Supporting care homes to identify deterioration

Being able to identify early signs that a person’s health is deteriorating helps to ensure timely support and treatment can be sought before the condition worsens and becomes more serious or even life threatening.

The ability for care home staff to be able to do this is particularly important, as the people they care for are often affected by multiple health conditions. It is also important when signs of deterioration are identified that care home staff know which healthcare services to contact for help.

The National Patient Safety Team’s Managing Deterioration Safety Improvement Programme is to date, working with 11,621 care homes in England. We have been working with Patient Safety Collaboratives across the country to support the training, adoption and sustainability of deterioration management tools in care homes to not only improve the quality of care for residents but also to ensure medical treatment is delivered at the right time and in the right place.

Data from the West Midlands suggests the impact of this work between January 2021 and September 2022 resulted in 2,236 fewer 999 calls; 3,232 fewer emergency admissions , and 34,900 fewer bed days. Based on this data, modelling suggests if scaled up and a deterioration management tool was adopted using the same approach by all 15,140 care homes across England, in the same 21 month timescale, there would have been potential for 31,116 fewer 999 calls, 44,969 fewer emergency admissions and 485,654 fewer bed days.

Caroline Morris, manager of Bradwell Hall nursing home in Staffordshire, which has 127 residents, said: “By introducing the deterioration management tools we have reduced risks for our residents. We have prevented harm by early detection resulting in a reduction in safeguarding referrals. The falls rate for the service is low and there are no home acquired pressure injuries. The early detection has also resulted in hospital avoidance.

“The tools have enabled a higher care delivery which has resulted in reduced complaints, improved our reputation and as a result staff now feel more empowered. Staff morale has improved and this has all made a significant positive impact for our residents.”

The impact of this programme could have a significant impact to the quality and experience of care received by care home residents and offer significant benefits to the NHS in addressing current challenges around urgent and emergency care and patient flow.

Further work is taking place to deepen our understanding of the high-impact interventions that could be replicated elsewhere to support wider adoption, spread and sustainability.

The Managing Deterioration Safety Improvement Programme is part of the wider National Patient Safety Improvement Programmes, which are a key part of the NHS Patient Safety Strategy, to deliver safety and quality improvements across the NHS in England. The impact of these programmes play a major part in progress towards meeting the ambition of the NHS Patient Safety Strategy, to save an additional 1,000 lives and £100 million per year. Find out more on our NHS Patient Safety Strategy webpage.