that there is no excuse for not providing good service to all residents and all staff should work towards the one goal which is the provision of holistic care. DDON (V1) asked staff if they require any additional equipment, training or in-services to assist them to provide good service. Staff stated that they were not aware that residents are unhappy and now they will do everything they can to ensure that resident satisfaction increases. Kitchen staff were notified not to take the food trolley out of the kitchen before dinner time and ensure to measure the food temperature prior to leaving the kitchen.

Staff double their efforts to put a smile on the faces of the residents.

Following the implementation of the above actions and follow up with staff, the same residents were again surveyed in February 2009, three months after the previous survey. The response from the residents showed a 20% improvement to a level of 94% - the highest score achieved since 2001. In November 2009 the survey was again repeated as part of the data collection for QPS Benchmarking and the result showed further improvement to the almost perfect score of 97%.

Resident Satisfaction climbed from 74% to 94% in a mid-term survey and then to 97% at the end of the year.

The strategies employed to improve resident satisfaction have been noticed and appreciated by relatives and it is noted that relative satisfaction climbed in the same year by 14%. The facility drew comfort from the fact that the views of the residents were being echoed by their relatives and friends.

Relative Satisfaction Climbed by 14% to 94%.

As Sr Elham explains, "the fact that only 12 residents are capable of providing feedback has worked in favour of the individual care and comfort we can provide to these particular residents. Over a period of 12 months we were able to focus our improvement strategies and monitor closely the resident's response to our actions".

Recent improvements include more visits from volunteers.

Other key improvements introduced over the past twelve months include:

• Continued variation of activities on the weekend. MSHFV employs a weekend RAO for 4 hours each day.
• Contact was made with the local parish and the Youth Groups have changed their visitation strategies from one major visit at Christmas time to several visits during the year and this has met with resident approval.
• Additional interaction with the community via the Parish's Ladies Group.
• The introduction of weekend Church services and it is noted that the current residents of MSHFV are highly religious and formal church services are very important to them.