While it is true that Birdie is designed and optimised to be used for hourly care packages, you can still effectively carry out live-in care packages.
This article explains how you can manage Care Management, Roster, Finance and Care Delivery for live-in care.
There are various options to consider for live-in care, which will depend on your needs and also the Birdie features that you have access to.
We recommend you discuss the options listed within this help centre article with your Customer Success Manager, so you can select the best option for your care business.
Option 1 (Recommended Approach) - Long and Short Visits
The below outlines our recommended approach for using Birdie to support live-in care clients and packages. While this requires more set-up on the Finance side of things, this approach follows best practice clinical safety recommendations. As ever, we recommend you discuss these options with your Customer Success Manager.
In this option, you will set up one long visit (for funding) and multiple shorter visits (for tasks and medications). See below for detailed set-up information.
For Live-in Care - Admin Guidance Part 1
Scheduling: The coordinator can schedule one long visit for the care recipient which spans the period of time (8, 10 or 12 hours) during which care is expected to be delivered. This ensures that the amount of ‘measured’ time is accurately reflected on the roster and within the finance module.
Funding: For a long visit, set funding information as appropriate.
Pay Rates: The care professional performing the visit will have a default pay rate assigned but this can be overridden if required (for example, in the case of differing lengths of care).
Invoicing period: If you invoice your live-in Care Recipients at a different frequency to your other Care Recipients, it may be easier to put them into an invoice group so you can easily distinguish them.
Travel Time: If you pay your live-in Care Professionals travel differently compared to other Care Professionals please ensure they have the appropriate travel rate assigned to them with the correct settings.
For Live-in Care - Admin Guidance Part 2
Scheduling: Alongside the long visit, create ‘short visits’ that wrap around the times in which tasks and medications need to be administered - e.g. morning, lunch, evening (or as applicable).
This helps to ensure that alerting is timely, and encourages real-time reporting.
If tasks and medications do not need to be administered between 12am - 6am, avoid your visit plans spanning these times altogether — the last ‘short visit’ of the day should have a finish time that corresponds to the realistic time that the last task/medication will be completed, informed by the client’s daily routine.
Finance: Within the finance tab, these shorter visits can be discarded from Payroll and Invoicing. This will prevent double payment to the care professional but does not delete the visit. All visit and task information will still be visible within the care log, schedules etc. Discarding the shorter visits from payroll also means that there will be no risk of double counting in holiday pay calculations
Record of the visit: discarding the visit does not remove the record of the visit happening. The visits will be visible on the roster and within the care log and client/carer feeds. If one of these shorter visits is completed by another care professional (e.g. domiciliary care) they will have their pay rate for this visit.
If you begin receiving unexpected alerts around medication outcomes not being recorded, contact Support so that this can be investigated. It may be the case that there is misalignment between the medication schedule and the ‘short visit’ schedule.
For Live-in Care - Care Professional Guidance
The Care Professional - Long Visits: The care professional checks into this ‘long visit’ at the start of the day and then immediately checks out of it.
Since you will be paying on planned time, the care professional will be paid for their total hours of care (as per the rate they are assigned).
The Care Professional - Short Visits: The care professional will check into each of the ‘short visits’ in order to complete the associated plan. The status of each visit plan and associated tasks/medications completed will appear in both the care log and associated locations (eMAR, Inbox).
The care professional will not receive a reminder within the app to check into these visits as they overlap with the main visit. If they do forget to check in, the office will receive an alert for missed activities and can follow up as normal.
Unless you are actively providing care after midnight, you must ensure that all your visit reports for the day are submitted before midnight. It is best to submit it after your final tasks and activities are completed for each of the short visits.
If not, this can misalign medication schedules with ‘visit’ schedules, which is problematic to resolve
If you notice anything strange in relation to task or medication outcomes in the app (e.g. it looks like an outcome has already been reported; you can’t see medications for the session), contact Support so that this can be investigated
Care professionals can complete ‘unscheduled visits’ to record any observations that are made outside of these ‘short visits’ if needed.
How does this work with visits that are overnight?
Where Care Professionals deliver overnight care to the Care Recipient, the above process needs to be followed i.e. create a long visit overnight and then short visits for the tasks/activities.
For Overnight Visits and Shifts - Admin Guidance
The short visits should wrap around the planned activity completion times e.g. if medication is due to be administered at 4am, they might want to have a 00:00 - 04:15 visit.
If any of these visits are due to start in an evening and extend until early morning hours (12am - 6am), the task/med should be assigned to that night visit from the same column as the START of the shift.
If you know that that ‘care’ will need to be delivered overnight (i.e. it’s planned), you can schedule one of the short visits over that time period.
If the care professional is woken unexpectedly throughout the night and is delivering more than the agreed number of hours of care, they should report this to the office. The office can arrange for the care professional to be paid accordingly and/or review the amount of measured time that has been agreed.
If you begin receiving unexpected alerts around medication outcomes not being recorded, contact Support so that this can be investigated. It may be the case that there is misalignment between the medication schedule and the ‘short visit’ schedule.
