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CCG supports care homes to recognise early signs of deterioration in vulnerable residents

The NHS Vale of York Clinical Commissioning Group (CCG) is supporting care home staff, informal carers and residents to use ‘softer signs’ tools to help identify the early signs of deterioration and reduce avoidable hospital admissions.

The number of elderly patients admitted to hospital from care homes as an emergency has increased nationally by 63% since 2011*. To address this issue and support avoidable harm, the CCG’s project team have delivered in-house training to care homes and domiciliary care providers using the softer signs prompt tool.

By identifying symptoms in a structured and logical way, the tool helps staff to recognise and response to people becoming unwell when they first appear to not be ‘their usual self’.

The SBAR (situation, background, assessment and recommendations) tool is used as part of this training, set out in an easy format which helps care staff to relay accurate, relevant and timely information to other health and care services including GPs, District Nurses and the Ambulance service.

Since February 2019 over 260 staff from care homes and domiciliary care providers have completed the ‘softer signs’ training, which includes those registered to care for adults with learning disabilities, frail elderly care (including those with complex care needs) and Dementia.

Michelle Carrington, the CCG’s Executive Director of Quality and Nursing said: “The CCG is committed to supporting Care Homes and Domiciliary Care organisations in providing the best care to residents. The aim of this work was to reduce avoidable harm, enhance clinical outcomes and improve the experience of deteriorating residents in care homes. We are incredibly proud of the work led by our Quality and Nursing Team and of the hard work put in by care home and domiciliary care staff which has had positive impact on residents’ safety and quality of experience.”

Care Home Managers across the Vale of York are now embedding the training and tools as part of staff induction and refresher training, demonstrating a dedication to improve residents’ quality of care.

Linda Donnellan, home manager at Avery Healthcare said: “Recognising early signs of deterioration are not always clinical, they can be functional and so using these ‘softer signs’ tools has allowed staff to enhance their confidence and ability to care for residents in a more personalised way. Since our training we have embedded these tools into our additional care plans such a pressure ulcer care and behaviour changes in Dementia as well as reducing our hospital attendances by 6% within the first 6 months.”

Debora Smith, Registered Manager, Ricall Care, York said: “We are pleased to have been included in this project as it has enhanced the skills and knowledge of our staff and has improved partnership working.  The tool has been effective in delivering a timely response when clients have been unwell, which has reduced the need for more intensive medical assistance and admittance to hospital. 

Due to the success and commitment from the CCG, care homes and domiciliary care providers, the training project has been extended and will ensure more staff across the Vale of York receive the ‘softer signs’ training.

More information can be found on the CCG’s website:

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