06 July 2017

 

A new initiative commences in Newham this summer to keep older people living in care homes, out of hospital. The new Enhanced Support pilot will be an additional service provided by the Newham Rapid Response Team and hopes to reduce unplanned or emergency hospital admissions by providing immediate nursing interventions to the patient, alongside the care given by care home staff.

Avoiding Distress and Disruption
Older people admitted into hospital in these circumstances can become disorientated and confused. They risk contracting further infections, or falling over in a new and unknown environment. They can become distressed by the change of routine and being looked after by unfamiliar staff and who may not fully understand their needs or preferred ways of doing things.

What Will be Different?
Three nursing homes have been selected to participate in the pilot which will last three months. The new approach aims to complement the resident’s usual care and will be a short term intervention. The Enhanced Support Team (a part of the Rapid Response Team) will not replace or change the way that care is currently given. They will simply enhance it if a resident develops a urinary tract infection, a chest infection, has a fall, shows signs of developing a pressure ulcer, or has symptoms which need to be acted on quickly.

Tracy Campbell, a Specialist Care of the Elderly Nurse, will be spearheading the initiative and working with care homes to provide the optimum support when a resident becomes unwell. She will observe what happens when a resident’s health deteriorates and support staff in managing their increased level of need. In addition she will review existing records and nursing care plans.

Additional supported will also be provided by the Therapy (Occupational Therapist & Physiotherapist) staff from the Rapid Response Team.

Focusing on Residents Who Are Most Vulnerable
The team will review data from the Newham Council Quality Dashboard to identify residents who have had frequent emergency hospital admissions or ambulance call-outs. This will enable the whole team to review the circumstances that may have led to emergency admissions and consider other options or interventions that could support the person to stay in their own bed next time, and receive care in the security of a setting that they are familiar with.

Tracy is excited at the prospect of testing some new approaches to avoid hospital admissions. She said “There is much written about ways in which people can be supported at home to avoid the disruption and stress of a hospital admission. We know that older people resident in care homes are at increased risk of requiring emergency hospital admissions compared to the general population, due to the high of prevalence chronic disease.

It will be interesting to see if providing intense support to care home staff when someone becomes unwell, and focusing on people who are particularly vulnerable, if we can keep more people in Newham at home in a setting they are familiar with and with staff that they know.”

This is a joint project involving Newham Care Commissioning Group, Newham Council and East London NHS Foundation Trust.

Interesting Facts
From January to the end of March this year, there were 125 London Ambulance Service call-outs to six residential homes in total during this period (28.1 %)

60 of these ended in an emergency admission into hospital.

Just under 13% of the total residents were admitted into hospital as an unplanned emergency during this period.

Nursing and Residential Care Homes (Information obtained from LBN/NCCG - Quarterly Quality Dashboard for Newham Care Homes May 2017)

Older people resident in care homes are at increased risk of requiring emergency hospital admissions compared to the general population, due to the high of prevalence chronic disease. (Smith et al, 2015).

For further information please contact:

Daniel Franey – Operational Manager (daniel.franey@elft.nhs.uk)

Jean Reilly – Clinical Lead (jean.reilly@elft.nhs.uk)

Tracy Campbell – Enhanced Care Nurse (tracy.campbell@elft.nhs.uk)

Telephone 0208 709 5555