THE BIG INTERVIEW: Nourish Care founder, Nuno Almeida
With its emphasis on supporting care teams in delivering high quality care, Nourish Care believes that their digital care planning system is the most adaptable and user-friendly product on the market. CHP caught up with Nourish Care founder, Nuno Almeida, at their office in Bournemouth to find out more.
Entering the sector in 2011 Nuno understood how his background in emerging technology and artificial intelligence could be applied to the challenges teams face across all different types of care.
“As both an entrepreneur and innovation enthusiast, I have always been intrigued by finding solutions to social problems through the power of design and technology,” he said.
“Spending time working with care homes, I quickly realised that the process of recording, sharing and analysing information was limited, and was genuinely detracting from the quality of care that teams could provide.
“You could actually see the frustration this caused to care teams, who had come into the sector because of their desire to help others – not to complete paperwork. Not knowing where certain documents were, not being able to easily access people’s care plans, feeling like they were writing notes simply to be compliant with regulators – these were all common feelings I encountered.”
Launching Nourish Care in 2015, Nuno’s vision for a simple-to-use care recording system was realised. By the end of that year Nourish was serving care teams supporting 270 people, and today serves more than 600 care services, supporting over 12,000 people.
“Some of our clients have one care home and some of them have hundreds,” Nuno said.
“Our clients are varied across residential and nursing homes, supported living, mental health and learning disability support and care in the community.”
Nourish Care has been built to mirror established practices already in place at care home providers, minimising disruption and easing adoption. Nuno believes it is this ability of Nourish to support different types of care, the bespoke requirements of providers and the personalised needs of the people they support, which makes the company’s overall services so attractive.
“Once a client decides to join us, we customise our services towards that provider,” Nuno said.
“We don’t believe in a one-size fits all approach, and we work to support how our clients already work, rather than asking them to work in a different way.
“We respect the structure of documentation that a provider uses,” Nuno said.
“Our product will resemble what they have always used in terms of terminology and structure, which makes the training process much smoother and allows providers and care teams to retain aspects of their care that sets them apart. If a provider worked hard to create a set of processes over the years, we’ll ensure they can still use them – having said that, with some providers we are able to supply a full set of documents that reflect our view on best practice.”
This makes Nourish particularly attractive to larger care organisations looking to maintain their unique brand and approach to care, and ensure that this is delivered consistently across their different services.
When asked for his differentiator from the numerous digital care planning systems on the market, Nuno first highlights his primary focus on the carer.
“Our focus has always been on the hypothesis that by making the life of a care team better – by simplifying the recording and empowering them, you will improve the quality of care for the people at the receiving end of that care team,” Nuno said.
“When we were evolving our platform, we made a decision to place a significant focus on design, in terms of improving the user experience. We knew it had to be about providing the information people need, at the time that it is needed; not cluttering the screen with too much peripheral information. Even now, five years later, people feedback that they use Nourish because it will make their carers lives easier, beyond what other systems can.”
While many providers remain reluctant to take the digital leap, the results in terms of improved care quality are compelling with 8% of Nourish customers achieving ‘outstanding’ within one year of adoption, more than double the overall sector level of 3.5%. Clients of Nourish also include providers with outstanding in all five KLOEs.
Nourish prides itself on offering the highest level of training and support to users, stressing that they always aim to go above and beyond with their support service.
“We don’t just show up at a care service and give them a software licence and then run away,” Nuno commented.
“We want our clients to know that we are an extension of their team. We train them and support them and are there to answer questions whenever that’s needed. Care is 24/7 and suppliers into the sector need to be able to support that.”
A lot of the team at Nourish have come from the care sector.
“When a care provider talks to us, they are not just talking to a technology provider – they are talking to a care specialist that helps them make the most of digital,” Nuno said.
He believes this insight allows Nourish Care to impact both the quality of care and efficiency of management far wider than just care recording software affords on its own.
“There is an impact in adopting the digital system and what it allows care providers to do,” Nuno commented.
“Once they get through the process of adoption there is a powerful opportunity for managers to shape their culture and empower carers, improve innovation within their team and make their care team more responsive to the needs of the people they support and be able to demonstrate that to CQC,” Nuno stated.
“Using digital allows our clients to have instant access to important information, whether they’re a carer or a manager. It’s very simple to do quality checks, to run audits and demonstrate lessons learnt and what changes have been made for better care. It’s possible to extract a lot of detail and trends in care and a resident’s health.”
When asked about CQC involvement, Nuno said the regulator had a key role to play in promoting sector wide adoption of digital care planning and noted he had already seen this starting to take place.
“There are inherent risks in using paper that digital solves, but it also encourages proactive care provision, rather than reactive care,” the Nourish Care founder said.
