Older people are the fastest-growing section of the community – the number of people over 85 is expected to double within two decades. Older people living in care homes increasingly have complex health and care needs. The number of older people living in care homes in England (329,000 as of December 2022) is already more than three times the number of hospital beds, and is set to increase further.
Research shows that the average care home resident is 85 years plus, has six or more diagnosed conditions, takes seven or more prescribed medicines, and has a combination of physical frailty, disability and mental health conditions. Meeting those complex needs means accessing a wide range of services, across many different health and care organisations.
When we work closely together with our health and care partners across the South West London ICS to better support our care homes and their residents, we can enhance our residents’ health and wellbeing, reduce avoidable unplanned hospital admissions and increase our care home staff’s skills and confidence and improve staff retention.
Co-ordinated services working together and promoting good health rather than only reacting to ill health – are at the heart of our enhanced health in care homes programme.
In south west London there are 343 care homes for older adults with over 8,400 residents being cared for in these homes. We have 59 residential homes, 97 nursing homes and care homes for adults with a learning disability or mental ill health, with almost 11,000 staff are employed in the care homes. We have introduced several initiatives to support to residents and staff. These include:
- A multi-disciplinary team model which is helping to improve the care of people with complex conditions by making full use of the knowledge and skills of team members from a range of disciplines.
- Red Bags and e-Red Bags are used to ensure that important information about care home residents can be easily accessed if they are admitted to hospital. Four coordinators recruited in 2021 are supporting the Red Bag and e-RedBag schemes to improve the efficiency and effectiveness of conveying, admitting and discharging care home residents. The coordinators also work with staff in our four south west London hospital trusts to ensure that care home residents receive safe co-ordinated and efficient care if they need and emergency hospital admission.
- We have rolled out RESTORE2 – an early warning system that helps care staff identify whether a care home resident is at risk of becoming unwell – across South West London. RESTORE2 is a tool that helps staff recognise and manage physical deterioration in care home residents, reduce 999 calls and prevent avoidable hospital admissions and improve outcomes for patients. We have trained staff in 332 homes across the six south west London boroughs. This has helped to improve their knowledge and confidence – and ultimately the care of their residents.
- Following on from the success of RESTORE2 training, remote monitoring of residents’ vital signs is also being rolled out. Already, 75 south west London care homes are using Bluetooth enabled technology, which features a digital dashboard to allow healthcare professionals to remotely review residents’ conditions and provide tailored medical advice to care home staff.
- We have worked with a range of organisations such as the Prince’s Trust, the Health Innovation Network (the HIN) and Skills for Care, to ensure that care home staff have the right skills and support to deliver the highest quality care that is needed in the sector.
How are we doing it?
Our program in 2022/23 will continue to build on the implementation of the national Enhanced Health in Care Home Framework with a focus on the following areas:
- Supporting care homes to care for residents so that fewer residents need to be seen by an ambulance or conveyed to hospital where it can be avoided
- Supporting care homes to be able to prevent falls in their residents and to manage those who do fall
- Smoothing transfers of care for residents when a hospital admission is required through use of the Red Bag and the eRedBag
- Undertaking a focused project on improving residents’ hydration through the use of “Smart Mugs”
- Continuing to improve digital access and integration with the NHS
- Supporting end of life care through training and access to the London Urgent Care Plan
- Supporting care homes to be able to manage a resident whose condition is deteriorating