RESTORE2 is a validated deterioration and escalation tool developed by West Hampshire ICB for care home residents. It allows care home staff and residents to get the right support at the right time in the right setting. NHS South West London adopted this tool and offered it to all CQC registered care homes in 2021/22.
RESTORE2 is designed to support homes and health professionals to:
- Recognise when a resident may be deteriorating or at risk of physical deterioration (recognise the soft signs)
- Act appropriately according to the resident’s care plan to protect and manage the resident
- Obtain a complete set of physical observations to inform escalation and conversations with health professionals (NEWS2)
- Speak with the most appropriate health professional in a timely way to get the right support
- Provide a concise escalation history to health professionals to support their professional decision making (SBARD)
Recognising The Soft Signs
Soft signs include, for example, shortness of breath, being unsteady, being more distressed, being withdrawn, increased tiredness or being very restless. Care homes will establish what is ‘normal’ for a resident based on their everyday behaviours, manner and appearance. When something changes, and the resident is not their usual self, this helps to identify deterioration or potential deterioration at an early stage and the resident can be monitored to help prevent further escalation.
News2 (National Early Warning Score)
NEWS2 stands for National Early Warning Score, and it includes six vital signs checks. These are temperature, blood pressure, breathing (respiratory) rate, level of oxygen in the blood (oxygen saturation), level of alertness and heart (pulse) rate. The score reflects what is normal for an individual. Any changes in the score can be monitored and escalated accordingly.
SBARD (Situation, Background, Assessment, Recommendation, Decision)
SBARD is a standardised way of relaying information to a health care professional. This helps the healthcare professional (such as a GP, nurse or ambulance staff) make the best decision for the resident to get the right care, in the right place, at the right time.