“These benefits are being noted by regulatory bodies like the CQC, who have publicly stated that they have an ambitious digital transformation programme ahead; supported by their appointment of a new Chief Digital Officer, Mark Sutton, this year.”
Nuno said he wouldn’t be surprised if the CQC started to make digital care planning systems a mandatory requirement within the next three years.
He added that local authorities (LAs) – as commissioners of just under half of care provided in care homes – had an incentive in encouraging digital adoption.
“LAs have to demonstrate the care they are providing for the funding they receive, so providing them with continued reporting will invariably generate savings in contract monitoring organisations,” Nuno observed.
“Digital platforms let them see in real-time the quality of care of each individual they are providing for.”
Nuno said there was a significant drive from LAs to see digital uptake amongst providers because it enabled a smoother and faster contract monitoring process.
He envisioned LAs making digital care planning a requirement in their procurement programmes because of their money saving capacity and ability to provide safeguarding oversight.
Looking ahead, Nuno is focused on realising Nourish’s vision of supporting care teams to provide high quality integrated care.
“We can see that the future lies in data intelligence in order to support better decision-making and allow us to better predict, optimise and improve care,” he said.
“It’s also about managing care between providers and improving the overall experience of those who work in the social care sector and the experience of each person receiving care when moving across multiple services.”
Nourish are able to support the sharing of people’s data across services, providing a vital tool in enabling care pathways and supporting health and social care integration.
“We are able to share information with relatives and with GP practices so that they can do remote consultations and have more information on residents,” Nuno noted.
“We are a firm believer that we don’t own the data we hold. The data is owned by the person receiving care and they should be able to make the most of that in the way that they choose.”
Nourish has demonstrated the transfer of data required when a person is admitted or discharged from hospitals or when someone transfers to another care home.
To expedite integration between different digital care planning systems, the business co-founded the Care Software Providers Association (CASPA), with two other leading technology suppliers within the sector.
“All of us have a common interest to improve interoperability within social care so that we prevent the sector from entering into a similar situation to the NHS, where interoperability is challenging due to passive behaviours from legacy IT suppliers and lack of robust standards,” Nuno noted.
“We want to make it easy for data to flow between different systems.
“We also want to integrate with other third-party systems, not just care planning. We want to make it really easy for clients to choose the best care planning system and nurse call solution and not have to think of whether they talk to each other. It’s not an easy journey but we want to set ourselves on that way.”
Having launched earlier this year, CASPA already has around 40 members.
Nourish is also a member of InterOpen a group of individuals, like-minded companies and health and social care providers, led by NHS Digital, who are aiming to develop interoperability standards.
“We have been working on being able to automatically transfer discharge notes directly to the care home, which would be revolutionary,” Nuno said.
“We have demonstrated that it is technically feasible. If we were able to implement that at scale the discharge notes would be transferred immediately rather than the up to two or three days this currently takes.”
While highlighting progress on research with the NHS, Nuno is under no illusions about the challenges of implementing such systems, however.
“There is a big gap between something being technically possible and it being implemented because most hospitals don’t use the same systems,” Nuno noted.
Over the last 18 months, Nourish has invested heavily in an artificial intelligence (AI) and statistical learning programme to provide added insights to care providers into specific areas such as incident management, falls prevention, hydration and nutrition.
The software provider launched a care analytics forum at the beginning of this year where it works with clients of all sizes and different care types on applying AI and data science techniques for optimising processes on compliance and audits, as well as operational matters such as occupancy, levels of need, falls and hospital admissions.
This work underpins the launch of the company’s new initiative: Nourish Analytics.
It will enable care providers to plan more strategically by predicting spikes in demand and assess the level of needs of people making enquiries so that they can ensure adequate staffing and training is in place.
“We expect this to provide a lot of business insight for high-level directors, as you can have a fluid and dynamic way of calculating levels of dependency, so that you have a much more realistic representation of the true cost of the care you are providing,” Nuno told CHP.
“Ultimately, though, this will ensure that care data can be used effectively to drive better decision-making, support care teams to be proactive rather than reactive to care needs and optimise and improve the care they’re able to provide.”
Wrapping up, Nuno said this was an exciting time for the care sector and that despite the challenges, there were so many reasons to be positive. Nuno and Nourish are looking forward to helping drive digital initiatives with other organisations.
“We are a fast-growing business but first and foremost we are focused on keeping our priorities right,” he concluded.
“It’s about providing technology that is comprehensive, intuitive and intelligent, yes – but ultimately remembering at the frontline, it needs to remain simple to use and genuinely helpful to the care teams using it; helping them to provide the best level of care that they can.”
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