For Overnight Visits and Shifts - Care Professional Guidance
Where the Care Professional is woken during the night to e.g. administer PRN medication or assist the Care Recipient to the toilet, the Care Professional can start an Unscheduled Visit within the Birdie App and complete notes and the PRN medication which will then feed through to the Agency Hub to be reviewed by the office team. This visit can then be discarded from Payroll and Invoicing.
If you notice anything strange in relation to task or medication outcomes in the app (e.g. it looks like an outcome has already been reported; you can’t see medications for the session), contact Support so that this can be investigated
Option 2 - Managing Live-in Care within 1 ‘scheduled’ visit
Please note: This section does not apply to agencies using Birdie for Care Management only and without a rostering integration.
Agencies using birdie Roster will need to schedule live-in care visits in their care recipients' Visits tab.
Some of our partner agencies schedule live-in sessions to last 24 hours; others schedule four sessions (morning, lunch, afternoon, evening) each day so that care professionals can record how long they are spending on breaks in between, and/or so that medication alerts are generated in a timely manner.
Note: When creating 24-hour rotas, they begin on the next day. For example, a rota for 8 AM - 07:59 AM (24 hrs) on Monday, the rota will effectively begin from 8 AM on Tuesday.
Note: If you have double-up care visits during this 24-hour period, you can schedule additional visits throughout the day, and assign them to a different care professional.
Agencies using birdie with a rostering integration do not create visit plans for live-in care visits.
Instead, when care professionals check into a live-in care visit, they can pick and choose from the tasks and medications scheduled for the care recipient, based on timings and notes. If you do decide to create visit plans, you will need to make sure they match the visits you have scheduled in your rostering system.
Tasks and Medications
It is common to use the Anytime option to schedule tasks that have no defined period for completion. For example, “Assist with laundry” may be done whenever there is a full laundry basket, so the task can be assigned to all days (assuming the live-in carer will be there for a whole week), and “anytime” can be selected.
On the Birdie app, care professionals can tick off the task once completed. You can use the notes section in the Task Manager to clarify when a task needs to be completed (e.g. specific times or anytime, optional or critical).
We highly recommend scheduling medications for exact times and not time periods. The time that the medication needs to be given to the care recipient will show in the app in the client's tasks and medication section.
Whilst checked in, care professionals can tick off tasks, record medications, and observations and notes as they would if they were doing hourly care. Care professionals can edit these until they submit their report. Any changes to this information can be made right up to the point that they submit their report.
When assigning tasks and medications to visits, it is recommended to reorder them so that the order of completion is clear and easy for carers to follow, as the list might get quite long for 24-hour visits.
If you schedule a medication using time periods, the scheduled time will not display in the care professionals app. See the example above, where Panadol has been scheduled using time periods, and Levetiracetam has been scheduled using exact times. This is why we recommend scheduling medications using exact times.
On care recipients' visit schedules, visit cards usually appear confined to the time period matching the visit start time, whereas tasks and medications are always confined to their scheduled time. For example, a visit starting at 9 AM and ending at 10 PM will show in the morning section. This does not stop you from dragging tasks and medications scheduled for the evening and dropping them into the visit card displayed in the morning section.
When adding medications to a visit card, you will receive a warning if a medication has already been added to a visit card (see below).
This is not unexpected, and if a medication is scheduled to be given 3x a day, all 3 doses should be dragged into the visit card. You need not worry about it, because when a care professional checks into a visit, the medications are displayed, along with any exact times they are scheduled for.
Invoicing and Pay Rates
(This section does not apply to agencies using Birdie for Care Management only.)
When you schedule a visit, you'll be able to assign a funding source and service type, and to select "live-in" if you charge and pay a different rate for live-in visits.
In that case, you will need to set up service type-specific rates within your rate cards.
Fixed rates aim to better support the funding of live-in care. Some of our partner agencies schedule live-in sessions to last 24 hours and use fixed rates to charge the funder and/or pay the care professional a set rate for those visits.
Other partners schedule four sessions (morning, lunch, afternoon, evening) each day, and either apply a smaller set rate per session or only attach the full funding information to one session, discarding the other sessions from invoicing and payroll when reconciling visits.
Make sure to create purchase orders. You will then be able to specify that a visit is a live-in care visit when scheduling it. It will be automatically paid and charged at the live-in care rate you have set up.
Checking in and out
If you use Birdie Roster or a rostering integration, how carers check into live-in visits will depend on how you have scheduled these visits, as care professionals will need to check in and out at the start and end of these sessions.
For example, over a 24-hour period, a carer may complete one session, i.e check in at 8 AM and check out at 7:59 AM, or perhaps two sessions, i.e. they may check into Birdie in the morning, and check out at midday, then check in again to start their second session and check out at the end of it.
If you do not use Birdie in combination with any rostering system, care professionals can check in and out at any time. You may ask them to only check in when they have something to report or to check in at defined intervals throughout the day.