Guidance for Care Assurance Visits
The purpose of the care assurance visit is to observe the clinical environment with fresh eyes and to provide the clinical team with objective feedback. The information gained will provide a better understanding of how patients and service users first experience their care environment and also how welcome visitors are made to feel on entering the clinical environment. (15 steps NHS England 2017 - accessible here)
Objectives of the visit:
Who should carry out the assurance visit?
An associate chief nurse or lead nurse and senior charge nurse/practice development nurse/allied health professional who are not from that clinical area
How often should the CCAAT be carried out?
It is envisaged that one CCAAT will be carried out twice annually as a minimum(dependent on the RAG status/improvement plan), and the corporate assurance visit should count as one of those CCAATs.
How long do the visits take?
Once the assurers have read the 15 steps guidance (NHS England), watched the podcast and familiarised themselves with the CCAAT, the visit should probably take on average 2.5-3hrs. As part of the visit, it is envisaged that the assurers observe a mealtime within designated clinical area.
Initial Approach in Clinical Environment
Arrival in Clinical Area
All staff on assurance visits must be in uniform and should identify themselves on arrival to the nurse in charge, explaining the purpose of the visit. Also ask if a previous CCAAT has been carried out and if so is it available to look at? Assessment of 5 sets of patients case notes, considering the following category of patients:
Speaking to Staff, Patients & Carers
Take time during your visits to speak to staff, patients and carers/visitors to gain feed-back about the clinical area from their perspective. However please check with nurse in charge should there be any patients that should not be approached due to their clinical condition.
Clinical area visited details, including date, SCN name & staffing skills mix
Welcoming ward Section
Quality Assurance Section
End of the Visit
Completion of the CCAAT should be done together by the two assurers, who discuss, agree and record their observations/comments into the electronic document. The assurers should then feedback to the senior charge nurse/nurse in charge. The completed CCAAT tool should then be saved and title with clinical area name and date of assurance visit. It should be emailed to the clinical areas senior charge nurse and the lead nurse respectively.
Where the CCAAT has been categorised by red (compliance of less than 70%) or amber (compliance 71%-85%) then the SCN and LN from that clinical area will develop an improvement plan to address the issues identified during the visit.