Care planning conversations in aged care facilities: piloting ASCOT

The Adult Social Care Outcomes Toolkit (ASCOT) measures social care-related quality of life across eight domains. It has been used by researchers, commissioners, who allocate funding, and providers. Most recently, providers in England and Australia have been considering integrating ASCOT into care planning conversations, as a means of identifying unmet needs and improving quality of life.

This paper reports on a pilot study in New South Wales, evaluating the feasibility and impact of integrating ASCOT into care planning conversations with 40 residents in four aged care services. Data is being collected at three time points in 2016 (baseline, 6 months and 12 months). Semi-structured interviews are being conducted with the administering RNs at each stage. Additional data about residents’ needs and characteristics and time/use data is also being recorded.

Care planning conversations using the ASCOT took an average of 33 minutes to complete. Social care-related quality of life was generally very high in the personal cleanliness and comfort and accommodation domains but some needs were identified in food and drink, control over daily life and occupation (how they spend their time). Registered nurses carrying out the conversations reported that they gave a valuable structure for discussing social and emotional needs, and empowered residents to raise needs they might not otherwise have raised or have never discussed with anyone. The conversations have resulted in some significant changes to care plans. Both RNs and residents have reported benefits, and some areas for improvement at service level have also been identified.

Early findings indicate that there is scope for the ASCOT interviews to be fully integrated into normal care planning, minimizing additional RN time required. Future analysis will examine whether improvements in quality of life can be measured over time as a means of measuring the impact of outcomes-focused care planning.