Dashboards and data comparisons: How Vivaldi will work

The Vivaldi Study has drawn on the expertise of people across the care home sector - such as Zoe Fry and Mike Slator. Zoe is the director of the Outstanding Society, and ran her own care home for many years. Mike is a pharmacist who has considerable experience of working in the NHS and care homes. They have both played a key role in the Vivaldi study, and Chris Smith met them in central London…

Zoe - I think it's such an exciting opportunity. If we look at the NHS, they use data and evidence all the time. We don't use as much evidence in adult social care. To be able to do that on such a large scale is exciting for the sector. I think we've seen academics who understand the complexities of adult social care.

Chris - It's a busy place, adult social care. There's an ask here: we've generated some findings, but now you have to implement them. What are you developing to help people read your data and use it?

Zoe - So we're going to be developing dashboards. These dashboards will show the results of the data we've been collecting, and we'll be able to use that to share best practice. So, for example, if one care home has had five hospital admissions in the last month and another care home has had 20, and they've both got 30 beds specialising in dementia care, we can look at benchmarking and ask: what is that care home doing that we can learn from? We can then use that data to inform policy to improve what we do and develop more bespoke approaches to adult social care, because it's quite a complex sector.

Chris - Can there be a sort of standardisation of this, Mike, in the same way that we have health standards that different parts of our health service subscribe to and are held accountable against? For example, clinical standards that say, "This is how you should manage infection control to prevent norovirus," or "This is what your policy should be around visitors at certain times of the year to prevent flu outbreaks." Is that something that could come from this?

Mike - Yes, that's exactly what we're aiming for—policies at regional, if not national, levels, to give care providers the substance behind their recommendations. If we think back to Covid, people were grasping at straws when guidance was released. It was very difficult to implement that guidance appropriately and quickly within each setting. So we're trying to create a much better system. Norovirus, for instance, comes up frequently in care homes. We visited one home recently where they'd done an incredible job preventing its spread. However, the cleaning products they used weren’t standardised, and their barrier nursing approach wasn’t standardised or shared with anyone else. So how do we take that best practice and disseminate it more widely?

Chris - And also, things as mundane as—I heard someone mention a care home that had a crèche, for example. A crèche brings in children, and children bring in germs. If you've got a high throughput of germs from the children, you might end up with more germs in the care home. It's about connecting those dots. I was a little bit shocked we weren’t already doing this more. But once you've got that information, you can share it, mitigate those risks, and also benefit from the fact that if you've got children around, they’re going to see grandma and grandad more.

Mike - Exactly that. And that's where benchmarking is so important, because no two homes are the same. We really struggle to compare services, because some have crèches and manage them exceptionally well without frequent norovirus outbreaks, while others struggle. We need to compare homes that are offering similar services. You can’t compare a home with a crèche and a large dementia population with one that’s operating at full capacity with different demographics. It’s just not fair. So we need to do the work in the background to ensure we’re providing providers with accurate, meaningful data.

Chris - What are the users going to see then? What will be the end result? Will they get a dashboard that shows what’s happening currently, what to watch out for, and a digest of best practice around various areas like X, Y, and Z? Will the information be presented in a way they can easily follow?
Mike - Initially, it’s probably going to be a lot more basic than what you've just described, but that is where we’re aiming. The idea is to identify best practice hot spots and areas where improvements can be made.

Chris - Is there a worry that some care homes will feel this could turn into a finger-pointing exercise?

Mike - Yes, and that's something we've been very keen to avoid. This isn’t about punishment—it’s all about support. The Care Quality Commission, the regulator of the industry, is fully on board with the idea that this is in the best interests of the sector, not a finger-pointing tool.

Chris - Zoe, about 700 care homes have signed up so far. We think there are over 10,000 in the country, so you’re on your way to having 10%. One of the challenges is that the care home sector isn’t like the NHS, where the taxpayer is footing the bill. Some care homes are public, others private, so there has to be value for everyone. If they can use the data without doing endless form-filling, like Slaw mentioned earlier, it actually removes a burden for them. So there’s a clear incentive to participate.

Zoe - I think it’s about saving everyone from duplicating work, and it’s also providing a service that benefits both health and social care. It supports the entire healthcare system by encouraging collaborative working.

Chris - How is it funded? How do you make this sustainable in the long term?

Zoe - We need public funding. We’ve had funding for the initial years. Recently, we’ve seen the results of the Covid inquiry and how important Vivaldi was during the pandemic. We need that funding to continue so we can keep this pilot going.