Managing deterioration in care homes

Several resources have been produced with the view to support care homes and their staff effectively deal with deterioration among patients and residents.

The COVID-19 pandemic raises challenges for care home residents, their families and the staff that look after them. Some people are more at risk than others of becoming unwell very quickly and developing serious illnesses, this is known as deterioration. It is important, especially during the COVID-19 outbreak that those who care for individuals who are at risk know how to spot the signs of deterioration.

Approximately 400,000 people live in care homes and a significant portion of these will be living with frailty. Care home residents are particularly vulnerable to COVID-19 due to complex medical problems and increased frailty, as outbreaks in care homes have proven.

Public Health England have suggested that COVID-19 should be suspected in any resident with a new and continuous cough and/or a high temperature. However, COVID-19 in care home residents may commonly present with non-respiratory tract symptoms. Care home staff, with detailed knowledge of residents, are well placed to intuitively recognise these subtle signs (soft signs) of deterioration.

Organisations including AHSNs have produced resources to aid staff in dealing with deterioration in their patients and residents. All these resources are available on the AHSN Network website via the link below.

If you work in a residential care home, or a professional or family carer supporting someone in their own home, there are many tools available to help you recognise physical deterioration and take the appropriate actions, including the four soft sign tools below.

The four soft signs tools

  • RESTORE2: designed for nursing and care homes, this tool combines recognising early soft signs with taking measurements for a NEWS score, and escalating concerns through a structured communications tool.
  • Is my resident unwell?: suitable for care homes, this tool uses a 12-point checklist to record changes in a resident’s condition and escalate concerns.
  • Significant Care: this tool is useful for home carers and care home staff to identify the signs deterioration from a person’s skin, toilet habits, mobility and levels of confusion.
  • Stop and Watch: suitable for families and carers, this early warning tool includes prompts of what to watch out for to check if someone’s condition is worsening.

All the resources listed above, and any new additions, will be kept up to date on the website below.

For more information about the Academic Health Science Networks’ work on the National Patient Safety Improvement Programme, please follow the link below.

Use the following link to keep up to date with all the AHSN Network COVID-19 news, including resources, updates and responses.